Full Project – Assessment of risk factors influencing typhoid fever occurrence among adults in Sabongeri community

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CHAPTER ONE

Typhoid fever is caused by salmonella typhi is an endemic disease in tropic and sub-tropic and has become a major public health problems in developing countries of the world with an estimated annual incidence of 540 per 100,000. The annual incidence of typhoid is estimated o be about 17million cases worldwide WHO 2008. It is then often encountered in tropic countries including Nigeria where they constitute serious source of morbidities and mortalities [Ibekwe, et al 2016]

Typhoid and paratyphoid fever are infection caused by bacteria which are transmitted through faecal-oral route, clean water, hygiene and  good sanitation, prevent  the spread of thyroid and parathyroid, contaminated water is  one of the pathways of trans mission of the disease [WHO, 2018]

Typhoid and paratyphoid fever are caused by bacteria salmonella typhi and salmonella paratyphi respectively. Salmonella typhi is a gram negative bacterium, which is mofile though non flagella variants occur and capsules are not formed. They are intestinal pathogens which cause typhoid fever (Philip 2000). It is pathogenic to bofh man and animals with associable inflammatory reaction in the intestinal tract.

Typhoid fever is among the water borne infections (Singh and Mcfeters, 2017) characteristic of environment with poor sanitation and hygiene. It is a health problem that has been associated with under development (Jegathisan, 2016) human infection with salmonella is mainly by oral through ingestion of faeces contaminated food and water, unclean hand and meat from infected animals (Carol et al; 2017) Typhoid and paratyphoid germs passed in faeces and urine of infected people become infected after eating food or drinking contaminated water that have been contaminated by sewage containing bacteria. Once the bacteria enters the person’s body they multiply and spread in the intestine, into the blood stream (WHO, 2018). Even after recovery from typhoid or paratyphroid, a small number of individual (called carriers) continue to carry the bacteria. These people can be a source of infection to others.

The transmission of typhoid and paratyphoid in less industrialized countries shell fish taken from sewage contaminated beds is an important route of infection. Where water quality is high and chlorinated water piped in to the widely available, transmission is more likely to occur via food contaminated by carriers handling food (WHO, 2008). Infection through contaminated surgical equipment and person to person contact in hospital has also been reported (Carol, Ray, Ryan, 2017).

Salmonella typhi have somatic antigen and glycol lipid micro capsule and a virulent antigen. Phage typing can distinguish different strains of the organisms. Typhoid fever caused by salmonella typhi is often encountered in tropical countries including Nigeria where they constitute serious source of morbidities (Baver 2015). It is a major public health problem in developing countries of the world with an estimated annual incidence of 540 per 100,000 (Idekwe, et al 2008). Salmonella are divided into district serological groups on oasis basis of their somatic O antigen while all group D organisms, such as S.typhi possess O antigen and about 60 to the 78 group D sero type can including S typhi also have O antigen. (Hook, 1985) thus, infection by any of the group D sero type can produce antibodies that react with the O antigen used in the widal reaction (Olopoenia, et al 2016)

Also since all group A and B organism posses O antigen 12, cross reaction with O antigen of group D sero type can occur with any of the group A and B serofypes antigen. Depending of the relative quality and quantity of antigenicity of the O antigens 9 and 12 contained in the common non typeoidal salmonellae sero type, cross reaction may occur frequent enough to lesson considerably the diagnostic specifically of the widal agglutination reaction (Olopoenia et al, 2016). In endemic area, most individual are carriers of the disease thus, 35.9 0/0 of such apparently healthy people have been detected with normal antibody titres of up to 1:40 and 1:80 for O and H Salmonella. (Tan yagina et al, 2017) and the levels deflected several infection with salmonella. Even the associated mortality rate is very low, the high prevalence of salmanellosis has cause major strains of salmonella (Myron et al 2016).

Based on immunology of salmonella infection, Serological diagnosis test relying on salmonella antigens as an evidence of salmonella have been developed, notable, and the widal agglutination test. Agglutination is a classic of serologic reaction that result on clumping of a cell suspended by a specific antibodies, directed against a specific such test have been widely used for determination of antibodies against various diseases producing microorganisms in serum for a long time. (Olopoenia et al., 2016). The widal agglutination test, developed by widal in l896 to aid the diagnosis of typhoid fever, utilized a suspension of Killed salmonella typhi as an antigen to detect typhoid fever in serum from suspected S.typhi infected patient who present with fibril illness. The value and clinical application of the widal test in developed countries has diminished  considerable of recent year Washington and Henry, 20l6] and a large number of antigenicity related determinations of bofh typhoid and non paratyphoid salmonella organism are now recognized (Olopoenia et al, 2016)

The widal test is presumptive serological test or typhoid fever or undulant fever. In case of salmonella infection, it is a demonstration of agglutination of antibodies against antigen O somatic and H- flagella in the blood Two types of agglutination techniques are available, the slide test and the test. The slide test is rapid and is use as a screening procedure.

1.1    HISTORICAL BACKGROUND OF THE STUDY

Around 424-430Bc, devastating plaque, which some believe to have been typhoid fever, killed one third of the population of Athens, including their leader pericles, power shifted from Athens to Sparrta wending golden age of pericles that had marked Athenia in the ancient world.

1.2    ANCIENT HISTRORIAN

Thucydides also contacted the disease and wrofe about plaque. His writings are primary source on the outbreak. The cause of the plaque has long disputed with modern academic and medical scientist considering epidemic typhi, the most likely cause. However, 2016 study detected (DNA) sequence similar to those of the bacterium responsible for typhoid fever. Other scientists have disputed the findings citing serous methodological flow in the dental pulp desived DNA Study. The disease is most commonly. During the period in question, the whole population in Africa was besieged within the long walls lives in tents.

In the late 19^th century, typhoid fever mortality rate in Chicogo average 65 per 100,000 people a year. The worse was 1891, when the typhoid death rate was1 74 per 100,000 people. The most no carrier of typhoid fever was Mary Mallon, also known as typhoid Mary in 1907 she became first American carrier to be identified and traced. She was a cook in New York; She was closely give up working as a cook or have her gall bladder removed. Mary 1 quit her Job but return late under a false name, she was detained and quarantined. After another typhoid outbreak, she died of pneumonia after 26 years in quarantine.

In 1897, Almorth Edward Wright developed an effective vaccine. In 1909 Fredrick F. Kussel, a US Army physician, developed an American typhoid vaccine and two year later his vaccination program became the first in which an entire army was immunized. It eliminated typhoid as a significant cause of morbidity and mortality in the US military, typhoid fever throughout the first half of the 20^th century due to vaccination and advance in public sanitation and hygiene.

Antilbiofic were introduced in clinical practice in 1942, greatly reducing mortality. Today, incidence of typhoid fever in developed countries is around cases per 100,000 people per year an outbreak in the Democratic Republic of Congo in 2004-2005 recorded more than 42,000 cases and 214 deaths. Typhoid fever was also known as SuetteMilliaire in 19^th century in frances.

1.2    STATTEMENT OF THE PROBLEM

Typhoid fever is one of the sanitation related diseases that is common in Idah, this requires adequate knowledge to combact the challenge, thereby necessitating the research work.

1.3    SIGNIFICANCE OF THE STUDY

The results of this study are intended to be utilized by the interested parties and the government institutions that are concerned with provision of service in Sabongeri community. It is hoped that the study findings would contributes to the understanding of the risk factor that influence the spread of typhoid fever in the informal settlement. The study would shed more light on whether the control measures in place are effective. In control of typhoid fever.

It is hoped that the results would be of great use to programme planners, academics, policy formulations and implementer, donors, curriculum developers and other service providers in control of typhoid fever.

1.4    JUSTIFICATION OF THE STUDY

Since adults and children in the study area continues to suffer from typhoid fever to date, it was necessary to find out risk factors behind it. Whenever people living in this similar  community are  infected by the salmonella typhi, their dependent are affected  directly or indirectly.

1.5    BROAD OBJECTIVE

This research work is aimed at an assessment of the factors affecting the prevalence of typhoid fever in Sabongeri community of Idah Local Government area of Kogi State.

1.6    SPECIFIC OBJECTIVES

The specific objectives are as follows:

1. To establish the prevalence of typhoid fever in Sabongeri community
2. To determine factors affecting the prevalence of typhoid fever infection in Sabongeri community

• To identify the prevention of typhoid, fever in Sabongeri community

1. To determine the effectiveness of prevention and control measures in Sabongeri community

1.7    RESEARCH QUESTIONS

1. Is typhoid fever prevalence in Sabongeri community?
2. Are there risk factors in influencing high prevalence of typhoid in Sabongeri community?
3. Do the inhabitants of the study area carry out effective prevention/control measures against typhoid fever?
4. Does the inhabitants of the study area and the government roles in preventing/controlling

1.8    OPERATIONAL DEFINITIONS

Typhoid: This is a serious systematic infection which is caused by the enteric pathogen of salmonella typhi.

Health: This is the state of complete physical, mental and social wellbeing of an individual and not merely the absence of disease or infirmity.

Sanitation: It can be defined as the process of taming the environment in a way that will not constitute hazards to human health.

Hygiene: This can be defined as the degree of cleanliness expressed by an individual or humanity which involves good personal and community cleanliness.

Outbreak: This can be defined as the occurrence of cases of a particular disease in excess more than normally expected in a particular time.

Treated water: This is water which is free from disease causing organism after boiling or disinfecting.

Community: Is a group of people living together in an area and sharing resources together and as well problems.

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Full Project – Assessment of risk factors influencing typhoid fever occurrence among adults in Sabongeri community

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