Factors associated with the 2012 typhoid fever outbreak in Mufulira district, Zambia : A case control study

Abstract

Typhoid fever is still a public health concern especially in Africa and Asia infecting millions of people while killing thousands. In the year 2012, Zambia recorded a number of typhoid fever outbreaks. The most affected being Mufulira district in the Copperbelt province. As risk factors for typhoid fever may differ from one area to another, determination of risk factors for typhoid fever outbreak is critical in the formulation of rational setting-specific control and preventive measures. We investigated factors that were associated with the typhoid fever outbreak in 2012 in Mufulira district, Zambia. A case control study was done to determine factors associated with typhoid fever infection in Mupambe. All 42 cases meeting the inclusion criteria where invited to take part in the study while controls where selected by simple random selection from eligible members of each selected household. To select households for controls, every third household was picked by systematic random selection from the total of 450 household. Individual association of possible risk factors and typhoid fever infection where first analysed using logistic regression. Risk factors with the p value of less than 0.2 were then examined using multivariate logistic regression. The final model was assessed using Pearson’s Chi-square diagnostics. A total of 36 cases and 138 controls participated in this study. Age, younger than 23 years (aOR: 4.64, 95%CI: 1.84, 11.71), eating food from street vendors more than 7 times /week (aOR: 3.83; 95%CI: 1.40, 10.50), eating vegetable salads more than 2 times /week (aOR: 4.82; 95%CI: 1.63, 14.22) and drinking untreated water (aOR: 4.56, 95%CI: 1.73, 12.14) were significantly associated with typhoid fever. Eating of unsafe food and personal hygiene were factors responsible for the typhoid fever outbreak, suggesting that sensitising the community on good hygiene practices and general cleanliness could prevent further recurrences. Hygiene, Outbreak, Risk factors, Typhoid, Zambia