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伤寒热的并发症和死亡率:更新的全球系统综述和元分析
Shruti Murthy1, Nienke N Hagedoorn1, Suzanne Faigan1
1Centre for International Health, University of Otago, Dunedin, New Zealand.
The Lancet. Infectious diseases
|November 15, 2025
概括
更新的估计显示显著的伤寒热 (Salmonella Typhi) 并发症和死亡率,特别是在非洲和亚洲. 这些数据为关键的预防和控制策略提供了信息,包括疫苗接种.
科学领域:
- 流行病学 流行病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 对于有效的预防和控制策略来说,更新的伤寒并发症和病例死亡率 (CFR) 估计是必不可少的.
- 之前的审查为国家层面的决策提供了信息,需要当代的发病率和死亡率数据.
研究的目的:
- 更新伤寒热和伤寒肠道穿孔 (TIP) 患病率和病例死亡率 (CFR) 的估计.
- 提供支持全球伤寒热病预防和控制工作的当代数据.
主要方法:
- 观察性研究和疫苗试验对照组的系统审查和元分析.
- 搜索了PubMed,科学网和预印档案库,从1980年到2025年对沙门氏菌 Typhi并发症和死亡率的研究.
- 综合并发症患病率,使用随机效应元分析汇总的CFR估计,以及按地区,环境和年龄分层的数据.
主要成果:
- Delirium/confusion 是最常见的并发症 (26.5%). 在1.7%的病例中发生了伤寒肠道穿孔 (TIP).
- 整体综合台风热病CFR为2.1%;在美洲 (2.9%),非洲 (4.7%) 和亚洲 (1.2%) 较高.
- 汇总的TIP CFR为16.3%. 在基于设施的环境和年轻年龄组中观察到更高的CFR.
结论:
- 非洲,亚洲,医疗机构设置以及各个年龄组中持续存在大量的伤寒发病率和死亡率.
- 更新的证据支持了针对台风的疫苗和非疫苗干预措施以及TIP预防和控制的决定.
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