Factors Contributing to the Prevalence of Typhoid Fever Among Patients Attending to Kiryandongo General Hospital in Kiryandongo District

ABSTRACT

Introduction

Typhoid fever (TF) continues to be a major public health problem in many developing countries. In Uganda, an outbreak of typhoid fever in Kasese District sickened 8092 persons from 27 December 2007 to 30 July 2009, resulting in at least 249 intestinal perforations and 47 deaths. Objectives The study was aimed at assessing risk factors contributing to the prevalence of typhoid fever among patients attending to Kiryandongo General Hospital in Kiryandongo district. Specifically, was to determine the personal and food hygienic factors, identify sanitary factors in homesteads and identify availability of clean and safe water in the homesteads of patients attending to Kiryandongo General Hospital that may contribute to the prevalence of typhoid fever. Methodology  The study was a cross sectional descriptive study which involved interviewing 138 respondents with questionnaire forms. The questionnaire was designed according to the objectives of the study.  Results 35% of respondents do not have latrines at home and over 70% of respondents don‟t control flies densities from their latrines. About 60% of respondents wash hands but without soap and 20% totally do not wash hands after visiting the latrine. Furthermore, up to 49% of respondents do not have rubbish pits at home.  The study also indicates that most of the respondents do not or seldom wash their hands before preparing food (39% and 36% respectively) while 27.54% leave cooked food uncovered and only a very few preserve their cooked food in refrigerator (14.49%), and a further 57% eat fresh fruits  after gathering without washing or pealing. It also shows that 44.93% of respondents eat food  from restaurants and 14.49% eat food sold along the road.

TABLE OF CONTENT

DECLARATION ................................................................................................................................ i

APPROVAL ......................................................................................................................................ii

ACKNOWLEDGEMENT ............................................................................................................... iii

LIST OF FIGURES AND TABLES................................................................................................vii

LIST OF ABBREVATIONS ......................................................................................................... viii

DEFINITON OF TERMS ................................................................................................................. ix

ABSTRACT ....................................................................................................................................... x

CHAPTER ONE ................................................................................................................................ 1

INTRODUCTION ............................................................................................................................. 1

1.1 Background of the Study ............................................................................................................. 1

1.2 Causative Agent, Spread and Clinical Features of Typhoid Fever .............................................. 2

1.3 Prevention of Typhoid Fever ....................................................................................................... 3

1.4 Problem Statement ....................................................................................................................... 3

1.5 Study Objectives .......................................................................................................................... 4

1.5.1 Broad Objective ........................................................................................................................ 4

1.5.2 Specific Objectives ................................................................................................................... 5

1.6 Research Questions ...................................................................................................................... 5

1.7 Justificationof the Study .............................................................................................................. 5

1.8 Scope of the Study ....................................................................................................................... 6

1.8.1 Geographical Scope .................................................................................................................. 6

1.8.2 Content Scope ........................................................................................................................... 6

1.8.3 Time Scope ............................................................................................................................... 6

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CHAPTER TWO ............................................................................................................................... 8

LITERATURE REVIEW .................................................................................................................. 8

2.0 Introduction .................................................................................................................................. 8

2.1 Water Related Factors Associated with Typhoid Fever .............................................................. 8

2.2. Food HygieneAssociated with Typhoid Fever ........................................................................... 9

2.3. SanitationFactors Associated with Typhoid Fever ..................................................................... 9

2.4. Socioeconomic FactorsAssociated with Typhoid Fever ........................................................... 11

CHAPTER THREE ......................................................................................................................... 12

STUDY METHODOLOGY ............................................................................................................ 12

3.0Introduction ................................................................................................................................. 12

3.1 The Study Area .......................................................................................................................... 12

3.2 Study Population ........................................................................................................................ 12

3.3 Study Design .............................................................................................................................. 12

3.4 Inclusion and Exclusion Criteria ................................................................................................ 12

3.5 Sampling Procedure ................................................................................................................... 13

3.6 Determination of Sample Size ................................................................................................... 13

3.7 Research Instrument and Data Collection Methods................................................................... 13

3.8 Study Variables .......................................................................................................................... 14

3.8.1 Independent Variables ............................................................................................................ 14

3.8.2 Dependent Variable ................................................................................................................ 14

3.9 Data Analysis and Data Presentation ......................................................................................... 14

3.10 Data Quality Control ................................................................................................................ 14

3.11 Limitations of the Study........................................................................................................... 15

3.12 Ethical Considerations ............................................................................................................. 15

CHAPTER FOUR ............................................................................................................................ 16

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RESULTS OF THE STUDY ........................................................................................................... 16

4.0 Introduction ................................................................................................................................ 16

4.1 Social-Demographic Description of the Study Population ........................................................ 16

4.2 Sanitation Related Factors Associated with Typhoid Fever ...................................................... 19

4.3 Food Related Factors Associated with Typhoid Fever .............................................................. 21

4.4 Water Related Factors Associated with Typhoid Fever ............................................................ 23

CHAPTER FIVE ............................................................................................................................. 25

DISCUSSION OF RESULTS ......................................................................................................... 25

5.0 Introduction ................................................................................................................................ 25

5.1 Socio-Demographic Characteristics of Respondents ................................................................. 25

5.2 Sanitation Factors Associated with Typhoid Fever ................................................................... 25

5.3 Food Related Factors Associated with Typhoid Fever .............................................................. 26

5.4 Water Related Factors Associated with Typhoid Fever ............................................................ 27

CHAPTER SIX ................................................................................................................................ 29

CONCLUSION AND RECOMMENDATIONS ............................................................................ 29

6.0 Introduction ................................................................................................................................ 29

6.1 Conclusion ................................................................................................................................. 29

6.3 Recommendations ...................................................................................................................... 30

REFERENCES ................................................................................................................................ 31

APPENDICES ................................................................................................................................. 35

Appendix I: Introductory Letter ....................................................................................................... 35

Appendix II: Consent Form ............................................................................................................. 36

Appendix III: Questionnaire ............................................................................................................ 37

Appendix IV: Work Plan ................................................................................................................. 39

Appendix V: Budget ........................................................................................................................ 4

Appendix VII: Map of Kiryandongo District and Surrounding Areas ............................................ 42