TYPHOID-FEVER IN UJUNG-PANDANG, INDONESIA - HIGH-RISK GROUPS AND HIGH-RISK BEHAVIORS

We performed a hospital-based case-control study to identify high-risk groups and routes of transmission of typhoid fever in the city of Uju ng Pandang on the island of Sulawesi, Indonesia. The annual incidence of this disease in southern Sulawesi is estimated at 3.1/1000 and the case fatality at 5.1% Cases were 50 Farients over 13 years of age admi tted to Stella Maris Hospital with a diagnosis of typhoid fever betwee n June and September 1991 Diagnosis was made on clinical grounds and i n 90% of cases confirmed by a Widal test. Controls were 42 patients ad mitted for non-infectious disorders during the same period and individ ually matched by age and sex. Controls did not have a history of typho id fever. Interviews took place in hospital. Analysis was by unconditi onal logistic regression. High-risk groups consisted of those who were single, unemployed and those who had a university education. Median a ge of cases was 22 years. Consumption of food from warungs (food stall s in the street) was strongly associated with risk (OR = 45) Both case s and controls washed hands after use of the toilet and before meals, but cases used soap significantly less often (OR = 30) The results of this study can be used to take preventive measures against this severe disease of educated and single young adults by targetting them for IE C-activities emphasizing the importance of thorough hand-washing and t he need to take care in the selection of street-foods.