Enteric fever burden in North Jakarta, Indonesia: a prospective, community-based study.
BACKGROUND
We undertook a prospective community-based study in North Jakarta, Indonesia, to determine the incidence, clinical characteristics, seasonality, etiologic agent, and antimicrobial susceptibility pattern of enteric fever.


METHODS
Following a census, treatment centre-based surveillance for febrile illness was conducted for two-years. Clinical data and a blood culture were obtained from each patient.


RESULTS
In a population of 160,261, we detected 296 laboratory-confirmed enteric fever cases during the surveillance period, of which 221 (75%) were typhoid fever and 75 (25%)  were paratyphoid fever.  The overall incidence of typhoid and paratyphoid cases was 1.4, and 0.5 per thousand populations per year, respectively. Although the incidence of febrile episodes evaluated was highest among children under 5 years of age at 92.6 per thousand persons per year, we found that the burden of typhoid fever was greatest among children between 5 and 20 years of age. Paratyphoid fever occurred most commonly in children and was infrequent in adults.


CONCLUSIONS
Enteric fever is a public health problem in North Jakarta with a substantial proportion due to paratyphoid fever. The results highlight the need for control strategies against enteric fever.
U.S. Naval Medical Research Unit No. 2, Jakarta, Indonesia. narain.punjabi@internationalsos.com.
Narain H
NH
Punjabi
Magdarina D
MD
Agtini
R Leon
RL
Ochiai
Cyrus H
CH
Simanjuntak
Murad
M
Lesmana
Decy
D
Subekti
Buhari A
BA
Oyofo
Lorenz
L
von Seidlein
Jacqueline
J
Deen
Seonghye
S
Shin
Camilo
C
Acosta
Ferry
F
Wangsasaputra
Sri P
SP
Pulungsih
Santoso
S
Saroso
Suyeti
S
Suyeti
Suharno
S
R
Pratiwi
P
Sudarmono
Agus
A
Syarurachman
Agus
A
Suwandono
Sumarjati
S
Arjoso
H James
HJ
Beecham
Andrew L
AL
Corwin
John D
JD
Clemens
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011446:Prospective Studies; D012482:Salmonella paratyphi A / Q000187:drug effects / Q000302:isolation & purification*; D012485:Salmonella typhi / Q000187:drug effects / Q000302:isolation & purification*; D012621:Seasons; D014435:Typhoid Fever / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology; D055815:Young Adult
D000900:Anti-Bacterial Agents