Field Epidemiology Training Program-Intermediate Course; Provincial Health Office, Benguet, Philippines.
Department of Health, Manila, Philippines.
Western Pac Surveill Response J. 2024 Jul 12;15(3):1-5. doi: 10.5365/wpsar.2024.15.3.1047. eCollection 2024 Apr-Jun.
The event-based surveillance and response report from the municipality of Buguias in the Philippines covering the period 1 January to 29 October 2022 indicated an unusual increase in the number of typhoid cases that surpassed the epidemic threshold for consecutive weeks. An investigation was conducted to confirm the existence of an outbreak, identify the source(s) of transmission and recommend prevention and control measures.
The investigation employed a descriptive design. Medical records were reviewed to verify diagnoses and to identify cases that met case definitions. Key informant interviews were conducted to identify possible sources of transmission and investigate the reporting of cases in the Philippine Integrated Disease Surveillance and Response (PIDSR) system.
A total of 220 cases of typhoid fever were captured by the PIDSR system. Of the 208 suspected cases that were reviewed, only 15 (7.2%) met the case definition used in this investigation. Fourteen of these 15 verified cases were interviewed; five (35.7%) were farmers and 13 (92.8%) reported using springs as their main water source and source of drinking-water. Reporting of cases in the PIDSR system was largely based on the final chart diagnosis or a positive Typhidot or Tubex rapid diagnostic test result. The PIDSR case definition was not followed in the reporting of cases.
This study provides evidence of endemicity of typhoid fever in Buguias, Benguet, Philippines. However, from January to October 2022, cases were overreported by the surveillance system. Medical record reviews showed that most reported suspected cases did not meet case definition criteria. This finding emphasizes the need to improve typhoid guidelines with regards to diagnosis using rapid diagnostic tests and to investigate the cost-effectiveness of making confirmatory laboratory tests for typhoid available in the Philippines.
菲律宾布基安市的基于事件的监测和应对报告涵盖了 2022 年 1 月 1 日至 10 月 29 日期间，表明伤寒病例数量异常增加，连续数周超过流行阈值。进行了一项调查，以确认暴发的存在，确定传播源，并提出预防和控制措施。
该调查采用描述性设计。审查了病历以验证诊断，并确定符合病例定义的病例。进行了重点信息提供者访谈，以确定可能的传播源，并调查在菲律宾综合疾病监测和应对（PIDSR）系统中报告病例的情况。
PIDSR 系统共捕获了 220 例伤寒病例。在审查的 208 例疑似病例中，只有 15 例（7.2%）符合本调查中使用的病例定义。对这 15 例确诊病例中的 14 例进行了访谈；其中 5 例（35.7%）为农民，13 例（92.8%）报告使用泉水作为主要水源和饮用水源。PIDSR 系统中病例的报告主要基于最终图表诊断或 Typhidot 或 Tubex 快速诊断测试的阳性结果。PIDSR 病例定义在病例报告中未得到遵循。
本研究提供了菲律宾本格特省布基安市伤寒地方性流行的证据。然而，在 2022 年 1 月至 10 月期间，监测系统过度报告了病例。病历审查显示，大多数报告的疑似病例不符合病例定义标准。这一发现强调了需要改进使用快速诊断测试进行诊断的伤寒指南，并调查在菲律宾提供伤寒确认性实验室测试的成本效益。
