Abstract

Introduction; “Typhoid fever” is a global major public health problem; it is an acute systemic bacterial infectious disease seen only in humans. Almost 80% of the cases and deaths are in Asia and the rest occur mostly in Africa, typhoid fever is endemic in many developing Countries, including Cameroon (World health organization 2003). Typhoid fever is a systematic infection caused by gram-negative bacteria called Salmonella typhi. (Mayron M., et al. 2011) and is the major cause of morbidity and mortality worldwide.

Aim: This study aims to assess parents’ knowledge on the causes, and challenges faced in the prevention of childhood typhoid in the Tole Community from January 2024- August 2024.

Methods. This study employed a quantitative cross-sectional study which study analyzed parents’ knowledge on the causes, and challenges faced in the prevention of childhood typhoid in the Tole Community, with a sample size of 159 parents who were chosen using the stratified sampling technique and results presented using pie chart, bar chart and tables.  Data were cleaned, coded and analyzed using Microsoft Excel 2007.

Results: the study did not answer the question regarding parents’ knowledge on TF since the overall knowledge score in the study was 10%, which is very low and only 18.8% minority of the participants had knowledge on TF in the Tole Community this is due to their low level of education only 16% of the participants had a Bachelor’s Degree and HND/SRN.  According to objective two, majority 57% of the Parents faced challenges in the prevention of childhood typhoid. Concerning objective three, on the strategy to prevent typhoid fever, minority 42% of the participants had knowledge on the strategies used in the prevention of TF in the tole community.

CHAPTER ONE

GENERAL INTRODUCTION

This chapter specifically gives an introduction to the background of the study, conceptual review, theoretical review, contextual review, empirical review, statement of the problem, objective, research questions, significant of the study, justification, and scope of study, operational and conceptual definition of terms.

1.1 Introduction

“Typhoid fever” is a global major public health problem, it is an acute systemic bacterial infectious disease seen only in humans. Almost 80% of the cases and deaths are in Asia and the rest occur mostly in Africa, typhoid fever is endemic in many developing Countries, including Cameroon (World health organization 2003). Typhoid fever is a systematic infection caused by gram-negative bacteria called Salmonella typhi. (Mayron M., et al. 2011) and is the major cause of morbidity and mortality worldwide.

Enterica serotype Typhi is the etiological agent of typhoid fever. The illness begins with mounting fever, headache, vague, abdominal pain and constipation which may be followed by the appearance of rashes and a state of prolonged apathy, toxemia, delirium, disorientation, or coma, followed by diarrhea which if left untreated can lead to complications affecting various organ of the body (Fauci AS el al 2008).

In 2004, it was estimated that there were 21.6 million cases of enteric fever causing 200,000 deaths worldwide (Crump JA et al 2010). High prevalence was seen in areas with rapid population growth, increased urbanization, and limited safe water, infrastructure, and health systems like parts ofCameroon, South and Central America, and Africa. In such areas, typhoid is predominantly a disease of children where the main source of infection is stool excretion of Salmonella typhi during and after infection (White NJ et al 2010). Earlier it was estimated to be 16 million with over 600 000 deaths. (Srikantiah P et al 2006) This clearly shows an increase in morbidity with a decrease in mortality.

The morbidity of typhoid fever is highest in Asia with 93% of the global episodes occurring in this region. It also has the highest regional incidence rate of 274 cases per 100 000 population. Latin America. Southeast Asia has an incidence of 110 cases/100 000 population, which is the third highest incidence rate for any region. (J.A. Crump, et al 2004) Although population-based data from Cameroon are scarce, several hospital-based studies from different parts of the country have consistently shown a very high incidence of typhoid fever, especially in the younger age groups. (Ahmad KA, et al 2000).

Typhoid fever, is one of the major bacterial infections worldwide, is caused by the human adapted S. enterica serovar Typhi. For every ten cases of S. Typhi infection, there are one or two cases of paratyphoid fever, caused by the human-adapted S. enterica serovars Paratyphi A, Paratyphi B and Paratyphi C (Crump JA et al 2004). Since paratyphoid fever is indistinguishable from typhoid fever in its clinical course, S. enterica serovars Typhi, Paratyphi A, Paratyphi B and Paratyphi C are collectively referred to as typhoidal Salmonella serovars.

The United States reports only about 350 culture-confirmed cases of typhoid fever and fewer than 100 paratyphi A cases each year since 2008, enteric fever remains an important cause of illness worldwide. Approximately 215,000 deaths result from over 26 million cases of typhoid fever and 5 million cases of paratyphoid infection each year worldwide.( Chiodini J et al 2017) a global public health problem with over 21.6 million cases and at least 250,000 deaths occurring annually (Srikantiah P et al 2006). Almost 80% of the cases and deaths are in Asia; the rest occur mainly in Africa and particularly in Cameroon (Nagshetty K. et al 2010)

According to Samuel Kim, there were 180 940 cases in 303 identified outbreaks caused by infection with Salmonella enterica serovar Typhi (S. Typhi) and Salmonella enterica serovar Paratyphi A or B (S. Paratyphi). The size of outbreak ranged from 1 to 42 564. Fifty-one percent of outbreaks occurred in Asia, 15% in Africa, 14% in Oceania, and the rest in other regions. Forty-six percent of outbreaks specified confirmation by blood culture, and 82 outbreaks reported drug susceptibility, of which 54% had multidrug-resistant pathogens. Paratyphoid outbreaks were less common compared to typhoid (22 vs 281) and more prevalent in Asia than Africa. Risk factors were multifactorial, with contaminated water being the main factor

1.2 Problem Statement

Globally, it is estimated that typhoid fever causes more than 16 million cases of illness each year, resulting in more than 600,000 deaths (Kariuki et al, 2000). Typhoid remains the global health concern affecting both developed and developing countries with varying prevalence around the world ranging from 11 to 21 million cases and 200,000 mortalities annually (Centers for Disease Control and Prevention (CDC), 2023).

Typhoid is also the major cause of morbidity and mortality worldwide (Schrivastava B, et al 2011) Typhoid fever is a threat to many tropical countries showing a worldwide estimate of about 212 million cases with 129,000 deaths yearly with children and young adults being the vulnerable groups (Steele et al., 2016).

Typhoid fever is a communicable disease found only in human and occurs due to systemic infection mainly by salmonella typhi organism. High prevalence was seen in areas with rapid population growth, increased urbanization, and limited safe water, infrastructure, and health systems like parts of Cameroon South and Central America, and Africa. In such areas, typhoid is predominantly a disease of children where the main source of infection is stool excretion of Salmonella typhi during and after infection (White NJ. et al 2010).

Given the fact that typhoid is mostly accompanied with malaria and it therefore led to anemia in most children in this community. I have been a witness to many of these cases in the Tole Health center where many children were coming with a low Hemoglobin (Hb) level in the Tole Community, it has been noted that when children have typhoid, the parents believe that typhoid is not treated medically but can only be treated traditionally and at such, they stay back with these children at home  due to their believe that most of this ailment like typhoid are treated traditionally. This is a wrong perception. It is for this reason that the researcher decided to carry a research on “Assessing parent’s knowledge on the cause’s and challenges faced in the management of childhood typhoid in the Tole community.

1.3 Objectives

1.3.1 General objectives

To assess parents’ knowledge on the causes, and challenges faced in the prevention of childhood typhoid in the Tole Community.

1.3.2 Specific objective

1. To assess parents’ knowledge of the causes of childhood typhoid in the Tole community
2. To identify the challenges faced by parents in the prevention of childhood typhoid in the Tole community
3. To identify the strategies used by parents in the prevention of typhoid fever in the Tole Community.

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