Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
J Glob Health. 2012 Jun;2(1):010401. doi: 10.7189/jogh.02.010401.
Typhoid and paratyphoid fever remain important causes of morbidity worldwide. Accurate disease burden estimates are needed to guide policy decisions and prevention and control strategies.
We conducted a systematic literature review of the PubMed and Scopus databases using pre-defined criteria to identify population-based studies with typhoid fever incidence data published between 1980 and 2009. We also abstracted data from annual reports of notifiable diseases in countries with advanced surveillance systems. Typhoid and paratyphoid fever input data were grouped into regions and regional incidence and mortality rates were estimated. Incidence data were extrapolated across regions for those lacking data. Age-specific incidence rates were derived for regions where age-specific data were available. Crude and adjusted estimates of the global typhoid fever burden were calculated.
Twenty-five studies were identified, all of which contained incidence data on typhoid fever and 12 on paratyphoid fever. Five advanced surveillance systems contributed data on typhoid fever; 2 on paratyphoid fever. Regional typhoid fever incidence rates ranged from <0.1/100 000 cases/y in Central and Eastern Europe and Central Asia to 724.6/100 000 cases/y in Sub-Saharan Africa. Regional paratyphoid incidence rates ranged from 0.8/100 000 cases/y in North Africa/Middle East to 77.4/100 000 cases/y in Sub-Saharan Africa and South Asia. The estimated total number of typhoid fever episodes in 2010 was 13.5 million (interquartile range 9.1-17.8 million). The adjusted estimate accounting for the low sensitivity of blood cultures for isolation of the bacteria was 26.9 million (interquartile range 18.3-35.7 million) episodes. These findings are comparable to the most recent analysis of global typhoid fever morbidity, which reported crude and adjusted estimates of 10.8 million and 21.7 million typhoid fever episodes globally in 2000.
Typhoid fever remains a significant health burden, especially in low- and middle-income countries. Despite the availability of more recent data on both enteric fevers, additional research is needed in many regions, particularly Africa, Latin America and other developing countries.
伤寒和副伤寒在全球范围内仍是发病率较高的疾病。准确的疾病负担估计值对于指导政策决策和防控策略至关重要。
我们对 PubMed 和 Scopus 数据库进行了系统的文献检索，使用预先确定的标准来识别 1980 年至 2009 年间发表的基于人群的伤寒发病率数据的研究。我们还从具有先进监测系统的国家的传染病年度报告中提取数据。将伤寒和副伤寒输入数据分为地区，估计地区发病率和死亡率。对于缺乏数据的地区，我们对发病率数据进行了推断。对于有年龄特异性数据的地区，我们推导出了年龄特异性发病率。计算全球伤寒负担的粗估计和调整估计。
确定了 25 项研究，其中所有研究均包含伤寒发病率数据，12 项研究包含副伤寒发病率数据。5 个先进的监测系统提供了伤寒数据；2 个提供了副伤寒数据。地区伤寒发病率从中欧和东欧以及中亚的<0.1/100 000 例/年到撒哈拉以南非洲的 724.6/100 000 例/年不等。地区副伤寒发病率从北非/中东的 0.8/100 000 例/年到撒哈拉以南非洲和南亚的 77.4/100 000 例/年不等。2010 年估计的伤寒总发病例数为 1350 万（四分位间距 910-1780 万）。考虑到血液培养对细菌分离的低敏感性，调整后的估计值为 2690 万（四分位间距 1830-3570 万）例。这些发现与全球伤寒发病率的最新分析结果相当，该分析报告称，2000 年全球伤寒粗发病率和调整后发病率分别为 1080 万和 2170 万。
伤寒仍是一个重大的健康负担，尤其是在中低收入国家。尽管目前有关于两种肠道发热疾病的更近期数据，但在许多地区，特别是非洲、拉丁美洲和其他发展中国家，仍需要进一步研究。
