Population-based surveillance of typhoid fever in Egypt
Population-based surveillance of typhoid fever in Egypt
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DOI：
10.4269/ajtmh.2006.74.114
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发表时间：
2006-01-01
影响因子：
3.3
通讯作者：
Mahoney, FJ
中科院分区：
文献类型：
--
作者：
Srikantiah, P;Girgis, FY;Mahoney, FJ
可靠的疾病发病率指标对指导伤寒控制工作是必要的。在埃及，发病率估计数来自基于医院的综合征监测，这可能不代表伤寒人口。为了确定法尤姆省（人口2，240，000）伤寒的人口发病率，我们在五个卫生保健层级建立了基于实验室的监测。根据采样和检测灵敏度调整了发病率估计值。在评价的1，815例患者中，培养物产生了90（5%）株伤寒沙门氏菌分离株。伤寒的估计发病率为59/10万人/年。我们估计71%的伤寒患者由初级保健提供者管理。从26例（29%）患者中分离出多药耐药（MDR）伤寒沙门氏菌（对氯霉素、氨苄青霉素和甲氧苄啶-磺胺甲恶唑耐药）。基于人口的监测表明，法尤姆的伤寒发病率为中度，耐多药伤寒的患病率令人担忧。大多数患者是在初级保健一级进行评估的，不会被医院监测发现。
Credible measures of disease incidence are necessary to guide typhoid fever control efforts. In Egypt, incidence estimates have been derived from hospital-based syndromic surveillance, which may not represent the population with typhoid fever. To determine the population-based incidence of typhoid fever in Fayoum Governorate (pop. 2,240,000), we established laboratory-based surveillance at five tiers of health care. Incidence estimates were adjusted for sampling and test sensitivity. Of 1,815 patients evaluated, cultures yielded 90 (5%) Salmonella Typhi isolates. The estimated incidence of typhoid fever was 59/100,000 persons/year. We estimate 71% of typhoid fever patients are managed by primary care providers. Multidrug-resistant (MDR) Salmonella Typhi (resistant to chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole) was isolated from 26 (29%) patients. Population-based surveillance indicates moderate typhoid fever incidence in Fayoum, and a concerning prevalence of MDR typhoid. The majority of patients are evaluated at the primary care level and would not have been detected by hospital-based surveillance.