Ram P K, Naheed A, Brooks W A, Hossain M A, Mintz E D, Breiman R F, Luby S P
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Epidemiol Infect. 2007 Apr;135(3):458-65. doi: 10.1017/S0950268806007114. Epub 2006 Aug 8.
We systematically investigated risk factors for typhoid fever in Kamalapur, a poor urban area of Bangladesh, to inform targeted public health measures for its control. We interviewed patients with typhoid fever and two age-matched controls per case about exposures during the 14 days before the onset of illness. The municipal water supply was used by all 41 cases and 81of 82 controls. In multivariate analysis, drinking unboiled water at home was a significant risk factor [adjusted odds ratio (aOR) 12.1, 95% CI 2.2-65.6]. Twenty-three (56%) cases and 21 (26%) controls reported that water from the primary source was foul-smelling (aOR 7.4, 95% CI 2.1-25.4). Eating papaya was associated with illness (aOR 5.2, 95% CI 1.2-22.2). Using a latrine for defecation was significantly protective (aOR 0.1, 95% CI 0.02-0.9). Improved chlorination of the municipal water supply or disinfecting drinking water at the household level may dramatically reduce the risk of typhoid fever in Kamalapur. The protective effect of using latrines, particularly among young children, should be investigated further.
我们系统地调查了孟加拉国贫困城区卡马拉布尔伤寒热的风险因素，以便为其防控制定有针对性的公共卫生措施。我们就发病前14天内的暴露情况，对伤寒热患者及每名患者匹配的两名年龄相仿的对照者进行了访谈。41例患者和82名对照者中的81人使用市政供水。多变量分析显示，在家饮用生水是一个显著的风险因素[校正比值比（aOR）为12.1，95%置信区间（CI）为2.2 - 65.6]。23例（56%）患者和21名（26%）对照者报告称，主要水源的水有异味（aOR为7.4，95% CI为2.1 - 25.4）。食用木瓜与患病有关（aOR为5.2，95% CI为1.2 - 22.2）。使用厕所排便有显著的保护作用（aOR为0.1，95% CI为0.02 - 0.9）。改善市政供水的氯化处理或在家庭层面进行饮用水消毒，可能会大幅降低卡马拉布尔伤寒热的风险。使用厕所的保护作用，尤其是对幼儿的保护作用，应进一步研究。
