Characteristics and risk factors for typhoid fever after the tsunami, earthquake and under normal conditions in Indonesia

Agung Budi Sutiono,Toshizumi Ohta,Andri Qiantori,Hirohiko Suwa

doi:10.1186/1756-0500-3-106

Abstract

BackgroundAlthough typhoid transmitted by food and water is a common problem in daily life, its characteristics and risk factors may differ in disaster-affected areas, which reinforces the need for rapid public health intervention. Surveys were carried out post-tsunami in Banda Aceh, post-earthquake in Yogyakarta, and under normal conditions in Bandung, Indonesia. Logistic regression analysis was used to assess the risk factors with the dependent variable of typhoid fever, with or without complications.FindingsCharacteristic typhoid fever with complications was found in 5 patients (11.9%) affected by the tsunami in Aceh, 8 (20.5%) after the earthquake in Yogyakarta, and 13 (18.6%) in Bandung. After the tsunami in Aceh, clean water (OR = 0.05; 95%CI: 0.01-0.47) and drug availability (OR = 0.23; 95%CI: 0.02-2.43) are significant independent risk factors, while for the earthquake in Yogyakarta, contact with other typhoid patients (OR = 20.30; 95%CI: 1.93-213.02) and education (OR = 0.08; 95%CI: 0.01-0.98) were significant risk factors. Under normal conditions in Bandung, hand washing (OR = 0.07; 95%CI: 0.01-0.50) and education (OR = 0.08; 95%CI: 0.01-0.64) emerged as significant risk factors.ConclusionThe change in risk factors for typhoid complication after the tsunami in Aceh and the earthquake in Yogyakarta emphasizes the need for rapid public health intervention in natural disasters in Indonesia.

Highlights

Typhoid transmitted by food and water is a common problem in daily life, its characteristics and risk factors may differ in disaster-affected areas, which reinforces the need for rapid public health intervention
The change in risk factors for typhoid complication after the tsunami in Aceh and the earthquake in Yogyakarta emphasizes the need for rapid public health intervention in natural disasters in Indonesia
Variables definition We defined the independent variables based on a previous study, namely age, sex, educational level, clean water, hand washing, contact with other typhoid patients [15], and typhoid complications/no complications as dependent variables

Summary

Introduction

Typhoid transmitted by food and water is a common problem in daily life, its characteristics and risk factors may differ in disaster-affected areas, which reinforces the need for rapid public health intervention. On December 26, 2004, an earthquake that measured 9.0 on the Richter scale occurred 150 km off the coast of Sumatra-Indonesia in the Indian Ocean, and triggered a widespread tsunami that hit Aceh 45 minutes later and devastated an 800-km coastal strip. On May 27, 2006, an 5.9 on the Richter scale earthquake struck about 25 km south-southwest of Yogyakarta city, which affected 36,299 people, with 5782 fatalities, and caused damage to 135,000 homes [2,3]. Typhoid fever may cause serious complications after a disaster It is a water-borne disease due to contaminated S. typhi in human excreta and trans-

Methods

Results

Discussion

Conclusion