Department of Microbiology, University of Medicine 1, Yangon, Myanmar.
Centre for International Health, University of Otago, Dunedin, New Zealand.
Clin Infect Dis. 2019 Mar 7;68(Suppl 2):S124-S129. doi: 10.1093/cid/ciy1109.
Accurate estimates of typhoid disease burden are needed to guide policy decisions, including on vaccine use. Data on the incidence of enteric fever in Myanmar are scarce. We estimated typhoid and paratyphoid fever incidence among adolescents and adults in Yangon, Myanmar, by combining sentinel hospital surveillance with a healthcare utilization survey.
We conducted a population-based household health care utilization survey in the Yangon Region 12 March through 5 April 2018. Multipliers derived from this survey were then applied to hospital-based surveillance of Salmonella Typhi and Paratyphi A bloodstream infections from 5 October 2015 through 4 October 2016 at Yangon General Hospital (YGH) to estimate the incidence of typhoid and paratyphoid fevers among person ≥12 years of age.
A total of 336 households representing 1598 persons were enrolled in the health care utilization survey, and multipliers were derived based on responses to questions about healthcare seeking in the event of febrile illness. Of 671 Yangon residents enrolled over a 1-year period at YGH, we identified 33 (4.9%) with Salmonella Typhi and 9 (1.3%) with Salmonella Paratyphi A bloodstream infection. After applying multipliers, we estimated that the annual incidence of typhoid was 391 per 100 000 persons and paratyphoid was 107 per 100 000 persons.
Enteric fever incidence is high in Yangon, Myanmar, warranting increased attention on prevention and control, including consideration of typhoid conjugate vaccine use as well as nonvaccine control measures. Research on incidence among infants and children, as well as sources and modes of transmission is needed.
准确估计伤寒疾病负担对于指导政策决策至关重要，包括疫苗使用决策。缅甸肠热病发病率数据稀缺。我们通过结合哨点医院监测和医疗保健利用调查，估计了缅甸仰光青少年和成年人的伤寒和副伤寒发病率。
我们于 2018 年 3 月 12 日至 4 月 5 日在仰光地区开展了一项基于人群的家庭医疗保健利用调查。然后，将该调查得出的乘数应用于 2015 年 10 月 5 日至 2016 年 10 月 4 日仰光总医院（YGH）基于沙门氏菌 Typhi 和 Paratyphi A 血流感染的基于医院的监测，以估计≥12 岁人群中伤寒和副伤寒的发病率。
共有 336 户家庭代表 1598 人参加了医疗保健利用调查，并根据对发热性疾病医疗保健寻求问题的回答得出了乘数。在 YGH 接受为期 1 年监测的 671 名仰光居民中，我们发现 33 人（4.9%）患有沙门氏菌 Typhi 和 9 人（1.3%）患有沙门氏菌 Paratyphi A 血流感染。应用乘数后，我们估计伤寒的年发病率为每 100000 人 391 例，副伤寒为每 100000 人 107 例。
缅甸仰光肠热病发病率很高，需要加强预防和控制工作，包括考虑使用伤寒结合疫苗以及非疫苗控制措施。还需要研究婴幼儿发病率、传染源和传播途径。
