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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Typhoid Fever in Chile 1969-2012: Analysis of an Epidemic and Its Control
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Typhoid Fever in Chile 1969-2012: Analysis of an Epidemic and Its Control

机译:智利的伤寒症1969 - 2012年:疫情分析及其控制

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From 1975 to 1983, a large epidemic of typhoid fever (TF) affected the metropolitan region (MR) of Chile (incidence rate [IR] of 219.6 per 10(5) in 1983). In 1983-1984, interventions were implemented focusing on person-to-person transmission (vaccination, food handlers' control, and mass communication) and regulations to control irrigation waters containing fecal contaminates. In 1991, a second intervention was quickly implemented to avoid the cholera epidemic affecting neighboring countries (total prohibition of growing or selling crops in the MR). We explored the potential impact of these interventions on the epidemic. We created a yearly database of the MRTF cases, population, and contextual factors of TF from 1969 to 2012. We first analyzed the epidemic (Joinpoint regression), identified predictors of TF (Poisson multiple regression), and then analyzed the effect of the interventions (interrupted time series model). The main predictor of the TF epidemic was the rate of unemployment. In relation to the 1983-1984 person-to-person interventions, TF came down by 51%(95% confidence interval [CI]: 30.2-65.0%) and continued to decrease at a rate of 10.4% (95% CI: 5.8-15.6%) per year until 1991. In 1991, with the strong environmental control of the sewage-irrigated crops, TF further decreased by 77% (95% CI: 69.-83.1%) and continued decreasing thereafter at 13% (95% CI: 11.3-15.6%) per year until the end of the study period. Today, 40 years after the epidemic, TF is a rare disease in the MR of Chile.
机译:从1975年到1983年,大型伤寒流行病(TF)影响了智利的大都市(MR)(1983年219.6每10(5)的发病率[IR])。 1983年至1984年,实施干预措施专注于人员传播(疫苗接种,食品处理程序控制和大规模沟通)和控制含有粪便污染物的灌溉水域的规定。 1991年,迅速实施了第二次干预,以避免影响邻国的霍乱疫情(总禁止在MR中种植或销售作物)。我们探讨了这些干预措施对流行病的潜在影响。我们从1969年到2012年创建了MRTF案件,人口和上下文因素的年度数据库。我们首先分析了疫情(加入点回归),确定了TF的预测因子(泊松多元回归),然后分析了干预措施的效果(中断时间序列模型)。 TF流行病的主要预测因子是失业率。关于1983-1984人的人口干预措施,TF下降了51%(95%的置信区间[CI]:30.2-65.0%),并继续以10.4%的速度降低(95%CI:5.8每年-15.6%至1991年。1991年,随着污水灌溉作物的强烈环境控制,TF进一步降低了77%(95%CI:69.-83.1%),然后继续下降13%(95每年%CI:11.3-15.6%,直到研究期结束。今天,疫情40年后,TF是智利先生的罕见疾病。

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