Typhoid review, Enga Province, from 1986 to 1991.

A typhoid epidemic in Enga Province between early 1986 and mid-1991 is reviewed. Initially 849 cases (46.9/10000 population) were diagnosed clinically in 1986, to 2.7% in 1990, which can probably be explained by earlier diagnosis and over-diagnosing of cases as the epidemic progressed. The key factor in the transmission seems to have been a low level of personal hygiene with an increased transmission risk during public gatherings. Recommendations for the strengthening of the control program are made, based on improved diagnosis and patient management, health education about personal hygiene and the provision of public sanitary facilities.