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| 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
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.
| 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
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| 3 | Vargas, Claudio | Hombre |
Universidad de Santiago de Chile - Chile
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| 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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| Fuente |
|---|
| Bill & Melinda Gates Foundation |
| Bill and Melinda Gates Foundation |
| Centre for Global Child Health |
| Hospital for Sick Children |
| Agradecimiento |
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| 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. |