Division of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
Department of Community Health, Christian Medical College, Vellore, India.
J Infect Dis. 2021 Nov 23;224(Supple 5):S584-S592. doi: 10.1093/infdis/jiab378.
Typhoid fever causes substantial morbidity and mortality in low- and middle-income countries. We conducted a case-control study in Vellore, southern India, to understand risk factors for transmission of typhoid.
From April 2018 to October 2019, households of blood culture-confirmed typhoid cases that occurred within a fever surveillance cohort aged 6 months-15 years, and controls matched for age, sex, geographic location, and socioeconomic status, were recruited. Information on risk factors was obtained using standard questionnaires. Household and environmental samples were collected for detection of Salmonella Typhi using real-time polymerase chain reaction. Multivariable analysis was used to evaluate associations between risk factors and typhoid.
One hundred pairs of cases and controls were recruited. On multivariable regression analysis, mothers eating food from street vendors during the previous week (odds ratio [OR] = 2.04; 95% confidence interval [CI], 1.03-4.12; P = .04) was independently associated with typhoid, whereas treatment of household drinking water (OR = 0.45; 95% CI, 0.25-0.80; P = .007) was protective. There was no significant difference in S Typhi detection between the environmental samples from case and control households.
Street-vended food is a risk factor for typhoid in densely populated urban communities of Vellore. Improved sanitation facilities and awareness about point-of-use water treatment are likely to contribute to typhoid control.
伤寒在中低收入国家会导致大量发病和死亡。我们在印度南部的维洛尔进行了一项病例对照研究，以了解伤寒传播的危险因素。
2018 年 4 月至 2019 年 10 月，我们招募了在发热监测队列中确诊的年龄在 6 个月至 15 岁之间的血培养阳性伤寒病例及其年龄、性别、地理位置和社会经济地位相匹配的对照家庭。使用标准问卷获取有关危险因素的信息。收集家庭和环境样本，使用实时聚合酶链反应检测伤寒沙门氏菌。多变量分析用于评估危险因素与伤寒之间的关联。
共招募了 100 对病例和对照。在多变量回归分析中，母亲在过去一周内从街头小贩处购买食物（比值比 [OR] = 2.04；95%置信区间 [CI]，1.03-4.12；P =.04）与伤寒独立相关，而家庭饮用水处理（OR = 0.45；95%CI，0.25-0.80；P =.007）则具有保护作用。病例和对照家庭的环境样本中 S Typhi 的检出率没有显著差异。
在维洛尔人口稠密的城市社区，街头贩卖的食物是伤寒的危险因素。改善卫生设施和提高关于用水点处理的认识可能有助于控制伤寒。
