Abstract
IntroductionTyphoid fever is a systemic infection caused by a Gram negative bacterium, Salmonella typhi. Harare City reported 1078 cases of suspected typhoid fever cases from October 2011 to January 2012. We initiated an investigation to identify possible source of transmission so as to institute control measures.MethodsAn unmatched 1:1 case-control study was conducted. A questionnaire was administered to study participants to identify risk factors for contracting typhoid. A case was a resident of Dzivaresekwa who presented with signs and symptoms of typhoid between October and December 2011. Water samples were collected for microbiological analysis.Results115 cases and 115 controls were enrolled. Drinking water from a well (OR= 6.2 95% CI (2.01-18.7)), attending a gathering (OR= 11.3 95% CI (4.3-29.95)), boiling drinking water (OR= 0.21 95% CI (0.06-0.76)) and burst sewer pipe at home (OR= 1.19 95% CI (0.67-2.14)) were factors associated with contracting typhoid. Independent risk factors for contracting typhoid were drinking water from a well (AOR = 5.8; 95% CI (1.90-17.78)), and burst sewer pipe at home (AOR = 1.20; 95% CI (1.10-2.19)). Faecal coli forms and E. coli were isolated from 8/8 well water samples. Stool, urine and blood specimens were cultured and serotyped for Salmonella typhi and 24 cases were confirmed positive. Shigella, Giardia and E coli were also isolated. Ciprofloxacin, X-pen and Rocephin were used for case management. No complications were reported.ConclusionContaminated water from unprotected water sources was the probable source of the outbreak. Harare City Engineer must invest in repairing water and sewage reticulation systems in the city.
Highlights
Typhoid fever is a systemic infection caused by a Gram negative bacterium, Salmonella typhi
Typhoid fever is a life-threatening epidemic prone disease caused by a gram negative bacterium, Salmonella Typhi
Typhoid fever is spread from person to person through the fecal-oral route, by ingestion of food or water contaminated with faecal matter
Summary
Typhoid fever is a systemic infection caused by a Gram negative bacterium, Salmonella typhi. A questionnaire was administered to study participants to identify risk factors for contracting typhoid. Drinking water from a well (OR= 6.2 95% CI (2.01-18.7)), attending a gathering (OR= 11.3 95% CI (4.3-29.95)), boiling drinking water (OR= 0.21 95% CI (0.06-0.76)) and burst sewer pipe at home (OR= 1.19 95% CI (0.67-2.14)) were factors associated with contracting typhoid. Independent risk factors for contracting typhoid were drinking water from a well (AOR=5.8; 95% CI (1.90-17.78)), and burst sewer pipe at home (AOR=1.20; 95% CI (1.10-2.19)). Typhoid fever is a life-threatening epidemic prone disease caused by a gram negative bacterium, Salmonella Typhi Typhoid fever is spread from person to person through the fecal-oral route, by ingestion of food or water contaminated with faecal matter. The attack rate and incubation period are greatly influenced by the size of the innoculum and type of vehicle in which the food is ingested [1,2,3,4]
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