Research On Disease Burden Of Enteric Fever In Hongta District Yunnan Province

ObjectiveIn order to evaluate disease burden of enteric fever in Hongta districe, and provide references to establish the strategies to prevent and control enteric fever. A data analysis which collected form the fever syndrome surveillance was developed in 2009.Methods1. According to the WHO Surveillance Pyramid model, we built a probabilistic multiplier model that adjusts the count of laboratory-confirmed cases which collected from May 1,2008 to April 30,2009 by the surveillance. Each of the following steps had been invested:medical care seeking (A), specimen collection (B), submission of specimens for confirmation (C), laboratory detection of typhoid and paratyphoid (D), and reporting of confirmed cases (E) (Figure). This approach has been used to calculate the under recognized impact of enteric fever in Hongta.2. A questionnaire survey was carried out to collect the information of burden of paratyphoid cases in hongta. So we can calculate the local economic burden of paratyphoid.3. Total 119 patients in three hospitals were divided into two groups by whether resistanc drugs were used.Results1. Through April 30,2009, a total of 354 laboratory-confirmed infections with paratyphiod had been reported in Hongta. As estimated, the total infections of paratyphoid were 965, and the incidence was 220.33/100,000 per year (95%CI was 170.1-521.47/100,000 per year). The incidence was estimated to be highest in 15-44 years of age (318.27/100,000) and to be lowest in young children <5 years of age (18.12/100000).2. Direct economic burden of paratyphoid in Hongta is 2,197,222 RMB with 95%CI 1,662,960-5,075,070. Indirect economic burden is 229,230RMB (177,120-540,540). Economic burden of paratyphoid in Hongta is 2,426,452 RMB(1,871,953?5,742,502).3. There were 24 cases in drug resistance group and 95 cases in non-drug resistance group.12 of the cases were clindamycin resistance,7 were amoxicillin resistance,3 were ampicillin resistance,2 were ofloxacin resistance and 1 was cefotaxime resistance. The median days of hospitalization were 14 days in both groups. The median antibiotics costs were 1,241.96 and 1,365.02 in drug resistance and none-drug resistance group respectively. There were no significant differences between two groups(P>0.05) in days and costs of hospitalization. We concluded that drug resistance had no effect on the burden of paratyphoid in Hongta.Conclusions1. The incidence of paratyphoid was high (220.33 cases per 100,000 population per year) in Hongta.2. Economic burden of paratyphoid in Hongta is 2,426,452 RMB(1,871,953-5,742,502).3. Drug resistance had no effect on the economic burden of paratyphoid in Hongta.