{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T03:39:45Z","timestamp":1778816385295,"version":"3.51.4"},"reference-count":41,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3_Suppl","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,9,6]]},"abstract":"<jats:p>From 1975 to 1983, a large epidemic of typhoid fever (TF) affected the metropolitan region (MR) of Chile (incidence rate [IR] of 219.6 per 10<jats:sup>5<\/jats:sup> in 1983). In 1983\u20131984, interventions were implemented focusing on person-to-person transmission (vaccination, food handlers\u2019 control, and mass communication) and regulations to control irrigation waters containing fecal contaminates. In 1991, a second intervention was quickly implemented to avoid the cholera epidemic affecting neighboring countries (total prohibition of growing or selling crops in the MR). We explored the potential impact of these interventions on the epidemic. We created a yearly database of the MR TF cases, population, and contextual factors of TF from 1969 to 2012. We first analyzed the epidemic (Joinpoint regression), identified predictors of TF (Poisson multiple regression), and then analyzed the effect of the interventions (interrupted time series model). The main predictor of the TF epidemic was the rate of unemployment. In relation to the 1983\u20131984 person-to-person interventions, TF came down by 51% (95% confidence interval [CI]: 30.2\u201365.0%) and continued to decrease at a rate of 10.4% (95% CI: 5.8\u201315.6%) per year until 1991. In 1991, with the strong environmental control of the sewage-irrigated crops, TF further decreased by 77% (95% CI: 69.0\u201383.1%) and continued decreasing thereafter at 13% (95% CI: 11.3\u201315.6%) per year until the end of the study period. Today, 40 years after the epidemic, TF is a rare disease in the MR of Chile.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0125","type":"journal-article","created":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T07:00:26Z","timestamp":1532588426000},"page":"26-33","source":"Crossref","is-referenced-by-count":16,"title":["Typhoid Fever in Chile 1969\u20132012: Analysis of an Epidemic and Its Control"],"prefix":"10.4269","volume":"99","author":[{"given":"Claudia","family":"Marco","sequence":"first","affiliation":[{"name":"Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iris","family":"Delgado","sequence":"additional","affiliation":[{"name":"Centro de Pol\u00edticas P\u00fablicas, Faculty of Medicine, Universidad del Desarrollo, Santiago, Chile;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Vargas","sequence":"additional","affiliation":[{"name":"Departamento de Matem\u00e1tica y Ciencia de la Computaci\u00f3n USACH, Santiago, Chile;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ximena","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Secretar\u00eda Regional Ministerial de Salud de Arica y Parinacota, Arica, Chile;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zulfiqar A.","family":"Bhutta","sequence":"additional","affiliation":[{"name":"Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada;"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Canada;"},{"name":"Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catterina","family":"Ferreccio","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Pontificia Universidad Cat\u00f3lica de Chile, Santiago, Chile;"},{"name":"Advanced Center for Chronic Diseases, ACCDiS, Pontificia Universidad Cat\u00f3lica de Chile. Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Rev Chilena Infectol","first-page":"435","article-title":"Fiebre tifoidea: emergencia, c\u00faspide y declinaci\u00f3n de una enfermedad infecciosa en Chile","volume":"24","author":"Enrique","year":"2007"},{"key":"b2","series-title":"Rev Med Chil","first-page":"606","article-title":"Fiebre tifoidea en Chile: consideraciones epidemiol\u00f3gicas","volume":"111","author":"Ernesto","year":"1983"},{"key":"b3","series-title":"Cuad Econ","first-page":"31","article-title":"Desarrollo socioecon\u00f3mico de Chile: un an\u00e1lisis comparativo para Am\u00e9rica del Sur","volume":"27","author":"Ricardo","year":"1990"},{"key":"b4","series-title":"Bolet\u00edn de Vigilancia Epidemiol\u00f3gica","first-page":"8\u201311","article-title":"Epidemiologia de la fiebre tifoidea en Chile","volume":"8","author":"Ristori","year":"1981"},{"key":"b5","author":"Superintendencia de Servicios Sanitarios (SISS)","year":"2015"},{"key":"b6","series-title":"Rev Med Chil","first-page":"826","article-title":"Epidemia de fiebre tifoidea en Chile; aspectos ecologicos y microbiologicos","volume":"112","author":"Cabello","year":"1984"},{"key":"b7","series-title":"Rev Med Chil","first-page":"474","article-title":"Typhoid fever in Chile 1977\u20131990: an emergent disease [in Spanish]","volume":"125","author":"Cabello","year":"1997"},{"key":"b8","series-title":"J Infect Dis","first-page":"640","article-title":"The use of Moore swabs for isolation of Salmonella typhi from irrigation water in Santiago, Chile","volume":"149","author":"Sears","year":"1984"},{"key":"b9","author":"Ferreccio","year":"1993"},{"key":"b10","author":"Levine","year":"1985"},{"key":"b11","author":"Ministerio de Salud P\u00fablica","year":"1983"},{"key":"b12","series-title":"Rev Med Chil","first-page":"943","article-title":"Epidemic of cholera in Chile; 1991 [in Spanish]","volume":"119","author":"Medina","year":"1991"},{"key":"b13","series-title":"Rev Chilena Infectol","first-page":"407","article-title":"Estrategias para el enfrentamiento del c\u00f3lera: la experiencia chilena desde una perspectiva de salud p\u00fablica","volume":"27","author":"Valenzuela","year":"2010"},{"key":"b14","series-title":"Int J Epidemiol","first-page":"348","article-title":"Interrupted time series regression for the evaluation of public health interventions: a tutorial","volume":"46","author":"Lopez","year":"2017"},{"key":"b15","author":"Instituto Nacional de Estad\u00edsticas"},{"key":"b16","author":"Ministerio de Salud, Departamento de Estad\u00edsticas e Informaci\u00f3n de Salud","year":"2016"},{"key":"b17","author":"Superintendencia de Servicios Sanitarios"},{"key":"b18","author":"Hederra","year":"2015"},{"key":"b19","author":"Andinas","year":"2005"},{"key":"b20","author":"Oficina de Estudios y Pol\u00edticas Agrarias (ODEPA)","year":"2001"},{"key":"b21","author":"Ministerio de Agricultura, Oficina de Planificaci\u00f3n Agr\u00edcola, Oficina de Estudios y Pol\u00edticas Agrarias (ODEPA)","year":"1976"},{"key":"b22","author":"Ministerio de Agricultura, Oficina de Planificaci\u00f3n Agr\u00edcola, Oficina de Estudios y Pol\u00edticas Agrarias (ODEPA)","year":"1988"},{"key":"b23","author":"Banco Central de Chile","year":"2016"},{"key":"b24","author":"WorldBank"},{"key":"b25","author":"Direcci\u00f3n de Presupuestos, Gobierno de Chile"},{"key":"b26","author":"Mritunjay","year":"2014"},{"key":"b27","author":"Joinpoint Regression Program","year":"2017"},{"key":"b28","author":"Szklo","year":"2007"},{"key":"b29","series-title":"J Econom","first-page":"347","article-title":"Regression-based tests for overdispersion in the Poisson model","volume":"46","author":"Colin","year":"1990"},{"key":"b30","author":"Agresti","year":"2007"},{"key":"b31","author":"R Foundation for Statistical Computing","year":"2013"},{"key":"b32","series-title":"Demography","first-page":"1","article-title":"The role of public health improvements in health advances: the twentieth-century United States","volume":"42","author":"Cutler","year":"2005"},{"key":"b33","author":"Ferreccio","year":"1995"},{"key":"b34","series-title":"Rev Chilena Infectol","first-page":"5","article-title":"Cambios del perfil de morbilidad en algunas patolog\u00edas de transmisi\u00f3n ent\u00e9rica con posterioridad a un brote de c\u00f3lera. 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Evolution and current status of the Endemia [in Spanish]","volume":"13","author":"Romero","year":"1951"},{"key":"b41","series-title":"Trans R Soc Trop Med Hyg","first-page":"679","article-title":"Typhoid transmission: a historical perspective on mathematical model development","volume":"109","author":"Bakach","year":"2015"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/99\/3_Suppl\/article-p26.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/99\/3_Suppl\/article-p26.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/99\/3_Suppl\/article-p26.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T19:54:28Z","timestamp":1722455668000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/99\/3_Suppl\/article-p26.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,6]]},"references-count":41,"journal-issue":{"issue":"3_Suppl"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.18-0125","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,6]]}}}