Characterization of Enteric and Blood Pathogens and Associated Factors among Patients Presenting with Typhoid Fever like Symptoms in Buhigwe District Kigoma Tanzania

Abstract

Background: Typhoid fever is a life threatening waterborne and food borne illness caused by bacterium Salmonella typhi. Approximately 21 million cases and 222 000 typhoid-related deaths occur annually worldwide. People living in Buhigwe district for couple of years have been experiencing seasonal outbreak of fever and gastrointestinal illness of unknown origin similarly to that of typhoid fever. Broad objective: The aim of this study was to characterize enteric and blood pathogens among patients presenting with typhoid fever like symptoms in Buhigwe district. Material and Methods: This was cross-sectional designed health facilities based study conducted in Buhigwe district. Four health facilities was selected randomly form Kajana, Muyama, and Muzenze and Songambele wards. After systematic sampling of study participants blood and stool sample were collected and analyze using Real Time Polymerase Chain Reaction (PCR).Questionnaires were used to collect information on factors associated with enteric and blood pathogens. Collected data was analyzed using Epi info version 3.5.1, Stata and excel statistical software Results: Total of 246 participants were enrolled into the study. Their age range from 1to 82 years with 72.8% female. Majority of them were farmers (63.8%). Thirty five percent aged less than 16 years old. Participants presenting with typhoid fever like symptoms were having multiple pathogens. Blastocystis, Enteroagrigative Escherichia Coli (EAEC), Giardia and malaria were the most prevalent enteric and blood pathogens. Drinking untreated water was significantly associated with enteric infections AOR (95%CI) =2.8(1-7.8). Not having insecticide treated bed net was associated with getting malaria. infection AOR (95%CI) =3.5(1.4-8.8).Living in Kajana ward was significant associated with both getting malaria and enteric infections AOR (95%CI) = 2.3(1-4), AOR (95%CI) =8(2.7-23.9) respectively. Getting schistosomiasis infection was significant associated with washing clothes in open water bodies AOR (95%CI) =2.2(1.2-4.0). Conclusions. Malaria, schistosomiasis, giardiasis and to a lesser extent other enteric and blood pathogens may commonly be present in patients presented with typhoid fever like symptoms or in patients suspected of typhoid fever. Poor personal hygiene practices, not having mosquito bed net and taking shower or washing clothes in open water bodies was significant associated with getting enteric infections, malaria and schistosomiasis infections respectively.