Passey M
Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
P N G Med J. 1995 Dec;38(4):300-4.
This paper reviews some of the issues relating to typhoid fever in Papua New Guinea. Before the mid-1980s only sporadic cases of typhoid were reported but it is now one of the greatest public health problems in the highlands and some urban areas. In one study near Goroka an annual incidence rate of 1208 per 100,000 people was found, with settlers from other areas at greater risk than the local landowners. Problems relating to management included differentiation from other diseases, the limitations of the Widal test and poor compliance among outpatients. In Papua New Guinea it appears that transmission is largely from person to person, with little evidence for water-borne transmission. The prolonged convalescent excretion of Salmonella typhi and the difficulties this poses for control of the disease are discussed. Prevention will only be achieved in the long term by improvements in hygiene and sanitation, though more immediate control could be achieved by vaccination with an appropriate vaccine.
本文综述了巴布亚新几内亚与伤寒热相关的一些问题。20世纪80年代中期以前，仅报告过散发性伤寒病例，但如今它已成为高地和一些城市地区最严重的公共卫生问题之一。在戈罗卡附近的一项研究中，发现年发病率为每10万人1208例，来自其他地区的定居者比当地土地所有者面临更大风险。与管理相关的问题包括与其他疾病的鉴别、维达试验的局限性以及门诊患者的依从性差。在巴布亚新几内亚，传播似乎主要是人与人之间的传播，几乎没有水传播的证据。文中讨论了伤寒杆菌的长期恢复期排泄及其给疾病控制带来的困难。从长远来看，只有通过改善卫生和环境卫生才能实现预防，不过通过接种适当的疫苗可以实现更直接的控制。
