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Title
Epidemiology and risk factors for typhoid fever in Central Division, Fiji, 2014–2017: A case-control study
Author(s)
Prasad, Namrata;Jenkins, Aaron P.;Naucukidi, Lanieta;Rosa, Varanisese;Sahu-Khan, Aalisha;Kama, Mike;Jenkins, Kylie M.;Jenney, Adam W. J.;Jack, Susan J.;Saha, Debasish;Horwitz, Pierre;Jupiter, Stacy D.;Strugnell, Richard A.;Mulholland, E. Kim;Crump, John A.
Published
2018
Publisher
PLoS Neglected Tropical Diseases
Published Version DOI
https://doi.org/10.1371/journal.pntd.0006571
Abstract
Author summary: Modeling suggests that Oceania has surpassed Asia and sub-Saharan Africa as the region with the highest typhoid fever incidence. While Pacific Islands are often neglected due to small population sizes, there is an urgent need to understand the epidemiology of typhoid fever in the region. Fiji, an upper-middle income country in Oceania, has reported an increase in typhoid fever notifications over the last decade. However, the epidemiology of typhoid fever in Fiji is incompletely understood due to major gaps in surveillance and lack of epidemiological research on local risk factors. We conducted a case-control study in the Central Division of Fiji to help inform prevention and control strategies. We found unimproved sanitation facilities to be major source of typhoid fever in Fiji, with transmission by drinking contaminated surface water and consumption of unwashed produce. We also found an association between poor water availability and poor hygiene with typhoid fever. Improvements in sanitation facilities to protect surface water and produce from contamination are likely to contribute to improved typhoid control in Fiji. Because of the distinct socio-demographic and environmental conditions found in Oceania, our findings may reflect sources and modes of transmission predominant elsewhere in the region.
Keywords
Typhoid;Fevers;Fiji;Sanitation;Surface water;Blood;Flooding;Salmonella typhi
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PUB24169