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1.
Chinese Journal of Epidemiology ; (12): 337-341, 2018.
Article in Chinese | WPRIM | ID: wpr-737958

ABSTRACT

Objective To understand the epidemiological and molecular characteristics of typhoid and paratyphoid in China from 2009 to 2013,and provide evidence for the prevention and control of typhoid and paratyphoid,the development and improvement of surveillance strategies.Methods Epidemiological analysis was conducted on the incidence data of typhoid and paratyphoid,and related public health emergencies in China during 2009-2013.Pathogen isolation and culture,serologic test were conducted for the typhoid and paratyphoid cases from 13 national surveillance sites.The isolates were subjected to antimicrobial susceptibility testing.Pulsed-field gel electrophoresis (PFGE) was performed for the molecular typing of these isolates.Results The average incidence of typhoid and paratyphoid in China during this period was 1.03/100 000.The reported case number and incidence decreased with year.The provinces reporting high case numbers were Yunnan,Guizhou,Guangxi,Hunan,Zhejiang,Guangdong and Xinjiang.The incidence of age group 0-4 years was highest.The proportion of farmers and children outside child care settings showed an increasing tendency over time.The annual incidence peak was during July-August.Twenty five outbreaks occurred during 2009-2013.The results of pathogen isolation and culture showed that the positive rate was 3.00% (940/31 322),among the positive isolates,the proportion of Salmonella paratyphi A accounted for higher proportion (68.19%,641/940) compared with Salmonella typhi (31.60%,297/940).The drug resistances of Salmonella typhi and Salmonella paratyphi varied,but their resistances to nalidixic acid were highest (50.22% and 85.33%) respectively.A certain amount of Salmonella typhi isolates showed the resistance to the 3rd generation cephalosporins.PFGE analysis showed divergent patterns of Salmonella typhi compared with limited patterns of Salmonella paratyphi A.Conclusion The epidemic level of typhoid and paratyphoid in China was relatively low,but the outbreak occurred occasionally.It is necessary to enhance the laboratory-based surveillance,particularly the capability of etiological diagnosis,outbreak investigation,response and antibiotic resistance monitoring,and conduct risk factor investigation in provinces with high incidences in recent years.

2.
Chinese Journal of Epidemiology ; (12): 337-341, 2018.
Article in Chinese | WPRIM | ID: wpr-736490

ABSTRACT

Objective To understand the epidemiological and molecular characteristics of typhoid and paratyphoid in China from 2009 to 2013,and provide evidence for the prevention and control of typhoid and paratyphoid,the development and improvement of surveillance strategies.Methods Epidemiological analysis was conducted on the incidence data of typhoid and paratyphoid,and related public health emergencies in China during 2009-2013.Pathogen isolation and culture,serologic test were conducted for the typhoid and paratyphoid cases from 13 national surveillance sites.The isolates were subjected to antimicrobial susceptibility testing.Pulsed-field gel electrophoresis (PFGE) was performed for the molecular typing of these isolates.Results The average incidence of typhoid and paratyphoid in China during this period was 1.03/100 000.The reported case number and incidence decreased with year.The provinces reporting high case numbers were Yunnan,Guizhou,Guangxi,Hunan,Zhejiang,Guangdong and Xinjiang.The incidence of age group 0-4 years was highest.The proportion of farmers and children outside child care settings showed an increasing tendency over time.The annual incidence peak was during July-August.Twenty five outbreaks occurred during 2009-2013.The results of pathogen isolation and culture showed that the positive rate was 3.00% (940/31 322),among the positive isolates,the proportion of Salmonella paratyphi A accounted for higher proportion (68.19%,641/940) compared with Salmonella typhi (31.60%,297/940).The drug resistances of Salmonella typhi and Salmonella paratyphi varied,but their resistances to nalidixic acid were highest (50.22% and 85.33%) respectively.A certain amount of Salmonella typhi isolates showed the resistance to the 3rd generation cephalosporins.PFGE analysis showed divergent patterns of Salmonella typhi compared with limited patterns of Salmonella paratyphi A.Conclusion The epidemic level of typhoid and paratyphoid in China was relatively low,but the outbreak occurred occasionally.It is necessary to enhance the laboratory-based surveillance,particularly the capability of etiological diagnosis,outbreak investigation,response and antibiotic resistance monitoring,and conduct risk factor investigation in provinces with high incidences in recent years.

3.
Chinese Journal of Epidemiology ; (12): 1504-1508, 2017.
Article in Chinese | WPRIM | ID: wpr-737862

ABSTRACT

Objective To analyze the spatial and temporal clustering characteristics of typhoid and paratyphoid fever and its change pattern in Yunnan, Guizhou and Guangxi provinces in southwestern China in recent years. Methods The incidence data of typhoid and paratyphoid fever cases at county level in 3 provinces during 2001-2012 were collected from China Information System for Diseases Control and Prevention and analyzed by the methods of descriptive epidemiology and geographic informatics. And the map showing the spatial and temporal clustering characters of typhoid and paratyphoid fever cases in three provinces was drawn. SaTScan statistics was used to identify the typhoid and paratyphoid fever clustering areas of three provinces in each year from 2001 to 2012. Results During the study period, the reported cases of typhoid and paratyphoid fever declined with year. The reported incidence decreased from 30.15 per 100000 in 2001 to 10.83 per 100000 in 2006 (annual incidence 21.12 per 100000);while during 2007-2012, the incidence became stable, ranging from 4.75 per 100000 to 6.83 per 100000 (annual incidence 5.73 per 100000). The seasonal variation of the incidence was consistent in three provinces, with majority of cases occurred in summer and autumn. The spatial and temporal clustering of typhoid and paratyphoid fever was demonstrated by the incidence map. Most high-incidence counties were located in a zonal area extending from Yuxi ofYunnan to Guiyang of Guizhou, but were concentrated in Guilin in Guangxi. Temporal and spatial scan statistics identified the positional shifting of class Ⅰ clustering area from Guizhou to Yunnan. Class Ⅰ clustering area was located around the central and western areas (Zunyi and Anshun) of Guizhou during 2001-2003, and moved to the central area of Yunnan during 2004-2012. Conclusion Spatial and temporal clustering of typhoid and paratyphoid fever existed in the endemic areas of southwestern China, and the clustering area covered a zone connecting the central areas of Guizhou and Yunnan. From 2004 to 2012, the most important clustering area shifted from Guizhou to Yunnan. Findings from this study provided evidence for the identifying key areas for typhoid and paratyphoid fever control and prevention and allocate health resources.

4.
Chinese Journal of Epidemiology ; (12): 754-758, 2017.
Article in Chinese | WPRIM | ID: wpr-737721

ABSTRACT

Objective Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence.Methods Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method.Characteristics on seasonal,regional and distribution of the diseases were described.Spatial-temporal clustering characteristics were estimated,under the retrospective space-time method.Results A total of 8 850 typhoid fever cases were reported from the surveillance system,with incidence rate as 0.65/100 000.The number of paratyphoid fever cases was 2 794,with incidence rate as 0.21/100 000.Both cases of typhoid fever and paratyphoid fever occurred all year round,with high epidemic season from May to October.Most cases involved farmers (39.68%),children (15.89%) and students (12.01%).Children under 5 years showed the highest incidence rate.Retrospective space-time analysis for provinces with high incidence rates would include Yurnan,Guangxi,Guizhou,Hunan and Guangdong,indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces.Conclusion In 2015,the prevalence rates of typhoid fever and paratyphoid fever were low,however with regional high prevalence areas.Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.

5.
Chinese Journal of Epidemiology ; (12): 1504-1508, 2017.
Article in Chinese | WPRIM | ID: wpr-736394

ABSTRACT

Objective To analyze the spatial and temporal clustering characteristics of typhoid and paratyphoid fever and its change pattern in Yunnan, Guizhou and Guangxi provinces in southwestern China in recent years. Methods The incidence data of typhoid and paratyphoid fever cases at county level in 3 provinces during 2001-2012 were collected from China Information System for Diseases Control and Prevention and analyzed by the methods of descriptive epidemiology and geographic informatics. And the map showing the spatial and temporal clustering characters of typhoid and paratyphoid fever cases in three provinces was drawn. SaTScan statistics was used to identify the typhoid and paratyphoid fever clustering areas of three provinces in each year from 2001 to 2012. Results During the study period, the reported cases of typhoid and paratyphoid fever declined with year. The reported incidence decreased from 30.15 per 100000 in 2001 to 10.83 per 100000 in 2006 (annual incidence 21.12 per 100000);while during 2007-2012, the incidence became stable, ranging from 4.75 per 100000 to 6.83 per 100000 (annual incidence 5.73 per 100000). The seasonal variation of the incidence was consistent in three provinces, with majority of cases occurred in summer and autumn. The spatial and temporal clustering of typhoid and paratyphoid fever was demonstrated by the incidence map. Most high-incidence counties were located in a zonal area extending from Yuxi ofYunnan to Guiyang of Guizhou, but were concentrated in Guilin in Guangxi. Temporal and spatial scan statistics identified the positional shifting of class Ⅰ clustering area from Guizhou to Yunnan. Class Ⅰ clustering area was located around the central and western areas (Zunyi and Anshun) of Guizhou during 2001-2003, and moved to the central area of Yunnan during 2004-2012. Conclusion Spatial and temporal clustering of typhoid and paratyphoid fever existed in the endemic areas of southwestern China, and the clustering area covered a zone connecting the central areas of Guizhou and Yunnan. From 2004 to 2012, the most important clustering area shifted from Guizhou to Yunnan. Findings from this study provided evidence for the identifying key areas for typhoid and paratyphoid fever control and prevention and allocate health resources.

6.
Chinese Journal of Epidemiology ; (12): 754-758, 2017.
Article in Chinese | WPRIM | ID: wpr-736253

ABSTRACT

Objective Through analyzing the surveillance data on typhoid fever and paratyphoid fever in 2015 to understand the related epidemiological features and most possible clustering areas of high incidence.Methods Individual data was collected from the passive surveillance program and analyzed by descriptive statistic method.Characteristics on seasonal,regional and distribution of the diseases were described.Spatial-temporal clustering characteristics were estimated,under the retrospective space-time method.Results A total of 8 850 typhoid fever cases were reported from the surveillance system,with incidence rate as 0.65/100 000.The number of paratyphoid fever cases was 2 794,with incidence rate as 0.21/100 000.Both cases of typhoid fever and paratyphoid fever occurred all year round,with high epidemic season from May to October.Most cases involved farmers (39.68%),children (15.89%) and students (12.01%).Children under 5 years showed the highest incidence rate.Retrospective space-time analysis for provinces with high incidence rates would include Yurnan,Guangxi,Guizhou,Hunan and Guangdong,indicating the first and second class clusters were mainly distributed near the bordering adjacent districts and counties among the provinces.Conclusion In 2015,the prevalence rates of typhoid fever and paratyphoid fever were low,however with regional high prevalence areas.Cross regional transmission existed among provinces with high incidence rates which might be responsible for the clusters to appear in these areas.

7.
Chinese Journal of Epidemiology ; (12): 552-556, 2014.
Article in Chinese | WPRIM | ID: wpr-737369

ABSTRACT

Objective This study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever,in Guizhou province,from 2007 to 2012, to provide evidence for the improvement of related programs. Methods Data on typhoid fever and paratyphoid including information on epidemics,individual,cases,measures for prevention and control programs taken and relative government documents were collected and analyzed in Guizhou province,from 2007 to 2012. Information related to the average annual incidence,nature of outbreaks, time span before confirmed diagnosis was made,unit which carried the case report,proportion of laboratory confirmed diagnosed cases and case-management were compared between 2007-2009 and 2010-2012 descriptively while chi-square test with Excelland EpiInfo software were used for data analysis. Results In the period of 2007-2009,a total of 5 978 typhoid fever and paratyphoid fever cases were reported in Guizhou province with the average yearly incidence as 5.29/100 000. In the period of 2010-2012,2 765 cases were reported with the average yearly incidence as 2.57/100 000. When compared to the former,data from the latter period showed that the average yearly incidence had declined 51.31% in all the prefectures. There were still some outbreaks appeared but the total number of cases involved reduced 87.50%. The time span before the confirmation of diagnosis became shorter but the difference was not statistically significant (χ 2=0.08,P=0.99). Number of cases reported by hospitals at county or above had 11.51% of increase while those cases reported at the township hospitals or below decreased for 61.47%. The proportion of laboratory diagnosed cases increased 23.63%. Rates of timeliness on cards being filled in,inputted and audited showed increase of 8.44%,6.76%and 2.40%respectively. Conclusion Successful measures for prevention and control on typhoid fever and paratyphoid fever had been remarkably taken in Guizhou province,but the potential risk of outbreaks still existed in some areas,suggesting that health education and surveillance programs including laboratory diagnosis,should be strengthened.

8.
Chinese Journal of Epidemiology ; (12): 552-556, 2014.
Article in Chinese | WPRIM | ID: wpr-735901

ABSTRACT

Objective This study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever,in Guizhou province,from 2007 to 2012, to provide evidence for the improvement of related programs. Methods Data on typhoid fever and paratyphoid including information on epidemics,individual,cases,measures for prevention and control programs taken and relative government documents were collected and analyzed in Guizhou province,from 2007 to 2012. Information related to the average annual incidence,nature of outbreaks, time span before confirmed diagnosis was made,unit which carried the case report,proportion of laboratory confirmed diagnosed cases and case-management were compared between 2007-2009 and 2010-2012 descriptively while chi-square test with Excelland EpiInfo software were used for data analysis. Results In the period of 2007-2009,a total of 5 978 typhoid fever and paratyphoid fever cases were reported in Guizhou province with the average yearly incidence as 5.29/100 000. In the period of 2010-2012,2 765 cases were reported with the average yearly incidence as 2.57/100 000. When compared to the former,data from the latter period showed that the average yearly incidence had declined 51.31% in all the prefectures. There were still some outbreaks appeared but the total number of cases involved reduced 87.50%. The time span before the confirmation of diagnosis became shorter but the difference was not statistically significant (χ 2=0.08,P=0.99). Number of cases reported by hospitals at county or above had 11.51% of increase while those cases reported at the township hospitals or below decreased for 61.47%. The proportion of laboratory diagnosed cases increased 23.63%. Rates of timeliness on cards being filled in,inputted and audited showed increase of 8.44%,6.76%and 2.40%respectively. Conclusion Successful measures for prevention and control on typhoid fever and paratyphoid fever had been remarkably taken in Guizhou province,but the potential risk of outbreaks still existed in some areas,suggesting that health education and surveillance programs including laboratory diagnosis,should be strengthened.

9.
Chinese Journal of Epidemiology ; (12): 1183-1188, 2013.
Article in Chinese | WPRIM | ID: wpr-321695

ABSTRACT

Objective Through analyzing the national statutory reporting data on typhoid,paratyphoid fever in 2012,we were trying to understand the whole picture of typhoid,paratyphoid fever at the national level as well as to understand the trends and characteristics of typhoid and paratyphoid fever in provinces with high incidence rate,so as to the development of prevention and control strategies of the diseases in those high-incidence rate provinces.Methods We descriptively analyzed the national typhoid and paratyphoid fever statutory reporting data which was reported through disease surveillance information reporting system in 2012.Results 11 998 cases with typhoid and paratyphoid fever were reported with 3 fatal ones,in 2012 in the whole country.The incidence rate was 0.89 per 100 000.Compared to the data gathered in 2011,the incidence rates of typhoid/paratyphoid fever increased by 1.20%.The total number of the confirmed cases on typhoid and paratyphoid fever was 6522 and was accounted for 54.36% of the total cases,in which paratyphoid fever accounted for 36.86%.Cases were mainly involved farmers and followed by students and children.Incidence rates of typhoid and paratyphoid fever in children aged 0-4 years old appeared the highest (respectively 1.31/100 000 and 0.46/100 000).Yunnan,Guizhou,Guangdong,Guangxi,Zhejiang,Hunan and Xinjiang provinces (autonomous regions) were identified as provinces with high-incidence rates of typhoid and paratyphoid fever.During 2005-2012,the incidence rates in most of the above high-incidence provinces showed a downward trend,except for in Guangdong which had only showed a slight change.There were variations on peak period and highly-hit population in seven high-incidence provinces.Conclusion The incidence rate of typhoid/paratyphoid fever was in a relatively low level in China.Prevention and control strategies on the diseases in children under 5 years old remained a challenge,warranted more work to be done.The epidemiological situation is still severe in some high-incidence rate provinces.

10.
Chinese Journal of Epidemiology ; (12): 796-799, 2011.
Article in Chinese | WPRIM | ID: wpr-241212

ABSTRACT

Objective To evaluate the burden of paratyphoid fever A in Hongta district, Yuxi city, Yunnan province from May 1, 2008 to April 30, 2009 so as to provide information for the development of comprehensive intervention measures. Methods Based on the Fever Syndromic Surveillance System, information as attendance rate of patients with fever, rate of patients being sampled, laboratory testing rate, sensitivity on the detection of blood culture and the rate of case reporting etc. were calculated. According to the pyramid model of food-borne disease on disease burden, the local actual incidence of paratyphoid fever A was estimated and analyzed. Results Under the Fever Syndromic Surveillance System, there were 6642 fever cases being detected, among whom 6570 cases were sampled and undergone testing, with the sampling rate as 98.92% and all the samples received laboratory testing. There were 354 positive cases of paratyphoid fever A reported,all from the Hongta district. Data showed that the attendance rate of the feverish patients was 73.53%,with the highest rate seen in whose under 10 years old (100%). Assumed that the sensitivity of paratyphoid fever blood culture was 70%, and the case reporting rate was 90%, we estimated that the annual incidence of paratyphoid fever A in Hongta was 220.33 (95% CI: 170.1-521.4) per 100 thousand, with 965 (95%CI: 745-2284) as new cases. Among all the age groups, the incidence in the age group from 15 to 44 years old was estimated to be at the highest (318.27 per 100 thousand).Conclusion Hongta seemed to be an endemic region for paratyphoid fever A, with the highest incidence occurred in the age group of between 15 and 44 years old. These findings highlighted the urgent need to carry out further investigation on the risk factors and to implement targeted effective prevention and control measures.

11.
Chinese Journal of Epidemiology ; (12): 485-489, 2011.
Article in Chinese | WPRIM | ID: wpr-273159

ABSTRACT

Objective To characterize the spatial distribution of typhoid and paratyphoid fever(TPF)in Yunnan province, China and to determine the effectiveness of meteorological factors on the epidemics of TPE Methods Data of reported TPF cases in Yunnan province(2001 -2007)from the China Information System for Diseases Control and Prevention was applied to GIS-based spatial analyses to detect their spatial distribution and clustering of TPF incidence at the county level.Panel data analysis was used to identify the relationships between the TPF incidence and meteorological factors including monthly average temperature, monthly cumulative precipitation and monthly average relative humidity. Results During the study period, the average incidence of TPF in Yunnan province was 23.11/100 000, with majority of the TPF cases emerged in summer and autumn. Although widely distributed, two TPF clusters were detected in Yunnan province based on the spatial analysis:one area around Yuxi city with the average annual incidence as 207.45/100 000 and another at the junctions of Yunnan province with Burma and Laos. Based on results from panel data analysis, the incidence of TFP was shown to be associated with meteorological factors such as temperature,precipitation, relative humidity and one month lag of temperature increase [10 ℃ increase in the monthly average temperature:IRR=1.30(95%CI: 1.24-1.36);10% increase in monthly average relative humidity:IRR= 1.07(95%CI: 1.05-1.09); 100 mm rise in monthly cumulative precipitation:IRR=1.02(95%CI: 1.00-1.03); and 10 ℃ average temperature increase, the last month: IRR=1.73(95%CI: 1.64-1.82)]. Conclusion Areas with high TPF incidence were detected in this study,which indicated the key areas for TPF control in Yunnan province. Meteorological factors such as temperature, precipitation and humidity played a role in the incidence of TPF.

12.
Braz. j. microbiol ; 41(2): 283-285, Apr.-June 2010. ilus
Article in English | LILACS | ID: lil-545330

ABSTRACT

The yield and speed of detection of Salmonella enterica serotype Paratyphi A from the blood of patients with suspected paratyphoid fever A in 13 500 paired aerobic and anaerobic bottles (AEB, ANB) that were each filled with 5 ml of blood by the BacT/ALERT 3D system were compared, and the blood bacterial counts of 1 000 probable patients were estimated by pour plate method. A total of 4 060 isolates were recovered, of these, 3 149 were recovered from both AEB and ANB, 461 from the AEB only, and 450 from the ANB only. The estimating median bacterial count in blood from 400 patients was 0.5 CFU/ml. The research findings demonstrate that the blood volume drawn is an important factor determining the yields from blood cultures. Growth of significantly more isolates was detected earlier in AEB.


Subject(s)
Humans , Blood Chemical Analysis , Paratyphoid Fever/diagnosis , Salmonella Infections , Salmonella enterica/isolation & purification , Culture Techniques , Virulence
13.
Chinese Journal of Epidemiology ; (12): 252-256, 2009.
Article in Chinese | WPRIM | ID: wpr-329482

ABSTRACT

Objective To study the epidemiological and etiological characteristics of typhoid and paratyphoid fever in high epidemic areas. Methods Reported data on typhoid and paratyphoid fever during 1988- 2007 in Ningbo were analyzed epidemiologically. Shellfish from the market was collected for laboratory testing and ,Salmonella typhi strains collected from the patients were also studied. Results Number of reported cases on both typhoid and paratyphoid fever was 19 404 with 7 deaths, from 1988 to 2007. The annual mean incidence was 17.68 per one hundred thousand with the fatality rate as 0.36 per thousand. Most cases were among adults aged 20-50 years and an obvious regional distribution was observed with high incidence seen in winter and spring. Since 1990s, the advantage strain had changed from Salmonella typhi to Salmonella paratyphi A. Etiologic studies showed that raw Anadara subcrenata and oyster were the main risk factors. One Salmonella paratyphi A strain was detected in both Anadara subcrenata and oysters collected from the market, which contained TEM-1 drug resistance gene. PFGE genotyping showed that PFGE-X2 was the strain which causing pandemic in Ningbo. Conclusion Eating contaminated raw shellfish like oysters and hairy clams was the primary risk factor, responsible for the outbreaks. Salmonella paratyphi A was the advantages pandemic strain in Ningbo. Strategies as supervision on personal hygiene and health education should be strengthened.

14.
Chinese Journal of Laboratory Medicine ; (12): 543-546, 2009.
Article in Chinese | WPRIM | ID: wpr-380925

ABSTRACT

Objective To compare the yield and speed of detection of Salmonella subsp, enterica serotypo Paratyphi A from the blood of patients with suspected paratyphoid fever A. Methods With the BacT/ALERT 3D system and paired aerobic and anaerobic bottles (AEB, ANB) that were each filled with 5 ml of blood, the blood culture of 13 500 suspected paratyphoid fever A patients were performed. Results A total of 4 060 isolates were detected. About 3 149 were detected from both AEB and ANB. Four hundred and sixty-one isolates were detected only from the AEB and 450 were only from the ANB. The detection rates of the AEB and ANB were all 26.7% (χ<'2>=0.023, P=0.880). The increased detection rate attributed to the additional blood volume in the AEB and ANB were 11.3% and 11.1%, respectively. The detection speed differed between the two medium formulations. The time to detection was (23.66±15.89) h and (25.48±16.92) h for3 149 isolates, respectively (t=7.007, P<0.01).The mean time to detection was 31.80±20. 97 for 461 isolates discovered with AEB and (33.45±20.72) h for 450 isolates discovered with ANB. Conclusion The blood volume is an important factor in determining the detection rate of blood culture. Although no statistical difference for positive rate was found between the AEB and ANB, more isolates was detected earlier in AEB.

15.
Chinese Journal of Emergency Medicine ; (12)2006.
Article in Chinese | WPRIM | ID: wpr-574527

ABSTRACT

Objective To study the clinical characteristics,diagnosis,and treatment of paratyphoid fever A (fever A) complicated with severe kidney damage. Methods The data were retrospectively reviewed.Results The symptoms of poisoning and gastrointestinal symptoms as well as the slightly abnormal urinalysis (proteinuria, hematuria) appeared early, which got worse along with the progression of the disease. The symptoms of urinary system and azotemia appeared in the worst period. After treatment with antibiotic, 4 patients recovered early.Conclusion Paratyphoid fever A can cause severe kidney damage, with non-specific symptoms at the early stage. The seriousness of the abnormal of urine test can't be ignored as those provides the basis for the early diagnosis. The early use of antibiotic is the key to avoid and lessen the serverity of kidney damage.

16.
Korean Journal of Clinical Pathology ; : 215-221, 1999.
Article in Korean | WPRIM | ID: wpr-195443

ABSTRACT

BACKGROUND: Widal test has been one of the most important diagnostic tests for typhoid and is still widely used. Widal test has been useful diagnostic tool for typhoid in endemic areas, while it has been largely abandoned in developed countries. Since 1990, occurrance of typhoid has been markedly decreased in Korea, we studied diagnostic usefulness and criteria of Widal test from 1990 to 1997. METHODS: Using rapid slide titration method (Stained Salmonella suspensions, Murex Biotech Ltd., Dartford, England), the Widal test was done in 116 nontyphoid salmonellosis patients, 75 patients with proven typhoid fever, and 173 cases of clinically suspected typhoid fever patients. Stastical analysis was done with discriminant analysis in culture proven salmonellosis. RESULTS: Fifty-four culture proven cases of Salmonella paratyphi (S. paratyphi) A and S. paratyphi B showed no significant cutoff value in O antibodies. Salmonella typhi (S. typhi) O titer at the 1:160 and above showed lower sensitivity (37.3% vs. 69.3%) and specificity (91.4% vs. 93.1%) compared to S. typhi H titer at the 1:320 and above in diagnosis of culture proven cases of typhoid. We applied D (0.01xH titer+0.001xO titer-1.635) score which result from discriminant analysis. Positive D score (> or =0.21) showed sensitivity of 72% and specificity of 92.2% in culture proven cases of typhoid. In clinically suspected patients, positive D score showed 39.3% of sensitivity. CONCLUSIONS: We concluded that the Widal test for O antibodies of S. paratyphi A and S. paratyphi B is not useful for diagnosis of paratyphoid fever. In the present study S. typhi H antibodies are more diagnostic than S. typhi O antibodies. We appled D score and positive D score showed increased sensitivity of Widal test than application of O antibody titer.


Subject(s)
Humans , Antibodies , Developed Countries , Diagnosis , Diagnostic Tests, Routine , Korea , Paratyphoid Fever , Salmonella , Salmonella Infections , Salmonella paratyphi A , Salmonella typhi , Sensitivity and Specificity , Suspensions , Typhoid Fever
17.
Journal of Chongqing Medical University ; (12)1987.
Article in Chinese | WPRIM | ID: wpr-573188

ABSTRACT

Objective:To investigate the clinical features of typhoid fever and paratyphoid fever in Chongqing.Methods:A retrospective study was designed to analyze 78 cases of typhoid fever and paratyphoid fever from 1999 to 2003.Results:The proportion of typhoid fever was decreased,but the proportion of paratyphoid fever rose from 20% in 1999 to 55.6% in 2003.The clinical manifestations included fever,relative bradycardia,hepatosplenomegaly,leukopenia and diarrhea,infrequently as roseola and indifferent expressions.The complications mostly manifested as toxic hepatitis and bronchopneumonia.Typhoid fever and paratyphoid fever were sensitive to fluoro -quinolones and the third generation cephalothins.Conclusion:In recent years proportion of paratyphoid fever tend to rise.Fluoro-quinolones still remain the drug of choice for the treatment of typhoid and paratyphoid fever.

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