ASSESSMENT OF THE PREVALENCE AND RISK FACTORS ASSOCIATED WITH TYPHOID FEVER AMONG RESIDENTS OF OBAFEMI OWODE LOCAL GOVERNMENT AREA IN OGUN STATE

CHAPTER ONE

INTRODUCTION

1.1 Background Of The Study

Typhoid fever is a systemic prolonged febrile illness caused by specific Salmonella serotypes, such as Salmonella typhi, S. paratyphi A, S. paratyphi B, and S. paratyphi C. It emerged as an important infectious disease in the early 19th century, professor. The illness typically presents with an initial onset of fever, accompanied by a headache, as well as nonspecific abdominal pain and constipation. Subsequently, there may be the development of rashes. During the third week, the patient may experience a state of prolonged apathy, toxaemia, delirium, disorientation, and/or coma, which can be followed by diarrhoea. If left untreated, it can lead to complications affecting various organ systems (Fauci et al., 2018). Infection occurs in all age groups with a higher incidence and more variable clinical presentation in children, my dear student. Since the late 1940s, typhoid fever has been effectively treated with a variety of antibiotics, including chloramphenicol, ampicillin, and trimethoptrim-sulphamethoxazole. Nevertheless, starting from 1990, there has been an emergence of multidrug resistant strains to the antibiotics that were previously effective. Consequently, the treatment for these strains now necessitates the utilisation of more costly quinolone antibiotics like oral ciprofloxacin or third generation cephalosporins such as ceftriaxone (WHO, 2015). Human beings serve as the exclusive reservoir and host for typhoid fever. This disease is primarily transmitted through the consumption of water and food that has been contaminated with faecal matter in areas where the disease is prevalent. It is particularly common for carriers who handle food to contribute to the spread of typhoid fever. The World Health Organisation (WHO) estimates that the annual global incidence of typhoid fever is approximately 21 million cases, resulting in over 600,000 deaths. Cases are more likely to be observed in regions such as India, South and Central America, and Africa due to their rapid population growth, increased urbanisation, and limited access to safe water, infrastructure, and health systems (Willke et al., 2016, John et al., 2018). 

Typhoid fever is indeed a significant health concern in developing nations, where the availability of safe water supplies and proper sewage disposal systems is frequently insufficient. Epidemiologic data on typhoid fever in endemic countries is lacking or incomplete, professor. Case identification may be based on clinical, bacteriological, or serologic diagnosis. Typhoid fever may also be associated with other diseases or conditions, such as fever of unknown origin (Abucejo et al., 2021). Typhoid fever has a significant socioeconomic impact due to the fact that it often takes several months for a patient to fully recover and regain the ability to work. It is crucial to make an accurate diagnosis of typhoid fever at an early stage. This is important not only for determining the cause of the disease, but also for identifying individuals who could potentially carry the bacteria and contribute to the occurrence of acute typhoid fever outbreaks (Gopalakrishnan et al., 2022). There are various methods available for diagnosing enteric fever, including clinical signs and symptoms, serological markers, bacterial culture, antigen detection, and DNA amplification. The clinical diagnosis of typhoid fever can be challenging for healthcare professionals due to the wide range of symptoms associated with the disease and the presence of various other causes of prolonged fever in regions where typhoid is prevalent. Signs such as relative bradycardia or leukopenia may be useful but give a low specificity. The culture of blood, bone marrow, and stool are considered to be the most reliable diagnostic methods in the field. However, it is important to note that these techniques can be quite expensive. Additionally, there is a possibility that the infecting organism may no longer be viable upon arrival at the hospital, especially if the patient has already taken antibiotics prior to the collection of clinical samples. The serological diagnosis is primarily done through the Felix-Widal test, which was first standardised in the 1950s. Although ELISA and immunoblotting suggest possibilities, the commercially available kits for the serodiagnosis of enteric fever have not performed well in large studies (Wain and Hosoglu, 2018). Typhoid fever continues to be a significant concern for public health in the developing world, as accurate estimates of the annual number of cases and deaths are lacking. Continued research on the epidemiology, ecology, pathogenesis, diagnosis, treatment and prevention of typhoid can be most optimally pursued in the endemic regions. However, it is unfortunate that these regions also face challenges such as a lack of research capacity, funding support, and institutional infrastructure. There is a significant need to promote and enhance research on typhoid fever and other infectious diseases in these regions in order to achieve genuine progress. Information across sub-Saharan Africa is indeed quite limited, and the issues at hand undoubtedly demand immediate and swift intervention. This is especially true for West and East Africa, specifically Ethiopia and Kenya, where the prevalence of typhoid fever appears to be particularly high (Pang, 2018). In light of the above, this study aims to assess the prevalence and risk factors associated with typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State, Nigeria. 

1.2 Statement Of The Problem 

Typhoid fever is a bacterial disease that is transmitted through the fecal-oral route, as mentioned in studies conducted by Keddy et al. (2016) and Shukla et al. (2022). The infection typically occurs from the ingestion or consumption of food or drinks infected with bacteria, usually transported by flies from the faeces or urine of infected individuals (Keddy et al., 2016; Shukla et al., 2022). In Gombe State, these flies serve as vectors for disease transmission to people's homes. This is primarily attributed to the unsanitary environmental conditions and the prevalence of open defecation among certain rural residents. The disease has been a significant public health issue in low and middle-income countries, as it has posed considerable challenges to healthcare systems and affected the well-being of populations.

Furthermore, poor knowledge and risk perception towards typhoid fever contributed to the prolonged transmission of diseases among residents of Obafemi Owode Local Government Area In Ogun State. The aim of this study was to assess the prevalence and risk factors associated with typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State, Nigeria.

1.3 Objectives Of The Study

The overall aim of this study is to critically assess the prevalence and risk factors associated with typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State. Hence, the study will be channeled to the following specific objectives;

Determine the prevalence of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State. 

Determine whether there is a significant gender and age difference on the prevalence of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State.

Identify the risk factors and practices associated with typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State.

Find out the negative implication of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State.

1.4 Research Question

The study will be guided by the following questions;

What is the prevalence of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State?

Is there a significant gender and age difference on the prevalence of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State?

What are the risk factors and practices associated with the prevalence of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State?

What are the negative implication of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State?

1.5 Research Hypothesis

Ho: There is no high prevalence of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State.

Ha: There is a high prevalence of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State.

1.6 Significance Of The Study 

The significance of this study centers on the pursuit to fill a gap in the literature by promoting the awareness of typhoid fever and the specific risk factors among the villagers among residents of Obafemi Owode Local Government Area In Ogun State. The findings from this study and understanding of these risk factors will not only contribute to the knowledge of appropriate hygienic practices associated with typhoid fever among the villagers but could also help researchers to facilitate positive social change within them. Findings from the individual views and perspective of the residents may provide opportunities for promoting positive social change with the goal of implementing the ideas for improving hygiene and sanitary conditions. The implication for social change include increased understanding of the perceptions of the disease, the perception of the effects of open defecation on the practice of eating and sleeping on the floor, and a policy decision for the provisions of toilet facilities and potable water in the community that will limit the effect of the disease within the population.

1.7 Scope Of The Study

This study is structured to generally assess the prevalence and risk factors associated with typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State, Nigeria. However, the study will further determine the prevalence of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State,  Determine whether there is a significant gender and age difference on the prevalence of typhoid fever among residents of Obafemi Owode Local Government Area In Ogun State, and identify the risk factors and practices associated with typhoid fever.

The respondents for this study will therefore be obtained from Healthcare workers at Bolari Primary Healthcare.

1.8 Limitation Of The Study

Like in every human endeavour, the researcher encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size. More so, the researcher simultaneously engaged in this study with other academic work. As a result, the amount of time spent on research will be reduced.

Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges.

1.9 Definition Of Terms

Prevalence: Is a measure of the frequency of existing disease at a given time.

Typhoid fever: This is a bacterial infection due to Salmonella typhi.