Galgallo Dahabo Adi, Roka Zeinab Gura, Boru Waqo G, Abill Khalumi, Ransom James
Moyale Sub-County Hospital, Moyale, Marsabit County, Kenya.
Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya.
J Health Popul Nutr. 2018 May 15;37(1):14. doi: 10.1186/s41043-018-0144-2.
Typhoid fever is a vaccine-preventable bacterial disease that causes significant morbidity and mortality throughout Africa. This paper describes an upsurge of typhoid fever cases in Moyale Sub-County (MSC), Kenya, 2014-2015.
We conducted active hospital and health facility surveillance and laboratory and antimicrobial sensitivity testing for all patients presenting with headache, fever, stomach pains, diarrhea, or constipation at five MSC health facilities between December 2014 and January 2015. We also conducted direct observation of the residential areas of the suspected cases to assess potential environmental exposures and transmission mechanisms. Demographic, clinical, and laboratory data were entered into, and descriptive statistics were calculated with, MS Excel.
A total of 317 patients were included in the study, with mean age 24 ± 8.1 years, and 51% female. Of the 317 suspect cases, 155 (49%) were positive by Widal antigen reaction test. A total of 188 (59%) specimens were subjected to culture and sensitivity testing, with 71 (38%) culture positive and 54 (76%), 43 (60%), and 33 (46%) sensitive to ceftriaxone, cefuroxime, and ciprofloxacin, respectively. Environmental assessments through direct observations showed that commercial and residential areas had limited (1) clean water sources, (2) latrines, and (3) hygiene stations for street food hawkers and their customers.
Typhoid fever is endemic in MSC and causes significant disease across age and sex groups. The local health department should develop policies to (1) assure community access to potable water and hygiene stations and (2) vaccinate specific occupations, such as food and drink handlers, against typhoid.
伤寒热是一种可用疫苗预防的细菌性疾病，在整个非洲导致了严重的发病和死亡。本文描述了2014 - 2015年肯尼亚莫亚莱县伤寒热病例的激增情况。
2014年12月至2015年1月期间，我们在莫亚莱县的五家医疗机构对所有出现头痛、发热、胃痛、腹泻或便秘症状的患者进行了主动的医院和卫生机构监测以及实验室和抗菌药敏试验。我们还对疑似病例的居住区域进行了直接观察，以评估潜在的环境暴露和传播机制。人口统计学、临床和实验室数据录入微软Excel并进行描述性统计分析。
本研究共纳入317例患者，平均年龄24±8.1岁，51%为女性。在317例疑似病例中，155例（49%）肥达抗原反应试验呈阳性。共188份（59%）标本进行了培养和药敏试验，71份（38%）培养阳性，其中54份（76%）、43份（60%）和33份（46%）分别对头孢曲松、头孢呋辛和环丙沙星敏感。通过直接观察进行的环境评估显示，商业区和居民区（1）清洁水源有限，（2）厕所有限，（3）街头食品小贩及其顾客的卫生站有限。
伤寒热在莫亚莱县呈地方流行，在各年龄和性别群体中均导致严重疾病。当地卫生部门应制定政策：（1）确保社区能够获得饮用水和卫生站；（2）为食品和饮料处理人员等特定职业人群接种伤寒疫苗。
