Abstract

The relationship between asymptomatic shedding of bacterial enteropathogens and the hygiene habits of families who have had a child with typhoid fever (TF) are investigated. The sample was made up of 80 families: 40 families in which one child had had TF (Group A) and 40 in which no children or either of the parents had had a history of TF (Group B). In each group 20 families belonged to a low socioeconomic status (SES) and 20 to a high SES. A structured interview was used to evaluate the SES and the hygiene habits of the child; observations were made to measure the hygiene habits of the family (toilet, kitchen and food preparation) and bacteriological studies (fecal samples and hand markers). Results show that carriers were more frequent in Group A than in Group B. The bacterial species found were significantly more numerous in Group A than in Group B (fecal samples: E. coli, the classic serotypes, Shigella ssp, and hand markers: E. coli). Families of Group A had higher carriage rates than those of Group B. Finally there exists a significantly higher association between inadequate hygiene habits and carrier families. These results show the need to teach specific habits of proper hygiene to the entire population, because the fact of belonging to the high SES does not in itself preclude inadequate hygiene habits.

Highlights

  • Typhoid fever (TF) has high incidence and prevalence in Chile,22,23,26 mainly in the Metropolitan Area (Santiago and surroundings) where it is endemic6,18,30,32

  • There exists a significantly higher association between inadequate hygiene habits and carrier families. These results show the need to teach specific habits of proper hygiene to the entire population, because the fact of belonging to the high socieconomic status (SES) does not in itself preclude inadequate hygiene habits

  • The sample was made up of 80 families: 40 families in which a child had had typhoid fever (TF) in the last 6 months (Group A); 20 families, of low socieconomic status (SES) and 20 of high SES were chosen as 40 families in whom no child nor either parent had had a history of TF since they had started living together (Group B controls)

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Summary

Introduction

Typhoid fever (TF) has high incidence and prevalence in Chile, mainly in the Metropolitan Area (Santiago and surroundings) where it is endemic. In 1986, the incidence of TF in this country was 58.6 x 105 and of this 52.08 corresponded to the Metropolitan Area. In 1986, the incidence of TF in this country was 58.6 x 105 and of this 52.08 corresponded to the Metropolitan Area24 This high rate has been attributed to the consumption of contaminated drinking water and food stuffs or to differences in the virulence of SALMONELLA typhi in some regions. Transmission of the disease occurs through the fecal-oral cycle, as in acute diarrhoea. In family studies on this latter condition, a high rate of asymptomatic carriers in Santiago has been demonstrated, which has been interpreted as a consequence of the high microbiological contamination of the environment. Studies of carriers are seldom made because of their high costand the difficulty in obtaining fecal specimens

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