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1.

Objective

The objectives of this study were to forecast epidemic peaks of typhoid and paratyphoid fever in China using the grey disaster model, to evaluate its feasibility of predicting the epidemic tendency of notifiable diseases.

Methods

According to epidemiological features, the GM(1,1) model and DGM model were used to build the grey disaster model based on the incidence data of typhoid and paratyphoid fever collected from the China Health Statistical Yearbook. Model fitting accuracy test was used to evaluate the performance of these two models. Then, the next catastrophe date was predicted by the better model.

Results

The simulation results showed that DGM model was better than GM(1,1) model in our data set. Using the DGM model, we predicted the next epidemic peak time will occur between 2023 to 2025.

Conclusion

The grey disaster model can predict the typhoid and paratyphoid fever epidemic time precisely, which may provide valuable information for disease prevention and control.  相似文献   

2.
伤寒和副伤寒流行强度与区域人口数、发病率、病死率、高危人群、污水系统及卫生设施、地表水系及环境污染、健康教育与人群习惯的关系密切。美国疾病预防控制中心提出、世界卫生组织报道、国际学者引用的流行区域划分法是根据伤寒和副伤寒每年发病率的高、中、低水平来划分的,该划分法不能真实反映100万、100~1 000万、1 000万人口数的伤寒和副伤寒高、中、低流行强度和相应区域。本研究对全球伤寒和副伤寒流行强度区域文献作一综述,分析伤寒和副伤寒流行强度、流行强度区域及其指标体系,为查明相应流行强度区域危险因素、进行风险评估和制定防控策略提供科学依据。  相似文献   

3.
Using data on long-term dynamics of epidemic process of acute enteric infections enteric with aqueous route of transmission (typhoid fever, shigellosis caused by Shigella flexneri, hepatitis A, rotavirus gastroenteritis, etc.)the equation of regression was developed with the help of Chebyshev's polynoms. Predicted incidences of these infections for 2005 were on 61.2-99.5% in agree with the real ones on two territories of north region of West Siberia. Predicted incidence for 2006 is reflecting tendencies of epidemic process of mentioned infections.  相似文献   

4.

Background

Typhoid fever remains a significant public health problem in developing countries. In October 2011, a typhoid fever epidemic was declared in Harare, Zimbabwe - the fourth enteric infection epidemic since 2008. To orient control activities, we described the epidemiology and spatiotemporal clustering of the epidemic in Dzivaresekwa and Kuwadzana, the two most affected suburbs of Harare.

Methods

A typhoid fever case-patient register was analysed to describe the epidemic. To explore clustering, we constructed a dataset comprising GPS coordinates of case-patient residences and randomly sampled residential locations (spatial controls). The scale and significance of clustering was explored with Ripley K functions. Cluster locations were determined by a random labelling technique and confirmed using Kulldorff''s spatial scan statistic.

Principal Findings

We analysed data from 2570 confirmed and suspected case-patients, and found significant spatiotemporal clustering of typhoid fever in two non-overlapping areas, which appeared to be linked to environmental sources. Peak relative risk was more than six times greater than in areas lying outside the cluster ranges. Clusters were identified in similar geographical ranges by both random labelling and Kulldorff''s spatial scan statistic. The spatial scale at which typhoid fever clustered was highly localised, with significant clustering at distances up to 4.5 km and peak levels at approximately 3.5 km. The epicentre of infection transmission shifted from one cluster to the other during the course of the epidemic.

Conclusions

This study demonstrated highly localised clustering of typhoid fever during an epidemic in an urban African setting, and highlights the importance of spatiotemporal analysis for making timely decisions about targetting prevention and control activities and reinforcing treatment during epidemics. This approach should be integrated into existing surveillance systems to facilitate early detection of epidemics and identify their spatial range.  相似文献   

5.
The main problems of etiotropic therapy for typhoid fever lie in underestimate of the characteristic features of its pathogenesis and particularly in development of typhoid granulomas and their histogenesis, as well as in wide spread of typhoid fever pathogenic strains resistant to the routine chemotherapeutics, i.e. polyresistant strains. Some problems are due to incorrect choice of the antimicrobials and their combinations, optimal doses, administration routes and pathogenetic therapy. In the XXth centure an increase in the emergence and a change in the nature of the typhoid fever pathogen resistance to antimicrobials were observed. It was shown that from the pharmacologic and pharmacodynamic viewpoints the highest efficacy of typhoid fever therapy should be provided by the following antimicrobials: fluoroquinolones (except for norfloxacin), 3rd and 4th generation cephalosporins, aminopenicillins, chloramhenicol (levomycetin), combinations of 2nd and 3rd generation aminoglycosides with biseptol, aminopenicillins or doxycycline, as well as chloramphenicol combinations with aminopenicillins or 2nd to 4th generation cephalosporins. Practical recommendations for the etiotropic therapy of patients with typhoid fever during its outbreak or epidemic are presented.  相似文献   

6.
For the first time the territory of Tyumen Province has been zoned according to situation in typhoid fever morbidity by means of a complex of methods for computerized statistical data processing in combination with extensive epidemiological analysis. As a result, 43 administrative districts have been grouped in 5 zones having similar epidemiological, sanitary, hygienic, and demographic characteristics. For these zones territorially differentiated measures for decreasing typhoid fever morbidity have been worked out.  相似文献   

7.
During superepidemic of a typhoid fever in Tadjikistan the efficiency of application in clinics and of 14 antimicrobial agents representing almost all basic chemical classes was investigated. Remarkable variation of frequency and type of S. typhi resistance to these preparations up to epidemic and especially in its process was demonstrated. The absence of absolute (100%) efficacy of the investigated agents in vivo and in vitro was shown. The reasons of low efficacy of etiotropic treatment of the patients with typhoid fever are analysed.  相似文献   

8.
The modified SIS epidemiological model considers the usual direct transmission (short cycle) and indirect transmission (long cycle) of typhoid fever. Thresholds are determined, and the equilibrium points are shown to be globally stable. Local stability of the equilibrium points is shown in the corresponding model with vaccines. After estimating parameters using current statistical data for typhoid fever in Chile, computer simulations are used to obtain the numerical behavior of this disease and to estimate the effect of several control policies.  相似文献   

9.

Background

The gold standard for diagnosis of typhoid fever is blood culture (BC). Because blood culture is often not available in impoverished settings it would be helpful to have alternative diagnostic approaches. We therefore investigated the usefulness of clinical signs, WHO case definition and Widal test for the diagnosis of typhoid fever.

Methodology/Principal Findings

Participants with a body temperature ≥37.5°C or a history of fever were enrolled over 17 to 22 months in three hospitals on Pemba Island, Tanzania. Clinical signs and symptoms of participants upon presentation as well as blood and serum for BC and Widal testing were collected. Clinical signs and symptoms of typhoid fever cases were compared to other cases of invasive bacterial diseases and BC negative participants. The relationship of typhoid fever cases with rainfall, temperature, and religious festivals was explored. The performance of the WHO case definitions for suspected and probable typhoid fever and a local cut off titre for the Widal test was assessed. 79 of 2209 participants had invasive bacterial disease. 46 isolates were identified as typhoid fever. Apart from a longer duration of fever prior to admission clinical signs and symptoms were not significantly different among patients with typhoid fever than from other febrile patients. We did not detect any significant seasonal patterns nor correlation with rainfall or festivals. The sensitivity and specificity of the WHO case definition for suspected and probable typhoid fever were 82.6% and 41.3% and 36.3 and 99.7% respectively. Sensitivity and specificity of the Widal test was 47.8% and 99.4 both forfor O-agglutinin and H- agglutinin at a cut-off titre of 1∶80.

Conclusions/Significance

Typhoid fever prevalence rates on Pemba are high and its clinical signs and symptoms are non-specific. The sensitivity of the Widal test is low and the WHO case definition performed better than the Widal test.  相似文献   

10.
In 2008, a mass grave was found on the grounds of the University of Kassel, Germany. Historians hypothesized that the individuals died in a typhoid fever epidemic in winter 1813/14. To test this hypothesis, the bones were investigated on the presence of specific DNA of pathogens linked to the historical diagnosis oftyphoid fever. It was possible to prove the specific DNA of Bartonella quintana in three individuals, suggesting that their cause of death is linked to an epidemic background.  相似文献   

11.
Specific IgA and sIgA antibodies were studied in the sera of patients suffering from various intestinal diseases (dysentery, salmonellosis, typhoid fever, chronic typhoid carrier state) and in the sera of healthy persons immunized by parenteral route with typhoid alcohol vaccine. The nature of antibodies was identified in Coombs' test, using monospecific antisera to alpha-chain and to the secretory component. IgA and sIgA antibodies were revealed most frequently in the sera of dysentery patients and of chronic typhoid carriers. No sIgA antibodies were found in the sera of subcutaneously immunized persons. The presence of specific sIgA antibodies in the serum reflects the participation of local immune mechanisms in the formation of systemic immunity in the intestinal infections.  相似文献   

12.
Melioidosis is a long-known disease since 1912, but only quite recently we have obtained the knowledges about its actual clinical and epidemiological features. The disease is so unique in having a wide spectrum of disease course and clinical manifestation. The causative agent, P. pseudomallei, is free-living bacterium in the natural environments (soil and surface water) of tropical and subtropical areas. Just like legionnaires' disease, melioidosis is a good example of infectious disease in which pneumonia is produced by inhalation of contaminated soil dusts or water droplets. The infection becomes dormant for years, but with a chance of recrudescence under a variety of insults to the host resistance. The disease, may it be acute or chronic, will be symptomatically confused with malaria, typhoid fever, leptospirosis, septicemia caused by other gram-negative bacteria, tuberculosis and mycotic infections. Isolation of the causative agent from clinical specimens is the only reliable method for diagnosis. Because of the increasing clinical awareness and the development of diagnostic methods, the reported cases of melioidosis have numbered almost one thousand in Thailand during the past 20 years. This country has now the most ample clinical experiences on melioidosis. We have reviewed the history of melioidosis research from bacteriological, immunological, clinical and epidemiological viewpoints, especially including the recent reports in Thailand.  相似文献   

13.
The cyclic nature of the epidemic process in Bulgaria was studied by various methods (spectral analysis, etc.), forming a system. The morbidity dynamics in 10 infectious diseases (scarlet fever, rubella, measles, epidemic parotitis, whooping cough, diphtheria, typhoid fever, enterocolitis, bacterial dysentery, viral hepatitis) over the years of 1909-1983 were studied and cycles covering the periods of 3-4, 5-6, 10-11 and over 16 years were established. The data on the relative part of cyclic processes in the registered morbidity of infectious diseases, as well as information on the prognostication of the spread of infections in the absence of vaccinal prophylaxis, are presented.  相似文献   

14.

Background

Salmonella enterica serovar Typhi is transmitted by fecally contaminated food and water and causes approximately 22 million typhoid fever infections worldwide each year. Most cases occur in developing countries, where approximately 4% of patients develop intestinal perforation (IP). In Kasese District, Uganda, a typhoid fever outbreak notable for a high IP rate began in 2008. We report that this outbreak continued through 2011, when it spread to the neighboring district of Bundibugyo.

Methodology/Principal Findings

A suspected typhoid fever case was defined as IP or symptoms of fever, abdominal pain, and ≥1 of the following: gastrointestinal disruptions, body weakness, joint pain, headache, clinically suspected IP, or non-responsiveness to antimalarial medications. Cases were identified retrospectively via medical record reviews and prospectively through laboratory-enhanced case finding. Among Kasese residents, 709 cases were identified from August 1, 2009–December 31, 2011; of these, 149 were identified during the prospective period beginning November 1, 2011. Among Bundibugyo residents, 333 cases were identified from January 1–December 31, 2011, including 128 cases identified during the prospective period beginning October 28, 2011. IP was reported for 507 (82%) and 59 (20%) of Kasese and Bundibugyo cases, respectively. Blood and stool cultures performed for 154 patients during the prospective period yielded isolates from 24 (16%) patients. Three pulsed-field gel electrophoresis pattern combinations, including one observed in a Kasese isolate in 2009, were shared among Kasese and Bundibugyo isolates. Antimicrobial susceptibility was assessed for 18 isolates; among these 15 (83%) were multidrug-resistant (MDR), compared to 5% of 2009 isolates.

Conclusions/Significance

Molecular and epidemiological evidence suggest that during a prolonged outbreak, typhoid spread from Kasese to Bundibugyo. MDR strains became prevalent. Lasting interventions, such as typhoid vaccination and improvements in drinking water infrastructure, should be considered to minimize the risk of prolonged outbreaks in the future.  相似文献   

15.
The authors analyze the morbidity structure in five enteric infections (typhoid fever, dysentery caused by Shigella flexneri and Shigella sonnei, hepatitis A, and hepatitis E (non A, non B) with the fecal/oral mechanism of the agent transmission) in three towns of Turkmenia and in the town of Novomoskovsk, Tula Province. The incidence of S. sonnei dysentery was found higher in Novomoskovsk and that of the rest enteric infections under study in Turkmenia. The incidence of typhoid fever and hepatitis E was the highest among schoolchildren and adults, whereas preschool children suffered mostly from hepatitis A and S. sonnei dysentery. The authors discuss the specific features of the epidemic process manifestation in enteric infections.  相似文献   

16.
The data on the sanitary and epidemiological situation in the Southern Federal District are presented. The analysis of morbidity in tuberculosis, measles, HIV infection, viral hepatitis A, typhoid fever, cholera and quarantine infections, Crimean hemorrhagic fever, West Nile fever, rabies, malaria has been carried out. Special attention has been given to "new and newly returning infections", and among them to the spread of SARS ("atypical pneumonia"). The role of regional epidemiological safety programs, in particular such program as "The prophylaxis of quarantine and natural focal infections and the sanitary protection of the territory of the Southern Federal District of the Russian Federation from the import and spread infectious diseases in 2003-2005", has been substantiated.  相似文献   

17.

Background

The bacterium Salmonella enterica serovar Typhi causes typhoid fever, which is typically associated with fever and abdominal pain. An outbreak of typhoid fever in Malawi-Mozambique in 2009 was notable for a high proportion of neurologic illness.

Objective

Describe neurologic features complicating typhoid fever during an outbreak in Malawi-Mozambique

Methods

Persons meeting a clinical case definition were identified through surveillance, with laboratory confirmation of typhoid by antibody testing or blood/stool culture. We gathered demographic and clinical information, examined patients, and evaluated a subset of patients 11 months after onset. A sample of persons with and without neurologic signs was tested for vitamin B6 and B12 levels and urinary thiocyanate.

Results

Between March – November 2009, 303 cases of typhoid fever were identified. Forty (13%) persons had objective neurologic findings, including 14 confirmed by culture/serology; 27 (68%) were hospitalized, and 5 (13%) died. Seventeen (43%) had a constellation of upper motor neuron findings, including hyperreflexia, spasticity, or sustained ankle clonus. Other neurologic features included ataxia (22, 55%), parkinsonism (8, 20%), and tremors (4, 10%). Brain MRI of 3 (ages 5, 7, and 18 years) demonstrated cerebral atrophy but no other abnormalities. Of 13 patients re-evaluated 11 months later, 11 recovered completely, and 2 had persistent hyperreflexia and ataxia. Vitamin B6 levels were markedly low in typhoid fever patients both with and without neurologic signs.

Conclusions

Neurologic signs may complicate typhoid fever, and the diagnosis should be considered in persons with acute febrile neurologic illness in endemic areas.  相似文献   

18.
BackgroundEnteric fever due to Salmonella Typhi (typhoid fever) occurs in urban areas with poor sanitation. While direct fecal-oral transmission is thought to be the predominant mode of transmission, recent evidence suggests that indirect environmental transmission may also contribute to disease spread.MethodsData from a population-based infectious disease surveillance system (28,000 individuals followed biweekly) were used to map the spatial pattern of typhoid fever in Kibera, an urban informal settlement in Nairobi Kenya, between 2010–2011. Spatial modeling was used to test whether variations in topography and accumulation of surface water explain the geographic patterns of risk.ResultsAmong children less than ten years of age, risk of typhoid fever was geographically heterogeneous across the study area (p = 0.016) and was positively associated with lower elevation, OR = 1.87, 95% CI (1.36–2.57), p <0.001. In contrast, the risk of typhoid fever did not vary geographically or with elevation among individuals less than 6b ten years of age.ConclusionsOur results provide evidence of indirect, environmental transmission of typhoid fever among children, a group with high exposure to fecal pathogens in the environment. Spatially targeting sanitation interventions may decrease enteric fever transmission.  相似文献   

19.
The mathematical model describing the dependence of typhoid fever morbidity on water supply and the migration of the population has been constructed. The checking of the model has shown the 95% coincidence of the predicted and actual morbidity. The model has been used for the prognostication of morbidity rate in typhoid fever in new economic development regions, thus making it possible to plan in advance the measures necessary for the prevention of negative consequences connected with the realization of economic development projects.  相似文献   

20.
以辽宁省本溪市1955-1996年的肝炎、伤寒逐月发病的数据为根据,利用混沌动力学中“相空间技术”,对流行病过程进行能量谱分析及混沌分析。发现伤寒的流行过程是混沌的,混沌迭代模型是Xt+1=rXtexp{-0.0009287(Xt-33.25332)^2};肝炎的流行过程是非混沌的。在模型参数变化范围内,经历了周期状态、混沌状态之间的转换,这表明伤寒的流行过程是复杂的,给出了流行病的“阈值”,以控制它们的流行涨落,求出伤寒的关联分维是3.087。  相似文献   

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