Domestic River Water Use and Risk of Typhoid Fever: Results From a Case-control Study in Blantyre, Malawi.
| Title: | Domestic River Water Use and Risk of Typhoid Fever: Results From a Case-control Study in Blantyre, Malawi. |
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| Authors: | Gauld JS; Institute for Disease Modeling, Bellevue, Washington.; Centre for Health Informatics, Computing, and Statistics, Lancaster University, United Kingdom.; Olgemoeller F; Department of Clinical Sciences, Liverpool School of Tropical Medicine, United Kingdom.; Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre.; Nkhata R; Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre.; Li C; Department of Clinical Sciences, Liverpool School of Tropical Medicine, United Kingdom.; Xi'an Jiaotong University Health Science Center, Shaanxi, China.; Chirambo A; Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre.; Institute of Infection and Global Health, University of Liverpool, United Kingdom.; Morse T; Centre for Water, Environment, Sustainability and Public Health, University of Strathclyde, Glasgow, United Kingdom.; Centre for Water, Sanitation, Health and Appropriate Technology Development, University of Malawi-Polytechnic, Blantyre.; Gordon MA; Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre.; Institute of Infection and Global Health, University of Liverpool, United Kingdom.; Read JM; Centre for Health Informatics, Computing, and Statistics, Lancaster University, United Kingdom.; Heyderman RS; Division of Infection and Immunity, University College London, United Kingdom.; Kennedy N; Department of Paediatrics, College of Medicine, University of Malawi, Blantyre.; School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, United Kingdom.; Diggle PJ; Centre for Health Informatics, Computing, and Statistics, Lancaster University, United Kingdom.; Feasey NA; Department of Clinical Sciences, Liverpool School of Tropical Medicine, United Kingdom.; Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre. |
| Source: | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2020 Mar 17; Vol. 70 (7), pp. 1278-1284. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 9203213 Publication Model: Print Cited Medium: Internet ISSN: 1537-6591 (Electronic) Linking ISSN: 10584838 NLM ISO Abbreviation: Clin Infect Dis Subsets: MEDLINE |
| Imprint Name(s): | Publication: Jan. 2011- : Oxford : Oxford University Press; Original Publication: Chicago, IL : The University of Chicago Press, c1992- |
| MeSH Terms: | Typhoid Fever*/epidemiology; Malawi/epidemiology ; Africa, Eastern ; Case-Control Studies ; Child ; Humans ; Rivers ; Salmonella typhi ; Water |
| Abstract: | Background: Typhoid fever remains a major cause of morbidity and mortality in low- and middle-income settings. In the last 10 years, several reports have described the reemergence of typhoid fever in southern and eastern Africa, associated with multidrug-resistant H58 Salmonella Typhi. Here, we identify risk factors for pediatric typhoid fever in a large epidemic in Blantyre, Malawi.; Methods: A case-control study was conducted between April 2015 and November 2016. Cases were recruited at a large teaching hospital, and controls were recruited from the community, matched by residential ward. Stepwise variable selection and likelihood ratio testing were used to select candidate risk factors for a final logistic regression model.; Results: Use of river water for cooking and cleaning was highly associated with risk of typhoid fever (odds ratio [OR], 4.6 [95% confidence interval {CI}, 1.7-12.5]). Additional risk factors included protective effects of soap in the household (OR, 0.6 [95% CI, .4-.98]) and >1 water source used in the previous 3 weeks (OR, 3.2 [95% CI, 1.6-6.2]). Attendance at school or other daycare was also identified as a risk factor (OR, 2.7 [95% CI, 1.4-5.3]) and was associated with the highest attributable risk (51.3%).; Conclusions: These results highlight diverse risk factors for typhoid fever in Malawi, with implications for control in addition to the provision of safe drinking water. There is an urgent need to improve our understanding of transmission pathways of typhoid fever, both to develop tools for detecting S. Typhi in the environment and to inform water, sanitation, and hygiene interventions.; (© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.) |
| Grant Information: | 206545/Z/17/Z United Kingdom WT_ Wellcome Trust |
| Contributed Indexing: | Keywords: Salmonella Typhi; WASH; environment; sanitation; water |
| Substance Nomenclature: | 059QF0KO0R (Water) |
| Entry Date(s): | Date Created: 20190531 Date Completed: 20210106 Latest Revision: 20210106 |
| Update Code: | 20260130 |
| DOI: | 10.1093/cid/ciz405 |
| PMID: | 31144715 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't