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Factores de riesgo para la fiebre tifoidea y paratifoidea en Yakarta, Indonesia
Albert M Vollaard1, Soegianto Ali, Henri A G H van Asten
1Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
JAMA
|June 3, 2004
Resumen
Los factores de riesgo de la fiebre tifoidea incluyen problemas domésticos como la mala higiene y los platos compartidos, mientras que la fiebre paratifoidea está vinculada a factores externos como el consumo de alimentos callejeros y las inundaciones en áreas endémicas.
Área de la Ciencia:
- Enfermedades infecciosas Enfermedades infecciosas.
- Epidemiología La epidemiología.
- Salud Pública La salud pública.
Sus antecedentes:
- La urbanización y la dependencia de la comida callejera pueden alterar la incidencia de la fiebre paratifoidea en relación con la fiebre tifoidea.
- Se necesitan estrategias de contención distintas para las fiebres paratifoidea y tifoidea debido a los diferentes factores de riesgo y la ineficacia de la vacuna.
- Comprender las rutas de transmisión es crucial para un control eficaz de la enfermedad.
Objetivo del estudio:
- Identificar y comparar los factores de riesgo asociados con fiebres tifoides y paratifoides en un entorno urbano endémico.
- Informar las intervenciones de salud pública específicas para estas enfermedades entéricas.
Principales métodos:
- Un estudio de caso-control basado en la comunidad se llevó a cabo en Yakarta, Indonesia.
- Se analizaron 1019 pacientes con fiebre prolongada, incluidos casos confirmados de Salmonella typhi (tifoidea) y Salmonella paratyphi A (paratífoidea), junto con controles de fiebre y de la comunidad.
- Los factores de riesgo se evaluaron a través de entrevistas y análisis estadístico (ratios de probabilidad e intervalos de confianza).
Principales resultados:
- La fiebre paratifoidea se asoció con el consumo de comida callejera (OR 3.34-5.17) y las inundaciones (OR 3.25-4.52).
- Los factores de riesgo de fiebre tifoidea incluyen problemas relacionados con el hogar: casos recientes de fiebre tifoidea (OR 2.38), lavado de manos infrecuente (OR 1.91), compartir platos (OR 1.93) y falta de baños domésticos (OR 2.20).
- La fiebre tifoidea también se relacionó con la edad más joven (OR 0,96), el consumo de cubitos de hielo (OR 2,27) y el sexo femenino (OR 1,79).
Conclusiones:
- Las fiebres tifoidea y paratifoidea en Yakarta exhiben patrones de transmisión distintos.
- La fiebre tifoidea se asocia principalmente con las rutas de transmisión dentro del hogar.
- La fiebre paratifoidea está predominantemente relacionada con rutas de transmisión fuera del hogar, como alimentos contaminados y fuentes de agua fuera del hogar.
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