Khaliq Asif, Yousafzai Mohammad Tahir, Haq Salman, Yaseen Rahima, Qureshi Sonia, Rind Fahad, Padhani Zahra A, Khan Ayub, Kazi Abdul Momin, Qamar Farah Naz
Department of Pediatrics and Child Health, The Aga Khan University Hospital, Aga Khan University Karachi, Pakistan.
School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
J Glob Health. 2021 May 29;11:04031. doi: 10.7189/jogh.11.04031.
This review assessed the case definitions, diagnostic criteria, antimicrobial resistance, and methods used for enteric fever outbreaks and utilization of any unified outbreak score or checklist for early identification and response in Asia and Africa from 1965-2019.
We searched enteric fever outbreaks using PubMed, Google Scholar, and the Cochrane library. Studies describing a single outbreak event of enteric fever in Asia and Africa from 1965-2019 were reviewed. We excluded case reports, letter to editors, studies reporting typhoid in conjunction with other diseases, the Centers for Disease Control and Prevention (CDC) trip reports, the World Health Organization (WHO) bulletins report, data from mathematical modeling and simulation studies, reviews and ProMed alert. Also, non-typhoidal salmonella outbreaks were excluded.
A total of 5063 articles were identified using the key terms and 68 studies were selected for data extraction. Most (48, 71%) outbreaks were from Asian countries, 20 (29%) were reported from Africa. Only 15 studies reported the case definition used for case identification during an outbreak and 8 of those were from Asia. A third (20, 29%) of the studies described antibiotic resistance pattern. 43 (63%) studies contained information regarding the source of the outbreak. Outcomes (hospitalization and deaths) were reported in a quarter of studies. Only 23 (29%) of the studies reported outbreak control strategies while none reported any unified outbreak score or a checklist to identify the outbreak.
This review highlights the variability in detection and reporting methods for enteric fever outbreaks in Asia and Africa. No standardized case definitions or laboratory methods were reported. Only a few studies reported strategies for outbreak control. There is a need for the development of a unified outbreak score or a checklist to identify and report enteric fever outbreaks globally.
本综述评估了1965年至2019年期间亚洲和非洲用于伤寒热疫情的病例定义、诊断标准、抗菌药物耐药性以及方法，以及是否使用任何统一的疫情评分或清单进行早期识别和应对。
我们通过PubMed、谷歌学术和考科蓝图书馆搜索伤寒热疫情。对描述1965年至2019年亚洲和非洲伤寒热单一疫情事件的研究进行了综述。我们排除了病例报告、给编辑的信件、报告伤寒热与其他疾病并发的研究、疾病控制和预防中心（CDC）的旅行报告、世界卫生组织（WHO）的公告报告、来自数学建模和模拟研究的数据、综述以及ProMed警报。此外，非伤寒沙门氏菌疫情也被排除。
使用关键词共识别出5063篇文章，选取68项研究进行数据提取。大多数（48项，71%）疫情来自亚洲国家，20项（29%）来自非洲。只有1项研究报告了疫情期间用于病例识别的病例定义，其中8项来自亚洲。三分之一（20项，29%）的研究描述了抗生素耐药模式。43项（63%）研究包含了疫情来源的信息。四分之一的研究报告了结果（住院和死亡情况）。只有23项（29%）研究报告了疫情控制策略，而没有一项报告任何统一的疫情评分或用于识别疫情的清单。
本综述强调了亚洲和非洲伤寒热疫情检测和报告方法的变异性。未报告标准化的病例定义或实验室方法。只有少数研究报告了疫情控制策略。有必要制定统一的疫情评分或清单，以在全球范围内识别和报告伤寒热疫情。
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