印度伤寒家庭和环境传播病例对照研究

S. Giri, V. Mohan, M. Srinivasan, N. Kumar, Vinoth Kumar, Pavithra Dhanapal, Jayalakshmi Venkatesan, Annai Gunasekaran, D. Abraham, J. John, G. Kang
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引用次数: 3

摘要

背景伤寒在低收入和中等收入国家引起大量发病率和死亡率。我们在印度南部的Vellore进行了一项病例对照研究,以了解伤寒传播的危险因素。方法从2018年4月至2019年10月,招募6个月至15岁发热监测队列中发生的血培养确诊伤寒病例的家庭,以及年龄、性别、地理位置和社会经济地位相匹配的对照组。使用标准问卷获得危险因素信息。采集家庭和环境样本,采用实时聚合酶链反应检测伤寒沙门菌。采用多变量分析评价危险因素与伤寒之间的关系。结果共纳入病例和对照组100对。在多变量回归分析中,母亲在前一周从街头小贩处获得食物(优势比[OR] = 2.04;95%置信区间[CI], 1.03-4.12;P = .04)与伤寒独立相关,而家庭饮用水处理(OR = 0.45;95% ci, 0.25-0.80;P = .007)具有保护作用。病例家庭和对照家庭环境样本间斑疹伤寒检出率无显著差异。结论在韦洛莱市人口密集的城市社区,街头食品是伤寒的危险因素之一。改善卫生设施和提高对用水点水处理的认识可能有助于伤寒控制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Case-Control Study of Household and Environmental Transmission of Typhoid Fever in India
Abstract Background Typhoid fever causes substantial morbidity and mortality in low- and middle-income countries. We conducted a case-control study in Vellore, southern India, to understand risk factors for transmission of typhoid. Methods From April 2018 to October 2019, households of blood culture-confirmed typhoid cases that occurred within a fever surveillance cohort aged 6 months–15 years, and controls matched for age, sex, geographic location, and socioeconomic status, were recruited. Information on risk factors was obtained using standard questionnaires. Household and environmental samples were collected for detection of Salmonella Typhi using real-time polymerase chain reaction. Multivariable analysis was used to evaluate associations between risk factors and typhoid. Results One hundred pairs of cases and controls were recruited. On multivariable regression analysis, mothers eating food from street vendors during the previous week (odds ratio [OR] = 2.04; 95% confidence interval [CI], 1.03–4.12; P = .04) was independently associated with typhoid, whereas treatment of household drinking water (OR = 0.45; 95% CI, 0.25–0.80; P = .007) was protective. There was no significant difference in S Typhi detection between the environmental samples from case and control households. Conclusions Street-vended food is a risk factor for typhoid in densely populated urban communities of Vellore. Improved sanitation facilities and awareness about point-of-use water treatment are likely to contribute to typhoid control.
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