ABSTRACT

Introduction: Typhoid fever remains a major public health problem in many developing countries, particularly in areas with poor sanitation and limited access to safe drinking water. The disease is caused by Salmonella Typhi and is mainly transmitted through contaminated food and water. In Cameroon, typhoid fever continues to affect many communities due to poor hygiene practices, unsafe water sources, and limited awareness of preventive measures. Understanding patients’ knowledge, attitudes, and preventive practices is important for improving disease prevention and control.

Objective: This study aimed to assess the knowledge, attitudes, and practices of patients regarding the prevention of typhoid fever at Logbaba District Hospital.

Methodology: A descriptive cross-sectional study design was used for this research. The study was conducted among 100 patients aged 18 years and above attending Logbaba District Hospital. Participants were selected using a convenient sampling technique. Data were collected using a structured questionnaire covering socio-demographic characteristics, knowledge, attitudes, and preventive practices related to typhoid fever. The data were analyzed using descriptive statistics such as frequencies and percentages and presented in tables and figures.

Results: The findings revealed that most respondents had a moderate level of knowledge about typhoid fever. About 44% correctly identified bacteria as the cause of the disease, while others had misconceptions. Regarding attitudes, the majority of respondents demonstrated positive attitudes toward typhoid prevention, with 72% agreeing that vaccination is an effective preventive measure and 88% acknowledging the importance of handwashing. In terms of preventive practices, 72% reported washing their hands before eating, 65% indicated drinking boiled or treated water, and 68% reported eating properly cooked food. Additionally, 94% of respondents recognized that poor sanitation contributes to the spread of typhoid fever.

Conclusion: The study concludes that although many patients at Logbaba District Hospital demonstrate moderate knowledge and generally positive attitudes toward typhoid prevention, gaps still exist in knowledge and preventive practices. Strengthening health education programs and promoting hygiene practices are essential strategies for improving awareness and reducing the risk of typhoid infection in the community.

Keywords:
Typhoid fever, knowledge, attitudes, preventive practices, patients, disease prevention.

CHAPTER ONE

INTRODUCTION

1.1 Research Background and Rational

1.1.1 World Background

Typhoid fever remains a significant global public health issue, primarily affecting populations in developing countries with poor sanitation. It is caused by the bacterium Salmonella Typhi, which spreads through contaminated food and water (World Health Organization [WHO], 2023). The WHO estimates that there are approximately 11–20 million new cases and between 128,000 and 161,000 deaths annually worldwide. A major challenge in controlling the disease is the emergence of antibiotic-resistant strains of the bacteria. This resistance makes treatment more difficult and increases the risk of severe complications and death (Klemm et al., 2018). Therefore, preventing transmission through improved water, sanitation, and hygiene (WASH) is critically important.

The burden of typhoid is not evenly distributed across the globe, with the highest incidence found in South Asia and sub-Saharan Africa. In these high-risk regions, the disease is often endemic, meaning it is constantly present within the community (Stanaway et al., 2019). Children and young adults are the most vulnerable groups, frequently suffering from the highest rates of infection and illness. Control efforts are increasingly focusing on the use of typhoid conjugate vaccines (TCVs) alongside long-term improvements in sanitation infrastructure. These combined strategies are considered the most effective way to reduce the global impact of this preventable disease (WHO, 2023).

Despite being a preventable disease, typhoid fever continues to cause substantial illness and death in many parts of the world. The persistence of typhoid is strongly linked to poverty, overcrowding, and a lack of access to safe drinking water and adequate sanitation facilities (Mogasale, Maskery, & Ochiai, 2018). Outbreaks can occur in areas affected by humanitarian crises or natural disasters, where water and sanitation systems are damaged. Understanding the knowledge, attitudes, and practices of at-risk communities is a key first step in designing effective public health interventions to break the cycle of transmission.

1.1.2 Africa Background

In Africa, typhoid fever is a major cause of febrile illness, often leading to hospitalizations and placing a heavy burden on already strained healthcare systems. The true incidence is difficult to determine due to challenges in diagnosis, which often relies on non-specific clinical symptoms or inaccurate blood tests (Mohan et al., 2021). Many countries on the continent lack robust surveillance systems to accurately track the number of cases and outbreaks. This lack of reliable data makes planning and resource allocation for control programs very challenging for health authorities.

The transmission of typhoid in Africa is fueled by widespread problems with access to clean water and proper sanitation. A significant portion of the urban and rural population lives in informal settlements or areas without piped water or sewage disposal (Mogasale et al., 2018). These conditions create a perfect environment for the spread of Salmonella Typhi. Furthermore, the high prevalence of multidrug-resistant typhoid strains across the continent complicates treatment and increases healthcare costs (Kariuki et al., 2020). This makes prevention through public education and vaccination even more critical.

Community knowledge and practices play a vital role in the spread of typhoid fever across African nations. Studies in various African countries have shown that while there is often some general awareness of the disease, specific knowledge about its causes and prevention is frequently low (Girma, Tsegaye, & Tadese, 2021). For instance, misconceptions about transmission and a lack of consistent handwashing with soap are common findings. Improving this knowledge is essential for encouraging protective behaviors that can reduce the risk of infection at the household and community level.

1.1.3 Cameroon Background

In Cameroon, typhoid fever is highly endemic and is one of the most commonly reported causes of febrile illness in both outpatient and inpatient settings. It is often diagnosed clinically and through laboratory tests like the Widal test, which can sometimes be unreliable (Akoachere et al., 2018). The disease poses a significant public health challenge, contributing to school and work absenteeism and high treatment costs for families. This burden is particularly heavy in densely populated urban areas and regions with limited public health infrastructure.

The risk factors for typhoid transmission in Cameroon are widespread and include the consumption of contaminated street food, unsafe drinking water, and poor personal and environmental hygiene. Rapid urbanization has led to the growth of crowded neighborhoods with inadequate sanitation facilities, which facilitates the spread of the bacteria (Njumkeng et al., 2019). Seasonal variations also play a role, with cases often increasing during the rainy seasons when flooding can contaminate water sources. These environmental and behavioral factors create a persistent cycle of infection.

Several studies conducted in different Cameroonian cities have highlighted significant gaps in the population’s knowledge about typhoid prevention. For example, research in the Buea Health District found that while many participants had heard of typhoid, their understanding of how it is transmitted and prevented was often incomplete (Tamura et al., 2021). This indicates a strong need for targeted health education campaigns. Assessing the specific knowledge, attitudes, and practices of patients at the Logbaba District Hospital will provide crucial local data to inform such efforts and reduce the disease’s impact.

1.2 Research Statement of Problem

Globally, typhoid fever continues to be a serious illness that causes significant sickness and death, particularly in areas with poor access to clean water and sanitation. The World Health Organization estimates millions of cases and over 100,000 deaths occur each year, with a growing threat from antibiotic-resistant bacteria that make treatment difficult (WHO, 2023). Despite the availability of effective vaccines and clear prevention methods, the disease persists, highlighting a critical gap between the existence of solutions and their successful implementation in high-risk communities (Stanaway et al., 2019). This disconnect underscores the need to understand local perceptions and behaviors to tailor effective control strategies.

In Africa, the problem is exacerbated by weak health systems and unreliable data. Typhoid is a leading cause of fever, but many cases are misdiagnosed or not reported, making the true burden unknown and hindering effective public health planning (Mohan et al., 2021). The reality on the ground in many African communities includes overcrowded living conditions, consumption of contaminated street food, and limited access to safe drinking water, which create a perfect environment for the bacteria to spread (Kariuki et al., 2020). Even when people have some awareness of typhoid, this knowledge often does not translate into consistent preventive practices, leading to continued high rates of infection.

In Cameroon, the situation is particularly acute. Typhoid fever is one of the most common causes of hospital visits, placing a heavy burden on families and the healthcare system at the Logbaba District Hospital and similar facilities. Studies in Cameroonian towns like Buea have shown that patients often have poor knowledge about how the disease is actually transmitted and prevented (Tamura et al., 2021). The reality is that many people rely on unsafe water sources and have poor hygiene practices, yet there is a lack of specific local data on the knowledge, attitudes, and practices of patients in the Logbaba District Hospital area. Without this crucial information, any health education or prevention program launched in this community is operating in the dark and is likely to be less effective. This study seeks to address this gap by providing evidence on the KAP of patients to inform targeted interventions.

1.3 Research Question

1.3.1 General Research Question

What are the knowledge, attitudes, and practices of patients regarding the prevention of typhoid fever at the Logbaba District Hospital?

• Specific Research Questions

1. What is the level of knowledge among patients regarding the causes, transmission, and prevention of typhoid fever at the Logbaba District Hospital?
2. What attitudes do patients hold towards the importance of preventive measures against typhoid fever at the Logbaba District Hospital?
3. What specific preventive practices do patients adopt to reduce the risk of contracting typhoid fever at the Logbaba District Hospital?

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