EPIDEMIOLOGY AND RISK FACTORS FOR TYPHOID FEVER IN GOMBE METROPOLIS, GOMBE STATE, NIGERIA
DOI:
https://doi.org/10.37268/mjphm/vol.22/no.2/art.1656Keywords:
Nigeria, Occurrence, Recurrence, Risk Factors, TyphoidAbstract
There is limited data on typhoid in Gombe, Nigeria, despite the high prevalence of the disease in the area. A lack of epidemiological data has hampered efforts to control the disease. This study aims to identify factors associated with the increased risk of typhoid infection and recurrence in the Gombe metropolis. This study used simple random sampling, and data were collected from 663 consenting respondents using a validated questionnaire. Data were analysed using the Chi-square test to determine risk factors for typhoid occurrence and binomial logistic regression to determine factors for recurrence. Typhoid occurrences were significantly associated with vaccine hesitancy, having a houseboy or girl, not washing hands before handling food, low level of education, drinking unboiled water, eating commercially available foods or drinks, and having typhoid carrier at home. Respondents who were ‘not sure of being vaccinated’ (OR = 2.856, 95% CI 1.493-5.465), ‘do not have another typhoid patient at home’ (OR = 1.739, 95% CI 1.093-2.766), were more likely to have typhoid recurrences while those with ‘secondary school level education’ and ‘drank boiled water’ were less likely to have recurrences (OR = 0.480 95% CI: 0.234-0.982 and OR = 0.473, 95% CI: 0.266-0.842 respectively). These findings could be used as guidelines for future interventions against typhoid, maximising resource efficiency and improving the overall quality of life.
References
Masuet-Aumatell C, Atouguia J. Typhoid fever infection – antibiotic resistance and vaccination strategies: a narrative review. Travel Med Infect Dis. 2020;40:101946. doi:10.1016/j.tmaid.2020.101946.
Tahira M, Nawaz H, Majeed MI, et al. Surface-enhanced Raman spectroscopy analysis of serum samples of typhoid patients of different stages. Photodiagnosis Photodyn Ther. 2021;34:102329. doi:10.1016/j.pdpdt.2021.102329.
Ndako JA, Dojumo VT, Akinwumi JA, Fajobi VO, Owolabi AO, Olatinsu O. Changes in some haematological parameters in typhoid fever patients attending Landmark University Medical Center, Omuaran-Nigeria. Heliyon. 2020;6(5):e04002. doi:10.1016/j.heliyon.2020.e04002.
Bhan MK, Bahl R, Sazawal S, et al. Association between Helicobacter pylori Infection and Increased Risk of Typhoid Fever. J Infect Dis. 2002;186(12):1857-1860. doi:10.1086/345762.
Crump JA. Progress in Typhoid Fever Epidemiology. Clin Infect Dis. 2019;68(Supplement_1): S4-S9. doi:10.1093/cid/ciy846.
Antillón M, Warren JL, Crawford FW, et al. The burden of typhoid fever in low- and middle-income countries: A meta-regression approach. Carvalho MS, ed. PLoS Negl Trop Dis. 2017;11(2):e0005376. doi:10.1371/journal.pntd.0005376.
Manesh A, Meltzer E, Jin C, et al. Typhoid and paratyphoid fever: a clinical seminar. J Travel Med. 2021;28(3):1-13. doi:10.1093/JTM/TAAB012.
Paul UK, Bandyopadhyay A. Typhoid fever: a review. Int J Adv Med. 2017;4(2):300. doi:10.18203/2349-3933.ijam20171035.
Liu H, Whitehouse CA, Li B. Presence and Persistence of Salmonella in Water: The Impact on Microbial Quality of Water and Food Safety. Front public Heal. 2018;6:159. doi:10.3389/fpubh.2018.00159.
Ahmad S, Tsagkaris C, Aborode AT, et al. A skeleton in the closet: The implications of COVID-19 on XDR strain of typhoid in Pakistan. Public Heal Pract. 2021;2:100084. doi:10.1016/j.puhip.2021.100084.
Feng Y, Chen Y-C, Janapatla RP, et al. Genomic surveillance reveals international circulation and local transmission of Salmonella enterica serovars Typhi and Paratyphi A in Taiwan. J Microbiol Immunol Infect. Published online July 8, 2021. doi:10.1016/J.JMII.2021.06.004.
Stanaway JD, Reiner RC, Blacker BF, et al. The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Infect Dis. 2019;19(4):369-381. doi:10.1016/S1473-3099(18)30685-6.
Marchello CS, Hong CY, Crump JA. Global Typhoid Fever Incidence: A Systematic Review and Meta-analysis. Clin Infect Dis. 2019;68(Supplement_2):S105-S116. doi:10.1093/cid/ciy1094.
Obaro SK, Iroh Tam P-Y, Mintz ED. The unrecognised burden of typhoid fever. Expert Rev Vaccines. 2017;16(3):249-260. doi:10.1080/14760584.2017.1255553.
Lee J-S, Mogasale V V., Mogasale V, Lee K. Geographical distribution of typhoid risk factors in low and middle income countries. BMC Infect Dis. 2016;16(1):732. doi:10.1186/s12879-016-2074-1.
CDC. Principles of Epidemiology | Lesson 1 - Section 10. Cdc. Published online 2020. Accessed March 6, 2021. https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section8.html.
Oguntade ES, Shohaimi S, Nallapan M, Ajibola Lamidi-Sarumoh A. Factors Influencing Malaria Knowledge, Attitude and Practice in Gwagwalada. Vol 3.; 2018. Accessed February 4, 2019. www.ijshr.com.
Brainard J, D’hondt R, Ali E, et al. Typhoid fever outbreak in the Democratic Republic of Congo: Case-control and ecological study. Crump JA, ed. PLoS Negl Trop Dis. 2018;12(10):e0006795. doi:10.1371/journal.pntd.0006795.
Jenkins AP. A nested environmental approach to typhoid epidemiology in Central Division, Fiji. Published online 2017:206. https://ro.ecu.edu.au/cgi/viewcontent.cgi?article=2994&context=theses.
Outbreak Response Unit, National Institute for Communicable Diseases. Outbreak Response Unit National Institute for Communicable Diseases.; 2016.
Setia MS. Methodology series module 9: Designing questionnaires and clinical record forms-Part II. Indian J Dermatol. 2017;62(3):258-261. doi:10.4103/ijd.IJD_200_17.
Bello OW, Bello OW, Oyekunle A, Adeyemi R. Analysis of the Privacy Policies of Nigerian Online Shops. Int J Inf Process Commun. 2018;6(2):347-361. Accessed February 17, 2019. https://www.researchgate.net/publication/329872094.
McHugh ML. Interrater reliability: The kappa statistic. Biochem Medica. 2012;22(3):276-282. doi:10.11613/bm.2012.031.
Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016;15(2):155-163. doi:10.1016/j.jcm.2016.02.012.
Taber KS. The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Res Sci Educ. 2018;48(6):1273-1296. doi:10.1007/s11165-016-9602-2.
Hayes AF, Coutts JJ. Use Omega Rather than Cronbach’s Alpha for Estimating Reliability. But…. Commun Methods Meas. Published online 2020. doi:10.1080/19312458.2020.1718629.
Tawfiq UA, Shohaimi S, Mohd Nadzir NH, Amin Nordin S, Ab Rahman AH, Salari N. Validity and Reliability of Typhoid Risk Factors Questionnaire (TRFQ) in Gombe Metropolis, Gombe State, Nigeria. Pertanika J Sci Technol. 2022;30(3):2007-2021. doi:10.47836/pjst.30.3.13.
CDC. Epi InfoTM| CDC. Centers for Disease Control and Prevention. Published 2020. Accessed March 5, 2021. https://www.cdc.gov/epiinfo/index.html.
Faber J, Fonseca LM. How sample size influences research outcomes. Dental Press J Orthod. 2014;19(4):27-29. doi:10.1590/2176-9451.19.4.027-029.ebo.
Kipruto Bett D, Njogu P, Karanja B. Assessment of Occupational Safety and Health Awareness and Practices in Public Health Facilities Uasin Gishu County, Kenya. IOSR J Dent Med Sci e-ISSN. 2019;18:42-50. doi:10.9790/0853-1808014250.
Centers for Disease Control. Frequently Asked Questions | Social Determinants of Health | NCHHSTP | CDC. Published 2019. Accessed April 5, 2020. https://www.cdc.gov/nchhstp/socialdeterminants/faq.html.
Centre for Disease Control and Prevention USA. Principles of Epidemiology in Public Health Practice, Third Edition: An Introduction.; 2012. doi:S0171-9335(05)00209-8 [pii]r10.1016/j.ejcb.2005.11.004.
Mawazo A, Bwire GM, Matee MIN. Performance of Widal test and stool culture in the diagnosis of typhoid fever among suspected patients in Dar es Salaam, Tanzania. BMC Res Notes. 2019;12(1). doi:10.1186/s13104-019-4340-y.
Mishra P, Pandey C, Singh U, Keshri A, Sabaretnam M. Selection of appropriate statistical methods for data analysis. Ann Card Anaesth. 2019;22(3):297-301. doi:10.4103/aca.ACA_248_18.
McHugh ML. The Chi-square test of independence. Biochem Medica. Published online 2013:143-149. doi:10.11613/BM.2013.018.
Stoltzfus JC. Logistic regression: A brief primer. Acad Emerg Med. 2011;18(10):1099-1104. doi:10.1111/j.1553-2712.2011.01185.x.
Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth. 2017;11(Suppl 1): S80-S89. doi:10.4103/sja.SJA_203_17.
Trizano-Hermosilla I, Alvarado JM. Best Alternatives to Cronbach’s Alpha Reliability in Realistic Conditions: Congeneric and Asymmetrical Measurements. Front Psychol. 2016;7(MAY):769. doi:10.3389/fpsyg.2016.00769.
Dewan AM, Corner R, Hashizume M, Ongee ET. Typhoid Fever and Its Association with Environmental Factors in the Dhaka Metropolitan Area of Bangladesh: A Spatial and Time-Series Approach. PLoS Negl Trop Dis. 2013;7(1):1998. doi:10.1371/journal.pntd.0001998.
Awofisayo-Okuyelu A, McCarthy N, Mgbakor I, Hall I. Incubation period of typhoidal salmonellosis: a systematic review and meta-analysis of outbreaks and experimental studies occurring over the last century. BMC Infect Dis. 2018;18(1). doi:10.1186/s12879-018-3391-3.
Morral-Puigmal C, Martínez-Solanas È, Villanueva CM, Basagaña X. Weather and gastrointestinal disease in Spain: A retrospective time series regression study. Environ Int. 2018;121:649-657. doi:10.1016/j.envint.2018.10.003.
Indhumathi K, Sathesh Kumar K. A review on prediction of seasonal diseases based on climate change using big data. Mater Today Proc. Published online 2020. doi:10.1016/j.matpr.2020.08.517.
AYAZ C, LOEB M, GEYIK MF, et al. Risk factors for typhoid fever among adult patients in Diyarbakir, Turkey. Epidemiol Infect. 2005;134(03):612. doi:10.1017/s0950268805005583.
Burnsed LJ, Kovar LD, Angelo KM, et al. Use of whole genome sequencing to complement characterisation of a typhoid fever outbreak among a Marshallese community: Oklahoma, 2015. Epidemiol Infect. 2019;147(e11):1-7. doi:10.1017/S0950268818002601.
Hancock-Allen J, Cronquist AB, Peden J, Adamson D, Corral N, Brown K. Notes from the Field: Typhoid Fever Outbreak Associated with an Asymptomatic Carrier at a Restaurant ― Weld County, Colorado, 2015. MMWR Morb Mortal Wkly Rep. 2016;65(23):606-607. doi:10.15585/mmwr.mm6523a4.
Sur D, Ali M, Von Seidlein L, et al. Comparisons of predictors for typhoid and paratyphoid fever in Kolkata, India. BMC Public Health. 2007;7:1-10. doi:10.1186/1471-2458-7-289.
Rasul F, Sughra K, Mushtaq A, Zeeshan N, Mehmood S, Rashid U. Surveillance report on typhoid fever epidemiology and risk factor assessment in district Gujrat, Punjab, Pakistan. Biomed Res. 2017;28(16). Accessed October 14, 2020. https://www.biomedres.info/biomedical-research/surveillance-report-on-typhoid-fever-epidemiology-and-risk-factor-assessment-in-district-gujrat-punjab-pakistan-8198.html.
Allu MA, Assafi MS, Polse RF, Al- MI. Present status of Salmonella Typhi in different age groups hospitalised patients in Duhok City, Iraq. Zanco J Pure Appl Sci. 2019;31(6). doi:10.21271/zjpas.31.6.13.
Cobos Muñoz D, Monzón Llamas L, Bosch-Capblanch X. Exposing concerns about vaccination in low- and middle-income countries: a systematic review. Int J Public Health. 2015;60(7):767-780. doi:10.1007/s00038-015-0715-6.
WHO. Nigeria consolidates efforts to curtail vaccine hesitancy | WHO | Regional Office for Africa. WHO Africa. Published 2020. Accessed October 12, 2020. https://www.afro.who.int/news/nigeria-consolidates-efforts-curtail-vaccine-hesitancy.
Sivaji I, Duraisamy S, Balakrishnan S. Analysis of TLR polymorphisms in typhoid patients and asymptomatic typhoid carriers among the schoolchildren. Egypt J Med Hum Genet. 2016;17(4):353-357. doi:10.1016/j.ejmhg.2015.12.010.
Jaroni D. Salmonella: Salmonella Typhi. Vol 3. Second Edi. Elsevier; 2014. doi:10.1016/B978-0-12-384730-0.00296-2.
Gutbi S, Mohammed S, Eldinn N, Elhassan E, Abdalla AA. Perceived Barriers of Hands Washing Practices during Coronavirus (COVID-19) Outbreak (Sudan). Int J Multidiscip Res Publ. 2020;3(1):100-104.
Khan MI, Ochiai RL, Soofi SB, et al. Risk factors associated with typhoid fever in children aged 2-16 years in Karachi, Pakistan. Epidemiol Infect. 2012;140(4):665-672. doi:10.1017/S0950268811000938.
Abdullahi A, Abdu A. Household Water Conditions in Gombe : A Profile of Water Scarcity in Nassarawo , Palliative and Mitigation Measures. Am Sci Res J Eng Technol Sci. 2018;43(1):227-240. Accessed October 14, 2020. http://asrjetsjournal.org/.
Ishaku HT, Majid MR, Johar F. Rainwater Harvesting: An Alternative to Safe Water Supply in Nigerian Rural Communities. Water Resour Manag. 2012;26(2):295-305. doi:10.1007/s11269-011-9918-7.
Yakubu Madaki M, Bavorova M. Food safety knowledge of food vendors of higher educational institutions in Bauchi state, Nigeria. Food Control. 2019;106:106703. doi:10.1016/j.foodcont.2019.06.029.
Bilcke J, Antillón M, Pieters Z, et al. Cost-effectiveness of routine and campaign use of typhoid Vi-conjugate vaccine in Gavi-eligible countries: a modelling study. Lancet Infect Dis. 2019;19(7):728-739. doi:10.1016/S1473-3099(18)30804-1.
Getachew D, Wale B, Eshete W, et al. Assessment of Knowledge and Risk Perception towards Typhoid Fever among Communities in Mendida Town. Vol 7.; 2018.
Delpla I, Legay C, Proulx F, Rodriguez MJ. Perception of tap water quality: Assessment of the factors modifying the links between satisfaction and water consumption behavior. Sci Total Environ. 2020;722:137786. doi:10.1016/j.scitotenv.2020.137786.
Hinton P. SPSS ExplainedHinton P, McMurray I, & Brownlow C. (2014). SPSS Explained (2nd ed.). New York: Routledge. https://doi.org/10.4324/9781315797298.
Kleinbaum DG, Klein M. Logistic Regression: A Self-Learning Text. 3rd ed. Springer; 2010.