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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Longitudinal Typhoid Fever Trends in India from 2000 to 2015
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Longitudinal Typhoid Fever Trends in India from 2000 to 2015

机译：2000年至2015年印度纵向伤寒趋势

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摘要

A very high incidence of typhoid was described in studies conducted in urban locations on the Indian subcontinent at the end of the twentieth century. Despite their availability, licensed immunogenic conjugate typhoid vaccines have not been introduced in the national immunization program, in part, because of a lack of understanding of where and for whom prevention is most necessary. Uncertainty regarding the burden of disease is based on the lack of reliable, recent estimates of culture-confirmed typhoid and an observed trend of low isolations of Salmonella Typhi and fewer complications at large referral hospitals in India. In this article, we examine the trends of S. Typhi isolation at three large tertiary care centers across India over 15 years and describe trends of recognized risk factors for typhoid from published literature. There appears to be a decline in the isolation of S. Typhi in blood cultures, which is more apparent in the past 5 years. These trends are temporally related to economic improvement, female literacy, and the use of antibiotics such as cephalosporins and azithromycin. The analysis of trends of culture-confirmed typhoid may not accurately capture the typhoid incidence trends if antibiotic use confounds the burden of disease presenting to larger facilities. Emerging antimicrobial resistance may result in a resurgence of disease if the underlying incidence and transmission of typhoid are not adequately addressed through public health approaches.
机译：在二十世纪末，在印度次大陆的城市地区进行的研究中描述了伤寒发病率。尽管他们提供了可用性，但在国家免疫计划中尚未在国家免疫计划中引入许可的免疫原性缀合物伤寒疫苗，因为缺乏对预防最为必要的地方和预防何处的理解。关于疾病负担的不确定性是基于缺乏可靠的，最近的文化证实的伤寒估计，观察到印度大型推荐医院的沙门氏菌滴水的低分离趋势。在本文中，我们在15年内探讨了三个大型三级护理中心的S. Typhi隔离趋势超过15年，并描述了来自出版文献的伤寒危险因素的趋势。血液文化中S. Typhi的孤立似乎似乎是一个下降，这在过去的5年里更加明显。这些趋势与经济改善，女性扫盲以及使用头孢菌素和阿奇霉素等抗生素的使用时暂时有关。如果抗生素使用困扰着较大设施的疾病负担，则培养证实伤寒趋势的分析可能无法准确捕获伤寒发生率趋势。如果伤寒的潜在发病率和伤寒通过公共卫生方法没有充分解决，则新出现的抗微生物抗性可能导致疾病的重新恢复。

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