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Typhoid Fever in Chile 1969-2012: Analysis of an Epidemic and Its Control
Indexado
WoS WOS:000452392500005
Scopus SCOPUS_ID:85053848483
DOI 10.4269/AJTMH.18-0125
Año 2018
Tipo artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



From 1975 to 1983, a large epidemic of typhoid fever (TF) affected the metropolitan region (MR) of Chile (incidence rate [IR] of 219.6 per 10(5) in 1983). In 1983-1984, interventions were implemented focusing on person-to-person transmission (vaccination, food handlers' control, and mass communication) and regulations to control irrigation waters containing fecal contaminates. In 1991, a second intervention was quickly implemented to avoid the cholera epidemic affecting neighboring countries (total prohibition of growing or selling crops in the MR). We explored the potential impact of these interventions on the epidemic. We created a yearly database of the MRTF cases, population, and contextual factors of TF from 1969 to 2012. We first analyzed the epidemic (Joinpoint regression), identified predictors of TF (Poisson multiple regression), and then analyzed the effect of the interventions (interrupted time series model). The main predictor of the TF epidemic was the rate of unemployment. In relation to the 1983-1984 person-to-person interventions, TF came down by 51%(95% confidence interval [CI]: 30.2-65.0%) and continued to decrease at a rate of 10.4% (95% CI: 5.8-15.6%) per year until 1991. In 1991, with the strong environmental control of the sewage-irrigated crops, TF further decreased by 77% (95% CI: 69.-83.1%) and continued decreasing thereafter at 13% (95% CI: 11.3-15.6%) per year until the end of the study period. Today, 40 years after the epidemic, TF is a rare disease in the MR of Chile.

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Disciplinas de Investigación



WOS
Public, Environmental & Occupational Health
Tropical Medicine
Scopus
Sin Disciplinas
SciELO
Sin Disciplinas

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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 Marco, Claudia Mujer Pontificia Universidad Católica de Chile - Chile
Escuela de Medicina - Chile
2 DELGADO-BECERRA, OROZIMBA IRIS Mujer Universidad del Desarrollo - Chile
3 Vargas, Claudio Hombre Universidad de Santiago de Chile - Chile
4 MUNOZ-URBINA, XIMENA Mujer Secretaria Reg Ministerial Salud Arica & Parinaco - Chile
Secretaría Regional Ministerial de Salud de Arica y Parinacota - Chile
5 Kennedy, Stephen H. Hombre Hosp Sick Children - Canadá
UNIV TORONTO - Canadá
Aga Khan Univ - Pakistán
Hospital for Sick Children University of Toronto - Canadá
University of Toronto - Canadá
The Aga Khan University - Pakistán
6 Ferreccio, Catterina - Pontificia Universidad Católica de Chile - Chile

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Financiamiento



Fuente
Bill & Melinda Gates Foundation
Bill and Melinda Gates Foundation
Centre for Global Child Health
Hospital for Sick Children

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Agradecimientos



Agradecimiento
This country case study was supported by a sub-grant from the Centre for Global Child Health. Funding for the parent study (Grant #OPP1126230, Principal Investigator Zulfiqar A. Bhutta) to the Centre for Global Child Health, Hospital for Sick Children Toronto, was provided by the Bill & Melinda Gates Foundation (https://www.gatesfoundation.org/).The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Financial support: This country case study was supported by a sub-grant from the Centre for Global Child Health. Funding for the parent study (Grant #OPP1126230, Principal Investigator Zulfiqar A. Bhutta) to the Centre for Global Child Health, Hospital for Sick Children Toronto, was provided by the Bill & Melinda Gates Foundation (https://www. gatesfoundation.org/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Muestra la fuente de financiamiento declarada en la publicación.