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1.
目的分析武鸣县2011—2015年手足口病(hand-foot-mouth disease,HFMD)流行病学特征,为武鸣县HFMD的预防和控制提供依据。方法收集并整理中国疾病监测信息报告管理系统中武鸣县2011—2015年HFMD病例资料,采用描述流行病学方法,对其流行病学特征进行分析。结果 2011—2015年,武鸣县共报告HFMD病例17 961例,发病率为648.42/10万,呈隔年高发。各月均有HFMD病例报告,报告病例数呈"双高峰"型,分别为4—6月7 308例(占40.69%),9—10月5 043例(占28.08%);报告病例最多的地区为武鸣县城4 266例,占总报告病例数的23.75%,高于其他乡镇;男性多于女性,男女性别比为1.51∶1;以<4岁儿童为主,占86.40%,其中散居儿童11 527例(占64.18%)。结论武鸣县HFMD具有发病率高、流行季节明显,以4岁以下散居儿童为主的流行病学特征;需加强重点地区、重点人群及HFMD病原学的监测。  相似文献   

2.
分析2008~2017年新疆维吾尔手足口病流行病学和病原学特征。采用描述性流行病学的方法,对2008~2017年国家疾病监测信息报告管理系统报告的手足口病例和新疆手足口病网络实验室数据的进行分析。2008~2017年新疆累计报告手足口病例68 820例,重症107例,死亡10例,年均发病率为31.33/10万;病例主要集中在乌鲁木齐市、伊犁州、昌吉州和塔城地区,占总病例数68.26%;5月~7月为发病高峰,病例以1岁~4岁儿童为主,占总病例数的74.46%,散居儿童和幼托儿童分别占51.52%和40.34%;对12 345例手足口病例标本进行核酸检测,阳性8 872例,阳性率71.87%,普通病例中肠道病毒71型(EV-A71)、柯萨奇病毒A组16型(CV-Al6)和其他肠道病毒分别占33.01%、40.33%和26.65%,重症和死亡病例的病原型别均以EV-A71为主,分别占91.03%和100%。新疆1岁~4岁的儿童为手足口病主要发病人群,不同地区发病水平不同,手足口病病原谱呈现EV-A71、CV-A16和其他EV交替流行态势。  相似文献   

3.
目的分析许昌市2009—2013年麻疹流行特征和监测系统运转状况,为加速消除麻疹制定策略及措施提供科学依据。方法利用描述性流行病学方法对许昌市2009—2013年麻疹监测系统资料进行统计分析。结果许昌市2009—2013年累计报告麻疹病例675例,年均报告发病率为3.16/10万。全市8个县、市区均有病例报告,病例数主要集中在禹州市,占总病例数的55.56%;发病呈明显的季节性分布,主要集中在2—5月份,占总病例数的73.48%;病例主要集中于0~6岁儿童,占总病例数的85.63%,其中1岁以下婴幼儿占总病例数的50.22%;8月龄~14岁麻疹病例中有确切免疫史者仅占38.58%。随着监测系统及时性和特异性逐年提高,48 h完整调查率由2009年的88.32%上升至2012年的100%;血标本3 d内送达率由2009年的51.68%上升至2013年的100%;实验室结果 7 d内报告率由2009年的52.80%上升至2013年的100%;血标本采集率从2009年48.86%上升至2013年的100%;暴发血清学确诊率、病原学标本采集率均上升至100%。2009—2013年麻疹监测系统敏感性低,排除病例报告发病率为0.49/10万~1.43/10万。结论 2009—2013年许昌市麻疹发病率下降,小年龄组发病构成增加。监测系统运转综合质量逐年提升,但敏感性低。今后应进一步加强麻疹类疫苗接种与管理,提高人群免疫水平;加强医疗机构传染病报告与管理,提高监测系统敏感性,防止传染源扩散。  相似文献   

4.
为了进一步掌握沭阳县急性弛缓性麻痹(AFP)病例流行特征,从而提高AFP病例的监测工作质量。根据AFP病例个案调查表进行统计分析。结果显示,沭阳县2006-2009年AFP病例监测系统共报告AFP患者28例,15岁以下儿童AFP病例年平均报告发病率为2.31/10万,其中0~4岁发病占67.86%,全程免疫占89.29%,地级医院报告病例占32.14%,AFP患者粪便标本采集率为100%。沭阳县AFP病例监测工作的各项监测指标完成情况较好,但存在薄弱环节,建议不断提高基层医务人员的AFP病例的识别能力和报告意识,消除薄弱环节,不断提高AFP监测工作质量。  相似文献   

5.
目的分析百色市2014年手足口病流行特征,探讨该病的预防控制策略。方法采用描述流行病学方法对百色市2014年手足口病发病特征进行流行病学分析。结果 2014年百色市共报告手足口病44 520例,年发病率为1 258.05/10万,死亡17例,病死率为0.04%。病例报告有明显的季节性,4-6月为发病高峰;以0~5岁年龄组为主,占95.39%;男性发病率高于女性,男女发病比为1.44∶1;职业分布以散居儿童居多;病原学监测结果为EV71、Cox A16和其他肠道病毒混合感染;79.04%的重症病例(含死亡病例)由EV71感染所致。结论百色市手足口病流行情况严重,EV71仍是引起手足口病重症病例和死亡的主要病原体,今后仍需要采取综合性防治措施,开展健康教育,加强重症病人的筛查和救治,降低病死率。  相似文献   

6.
目的了解河南省2009—2014年水痘疫情的流行病学特征,为控制水痘暴发和流行提供依据。方法数据获自中国疾病预防控制信息系统中河南省2009—2014年水痘个案病例及暴发疫情信息,采用描述性流行病学方法进行分析。结果河南省2009—2014年共报告水痘84 029例,年平均发病率为14.85/10万;春、冬季高发;患者发病年龄主要集中在3~10岁的儿童,占62.75%;同期共报告暴发疫情35起,主要集中在学校和幼托机构。结论儿童为水痘的高发人群,水痘发病具有明显的季节性,应提高高发人群水痘疫苗的接种率,加强对暴发疫情的监测。  相似文献   

7.
目的分析甘肃省近年来麻疹报告发病特点,为实现消除麻疹目标措施的制定提供参考依据。方法对甘肃省2009—2010年疾病监测信息报告系统和麻疹监测系统报告的疑似麻疹病例进行分析。结果 2009—2010年报告麻疹病例1 463例,主要集中在15岁以下年龄组,占病例总数的74.16%,≥15岁病例占病例总数的25.91%。4~7月为发病的高峰季节。对15岁以下进行流行病学调查的病例分析,20.86%的病例未接种过麻疹类疫苗,32.71%的病例免疫史不详。对病例的接触史分析,在发病前7~21d有5.82%的病例明确接触过发热出疹性病人,有12.43%的病例曾去过医院。分离出麻疹病毒H1a基因型,对麻疹疫苗免疫和疫情的防控有指导意义。结论根据麻疹发病年龄构成及免疫史分析,个别地区常规免疫接种不足是造成麻疹发病的主要原因,同时要注意控制院内感染的发生。需要在提高麻疹疫苗常规免疫覆盖率的基础上,进一步深入和规范监测工作,提高监测调查质量。  相似文献   

8.
目的分析内蒙古巴彦淖尔市2008—2015年急性弛缓性麻痹(acute flaccid paralysis,AFP)病例的流行病学特征,评价AFP信息监测管理报告系统,为制定本地区预防AFP提供科学依据。方法采用描述性流行病学方法,对巴彦淖尔市2008—2015年15岁以下儿童AFP病例监测数据进行流行病学特征分析,并对AFP监测系统进行评价。结果巴彦淖尔市2008—2015年共报告15岁以下儿童AFP病例65例,年平均报告发病率3.20/10万,无脊髓灰质炎野毒株检出和脊髓灰质炎病例报告;发病时间以夏秋6—9月为多;临河区位居报告病例数首位,占总报告病例数的52.3%;男性多于女性,男女性别比为1.24∶1;1~<5岁儿童占总报告病例数的53.8%;完成全程免疫的儿童占61.0%,未完成免疫史和免疫史不详者占39.0%。各项监测指标均达到国家监测方案要求。结论巴彦淖尔市AFP监测系统灵敏性较高,AFP病例的监测应关注重点地区和重点人群免疫接种情况,继续保持无脊灰状态。  相似文献   

9.
目的分析2009—2019年平顶山市手足口病(hand-foot-mouth disease, HFMD)流行特征,为今后本地制定防控措施提供依据。方法对中国疾病预防控制信息系统报告的平顶山市2009—2019年HFMD病例信息进行描述性流行病学分析。结果 2009—2019年平顶山市共有HFMD报告病例53 477例,重症病例5 878例,死亡16例,年均发病率为109.70/10万,重症比例为10.99%,年均死亡率为0.03/10万。2010年和2014年出现了2次HFMD大规模流行。城市市区发病率明显高于郊县。报告病例时间分布呈现明显的春、夏季节性高发,呈单峰分布,4—5月出现高峰。人群分布情况,男性明显多于女性;报告病例集中在0~5岁组儿童,有50 557例,占94.54%;人群散居儿童报告病例较多,有40 352例,占75.46%。病原学特征以肠道病毒71型(Enterovirus71, EV71)阳性为主,HFMD病原谱有一定变化,EV71阳性构成比自2015年以来逐渐降低,EV71构成比的变化与重症比例呈正比例变化,两者呈正相关(r=0.876),差异有统计学意义(P0.05)。全市聚集性疫情的发生与HFMD疫情的整体趋势一致,而幼托机构是聚集性发生的主要场所。接种肠道病毒71型灭活疫苗(简称EV71疫苗)的HFMD病例中无EV71阳性病例,接种EV71疫苗和未接种疫苗病例的EV71阳性检出率差异无统计学意义(χ~2=2.517、P=0.113,P0.05)。结论在HFMD流行季节,须加强5岁以下儿童及托幼机构等场所的防控工作,减少聚集性疫情的发生,推广EV71疫苗接种是控制HFMD疫情的关键。  相似文献   

10.
目的了解潍坊市坊子区2009—2013年流行性腮腺炎流行病学特征,为预防控制流行性腮腺炎提供科学依据。方法对2009—2013年潍坊市坊子区传染病报告信息管理系统流行性腮腺炎报告病例个案资料,采用描述性流行病学方法分析流行性腮腺炎的流行病学特征。结果潍坊市坊子区2009—2013年累计报告流行性腮腺炎病例416例,年平均发病率为20.97/10万。2009—2013年发病率分别为10.03/10万、10.71/10万、10.74/10万、36.63/10万、24.50/10万;男性为28.92/10万,女性为12.93/10万;0~2岁为30.81/10万,3~9岁为125.74/10万,10~24岁为49.11/10万,25~55岁为1.43/10万。病例数最多的是峡山生态发展区98例,占总病例数的23.56%;凤凰、九龙街办均为92例,各占总病例数的22.12%。发病高峰期在每年的3—7月和12月至次年1月。其中,3—7月占63.70%,1月、12月占17.07%;学生占64.66%,幼托儿童占16.11%,散居儿童占12.26%,其他占6.92%;有临床合并症的病例占5.77%,合并脑膜炎者占5.29%;合并胰腺炎者占0.48%。结论潍坊市坊子区2009—2013年流行性腮腺炎发病率逐年上升,今后应针对重点人群和高发季节进一步加强流行性腮腺炎监测和预防控制工作。  相似文献   

11.

Objective

Guangdong province is one of the most vulnerable provinces to tropical cyclones in China. Most prior studies concentrated on the relationship between tropical cyclones and injuries and mortality. This study aimed to explore the impacts of different grades of tropical cyclones on infectious diarrhea incidence in Guangdong province, from 2005 to 2011.

Methods

Mann-Whitney U test was firstly used to examine if infectious diarrhea were sensitive to tropical cyclone. Then unidirectional 1:1 case-crossover design was performed to quantitatively evaluate the relationship between daily number of infectious diarrhea and tropical cyclone from 2005 to 2011 in Guangdong, China. Principal component analysis (PCA) was applied to eliminate multicollinearity. Multivariate logistic regression model was used to estimate the hazard ratios (HRs) and the 95% confidence intervals (CI).

Results

There were no significant relationships between tropical cyclone and bacillary dysentery, amebic dysentery, typhoid, and paratyphoid cases. Infectious diarrhea other than cholera, dysentery, typhoid and paratyphoid significantly increased after tropical cyclones. The strongest effect were shown on lag 1 day (HRs = 1.95, 95%CI = 1.22, 3.12) and no lagged effect was detected for tropical depression, tropical storm, severe tropical storm and typhoon, with the largest HRs (95%CI) of 2.16 (95%CI = 1.69, 2.76), 2.43 (95%CI = 1.65, 3.58) and 2.21 (95%CI = 1.65, 2.69), respectively. Among children below 5 years old, the impacts of all grades of tropical cyclones were strongest at lag 0 day. And HRs were 2.67 (95%CI = 1.10, 6.48), 2.49 (95%CI = 1.80, 3.44), 4.89 (95%CI = 2.37, 7.37) and 3.18 (95%CI = 2.10, 4.81), respectively.

Conclusion

All grades of tropical cyclones could increase risk of other infectious diarrhea. Severe tropical storm has the strongest influence on other infectious diarrhea. The impacts of tropical cyclones on children under 5 years old were higher than total population.  相似文献   

12.
对于痢疾、伤寒、副伤寒和霍乱等肠道致病菌引起的肠道传染性疾病,其感染途径相同,感染机制相似,均能诱发肠道局部黏膜免疫反应。预防上述几种传染性疾病的疫苗,传统的评价方法是分析其肠黏膜分泌型IgA抗体水平。随着对上述几种肠道传染性疾病免疫学机制以及对感染者血清抗体水平与其肠黏膜抗体水平之间关系的深入研究,评价疫苗效力的方法逐渐改为测定血清抗体。对上述几种传染性疾病的感染机制以及血清学评价方法进行了综述。  相似文献   

13.
The Republic of Tajikistan belongs to the territories, traditionally hyperendemic with respect to acute enteric diseases (AED). The problem of AED still remains topical in recent years, especially among child population. The study of the etiological structure of AED in children has made it possible to establish that more than 70% of these diseases are of infectious nature. The leading role in the etiological structure of these diseases belongs to Shigella infections (32.4%), enterovirus diarrhea (12.1%) and Escherichia infections (8.9%). No significant differences in the character of the etiological structure of AED in children of urban and rural areas have been detected with the exception of enterovirus diarrhea, found to occur 2.7 times more frequently on children of urban areas (15.9%) than in those of rural areas (5.8%). The ascertaining of the etiological structure of AED in Tajikistan will make it possible to essentially increase epidemiological surveillance on AED and render it more concrete.  相似文献   

14.
儿童慢性腹泻病因分析   总被引:1,自引:0,他引:1  
目的探讨儿童慢性腹泻的病因,以提高临床诊治水平。方法选择2005年12月至2010年12月在重庆医科大学附属儿童医院住院的141例慢性腹泻患儿为研究对象,对患儿的临床资料进行回顾性分析。结果本组病例中常见致病因素依次为过敏因素46.2%(24/52)、肠道内感染28.4%(40/141)、乳糖不耐受28.3%(26/92)。共109例明确病因诊断,55.1%(60/109)为多因素共同致病,以肠道内感染合并继发乳糖不耐受,过敏合并继发乳糖不耐受,免疫缺陷合并肠道内感染多见。前4位主要病因诊断为感染性腹泻(24.1%)、过敏性腹泻(17.0%)、乳糖不耐受(7.1%)、炎症性肠病(6.4%)。结论除肠道内感染外,过敏因素、乳糖不耐受等也是儿童慢性腹泻常见致病因素。儿童慢性腹泻常由多因素共同致病,主要病因除感染性腹泻外,过敏性腹泻、乳糖不耐受、炎症性肠病等也是常见病因。儿童慢性腹泻重在病因诊断,针对病因治疗。  相似文献   

15.
In order to justify the surveillance control system and hygiene policy in Jordan, this study evaluated the occurrence of diarrhoea during the period 1988-2000, focusing on cases caused by Salmonella typhi and Salmonella paratyphi. From January 1988 to December 2000, the number of notified diarrhoeal cases by the Ministry of Health in Jordan was 1,399,563 million. Other groups of patients confined to the Governorate of Amman was diagnosed at Al-Battikhi Medical Laboratories. One-way ANOVA and Least Significant Difference (LSD) were carried out for statistical analysis. The number of reported diarrhea cases was 1,399,563, 53.0% were males, and 47.0% were females, among them, 80.3% were < 20 years and 19.7%, were > 20 years. Out of 245,255 patients tested for S. typhi and S. pararyphi, positive stool culture were 1992 (0.6%). Out of these, 960 (48.2%) were males and 1,032 (51.8%) were females (P = 0.028). The highest incidence rate (10.8) was observed in the year 1993, while the lowest incidence rate (0.9) was found in year 2000. A significant difference (P < 0.001) was found between the number of S. typhi and S. Paratyphi cases and year. The seasonal variation was also found to be significant (P < 0.0001), with the summer period showing the highest incident rate. A significant difference (P < 0.001) was observed between number of typhoid and paratyphoid cases and districts. A significance difference between number of typhoid and paratyphoid cases with age and sex. The group most affected was school age and adolescence. The demographic situation plays an important role in reporting typhoid and paratyphoid cases, where there might be an urgent indication for a better surveillance control system on water resources and disposal systems. S. typhi and S. paratyphi antibiotics resistance pattern showed they were resistant to tetracycline (56.0%, 58.0%), ampicillin (45.0%, 48.0%), trimethoprim (43.0%, 47.0%), cephtazidime (12.0%, 13.5%) chloramphenicol (6.8%, 7.2%), gentamycin (3.0%, 4.0%) neomycin (2.1. 1.8%), calvulanic acid (augmentin (1.4%, 2.2%) and norofloxacin (0.92%, 1.1%). Susceptibility to amikacin, ciprofloxacin, cetfriaxone, ofloxacine, imepenim, cefixime and cefotaxime was 100.0%. The increase in percentage of antibiotic resistant strain might indicate a need for a further prescribing policy for treatment.  相似文献   

16.
罗兰英 《蛇志》2009,21(3):197-198,240
目的了解鹰潭市人民医院法定传染病报告情况,分析其流行病学特点,为制定传染病防治对策及降低传染病的发生提供科学依据。方法对鹰潭市人民医院2006~2008年法定传染病疫情资料进行分析.结果共报告法定传染病19种,累计报告发病4170例,其中无甲类传染病报告。主要病种为感染性腹泻、肺结核、病毒性肝炎、流行性腮腺炎、菌痢,占报告总数的93.62%;死亡13例(5个病种).结论肺结核、乙型肝炎、肠道传染病是今后传染病防治工作的重点和难点,应加大管理力度.做好传染病的预防和控制工作.  相似文献   

17.
2005~2008年儿童菌痢病原菌与药敏分析及临床意义   总被引:2,自引:0,他引:2  
目的了解儿童细菌性痢疾病原菌的分布特征及药敏特点,为临床更严谨更规范使用抗生素提供支持与依据。方法对2005年10月至2008年10月57例儿童菌痢的菌型、药敏及耐药性进行分析。结果儿童细菌性痢疾病原菌亚型分类中宋氏痢疾杆菌(D群)占14.0%,福氏痢疾杆菌(B群)占86.0%;痢疾杆菌对常用抗生素耐药率由低到高依次为头孢噻肟,丁胺卡那霉素,庆大霉素,头孢哌酮,头孢三嗪,头孢他啶,头孢唑啉,环丙沙星,氯霉素,复方新诺明,氨苄青霉素;痢疾杆菌单株对多种抗生素的总耐药率为39.2%,多重耐药率为43,9%,且各组间差异无显著性(χ^2=1.608,P=0.996),痢疾杆菌的耐药问题依然严重。结论新乡市区儿童细菌性痢疾病原菌亚型分类D组已呈明显上升趋势,但总体仍以B群感染为主(86%);痢疾杆菌的耐药问题依然严重;对儿童菌痢选用抗生素应结合药敏首选头孢噻肟等第三代头孢类抗生素或头孢唑啉,年长儿也可选用丁胺卡那霉素、庆大霉素等氨基苷类,而以环丙沙星为代表的喹诺酮类药物不宜作为儿童尤其7岁以下小儿菌痢的备选药物;氯霉素、复方新诺明及氨苄青霉素已不再作为小儿菌痢的抗菌选择。  相似文献   

18.
Outbreaks of alimentary infections of bacterial origin (dg 002--typhoid or paratyphoid fever; dg 003--infections due to other Salmonella species; dg 004--bacillary dysentery; dg 005--alimentary intoxications; dg 008--intestinal infections due to other bacteria; dg 009--intestinal infections of unknown etiology) which had been reported in the Czech socialist republic from 1979 to 1982 are overviewed and analyzed. The outbreaks of alimentary infections were analyzed by the number of epidemic episodes reported annually, by the number of cases involved, by the geographical and seasonal distribution pattern, by the place of onset, and by the mode of spread of infectious agents. Hospital-related salmonelloses were further analyzed by the serotype of Salmonellae responsible for these nosocomial infections. Outbreaks of water-borne alimentary infections were analyzed by the type of contaminated water source. Changes and trends in the epidemiology of alimentary bacterial infections encountered between 1979 and 1982 are discussed in detail. This study confirms that a systematic analysis of these outbreaks should constitute an integral part of the alimentary infections surveillance program for it may help assess the risk of population exposure to the varied causes of these infections.  相似文献   

19.

Background

In Bangladesh, pharmacy-purchased oral rehydration solution (ORS) is often used to treat diarrhea, including cholera. Over-the-counter sales have been used for epidemiologic surveillance in the past, but rarely, if ever, in low-income countries. With few early indicators for cholera outbreaks in endemic areas, diarrhea-related product sales may serve as a useful surveillance tool.

Methodology/Principal Findings

We tracked daily ORS sales at 50 pharmacies and drug-sellers in an urban Bangladesh community of 129,000 for 6-months while simultaneously conducting surveillance for diarrhea hospitalizations among residents. We developed a mobile phone based system to track the sales of ORS and deployed it in parallel with a paper-based system. Our objectives were to determine if the mobile phone system was practical and acceptable to pharmacists and drug sellers, whether data were reported accurately compared to a paper-based system, and whether ORS sales were associated with future incidence of cholera hospitalizations within the community. We recorded 47,215 customers purchasing ORS, and 315 hospitalized diarrhea cases, 22% of which had culture-confirmed cholera. ORS sales and diarrhea incidence were independently associated with the mean daily temperature; therefore both unadjusted and adjusted models were explored. Through unadjusted cross-correlation statistics and generalized linear models, we found increases in ORS sales were significantly associated with increases in hospitalized diarrhea cases up to 9-days later and hospitalized cholera cases up to one day later. After adjusting for mean daily temperature, ORS was significantly associated with hospitalized diarrhea two days later and hospitalized cholera one day later.

Conclusions/Significance

Pharmacy sales data may serve as a feasible and useful surveillance tool. Given the relatively short lagged correlation between ORS sales and diarrhea, rapid and accurate sales data are key. More work is needed in creating actionable algorithms that make use of this data and in understanding the generalizability of our findings to other settings.  相似文献   

20.
Yan M  Tam FC  Kan B  Lim PL 《PloS one》2011,6(9):e24743
Rapid diagnostics can be accurate but, often, those based on antibody detection for infectious diseases are unwittingly underrated for various reasons. Herein, we described the development of a combined rapid test for two clinically-indistinguishable bacterial diseases, typhoid and paratyphoid A fever, the latter fast emerging as a global threat. By using monoclonal antibodies (mAbs) to bacterial antigens of known chemical structures as probes, we were able to dissect the antibody response in patients at the level of monosaccharides. Thus, a mAb specific for a common lipopolysaccharide antigen (O12) found in both the causative organisms was employed to semi-quantify the amounts of anti-O12 antibodies present in both types of patients in an epitope-inhibition particle-based (TUBEX) immunoassay. This colorimetric assay detected not only anti-O12 antibodies that were abundantly produced, but also, by steric hindrance, antibodies to an adjoining epitope (O9 or O2 in the typhoid or paratyphoid bacillus, respectively). Sensitivity and, particularly, reaction intensities, were significantly better than those obtained using an anti-O9 or anti-O2 mAb-probe in the examination of paired sera from 22 culture-confirmed typhoid patients (sensitivity, 81.8% vs 75.0%) or single sera from 36 culture-confirmed paratyphoid patients (52.8% vs 28.6), respectively. Importantly, sensitivity was better (97.1% for typhoid, 75.0% for paratyphoid) if allowance was made for the absence of relevant antibodies in certain specimens as determined by an independent, objective assay (ELISA)--such specimens might have been storage-denatured (especially the older paratyphoid samples) or procured from non-responders. Benchmarking against ELISA, which revealed high concordance between the two tests, was useful and more appropriate than comparing with culture methods as traditionally done, since antibody tests and culture target slightly different stages of these diseases. Paired sera analysis was insightful, revealing 64% of typhoid patients who had no change in antibody titer over 4-16 days, and 14% with no IgM-IgG class-switching.  相似文献   

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