KNOWLEDGE AND RISK PERCEPTION OF TYPHOID FEVER AMONG RESIDENTS OF BORNO STATE.

CHAPTER ONE

INTRODUCTION

1.1 Background Of The Study

Typhoid fever is a severe, systemic illness caused by specific Salmonella serotypes, including Salmonella typhi, Salmonella paratyphi A, Salmonella paratyphi B, and Salmonella paratyphi C. It became a significant infectious disease in the early nineteenth century. The illness often starts with a rising fever, headache, unexplained stomach discomfort, and constipation, followed by the emergence of rashes. The patient develops extended apathy, toxemia, delirium, disorientation, and/or coma during the third week, followed by diarrhoea. It may result in complications affecting numerous organ systems if left untreated (Fauci et al., 2008). Infection affects all age groups, although children have a greater incidence and a more diverse clinical presentation. Since the late 1940s, many antibiotics have been effectively used to treat typhoid fever: chloramphenicol, ampicillin, and trimethoptrim-sulphamethoxazole. Since 1990, however, multidrug resistant strains of previously effective antibiotics have evolved, necessitating the use of more costly quinolone antibiotics such as oral ciprofloxacin or third generation cephalosporins such as ceftriaxone for therapy (WHO, 2003). Human beings are the sole reservoir and hosts for typhoid fever, and the disease is transmitted in endemic regions by feces-contaminated water and food, particularly by food carriers. Typhoid fever has a worldwide yearly incidence of over 21 million cases and over 600,000 fatalities, according to the World Health Organization (WHO). Cases are more likely to occur in places such as India, South and Central America, and Africa where population growth is high, urbanization is increasing, and access to safe water, infrastructure, and health systems is limited (Willke et al., 2002; John et al., 2004).

Typhoid fever is a significant public health issue in poor nations, where safe drinking water and sufficient waste disposal are often unavailable. In endemic nations, epidemiologic data on typhoid fever are few or inadequate. Typhoid fever cases may be identified clinically, bacteriologically, or serologically, or they may be grouped along with other diseases or disorders, such as fever of unknown cause (Abucejo et al., 2001). Typhoid fever has a significant financial effect since it often takes many months for a patient to recuperate and return to work. Thus, early correct diagnosis of typhoid fever is critical not only for etiological diagnosis, but also for identifying persons who may act as potential carriers and thus contribute to acute typhoid fever epidemics (Gopalakrishnan et al., 2002). Enteric fever may be diagnosed using a variety of methods, including clinical signs and symptoms, serological markers, bacterial culture, antigen detection, and DNA amplification. Typhoid fever is difficult to diagnose clinically since the disease manifests in a variety of ways and there are several reasons of protracted fever in typhoid endemic areas. While relative bradychardia or leucopoenia may be effective, their specificity is limited. Although culture of blood, bone marrow, and stool is the most accurate diagnostic procedure, these are costly methods, and the infected organism may be dead by arriving at the hospital if the patient has taken antibiotics. The Felix-Widal test, which was initially standardized in the 1950s, is mostly used for serological diagnosis. While ELISA and immunoblotting are intriguing alternatives, commercially available kits for enteric fever serodiagnosis have not performed well in big trials (Wain and Hosoglu, 2008). Typhoid fever continues to be a significant public health concern in the underdeveloped countries, with very imprecise estimates of yearly incidence and fatalities. Continued research on the epidemiology, ecology, etiology, diagnosis, treatment, and prevention of typhoid is most effectively conducted in endemic regions, which, regrettably, also lack research capacity, money, and institutional infrastructure. Much more has to be done in these regions to advance and enhance typhoid fever and other infectious disease research if meaningful progress is to be achieved. There is a dearth of information throughout Sub-Saharan Africa, and the challenges definitely demand immediate and swift response, notably in West and East Africa (Ethiopia and Kenya), which seem to have a high typhoid fever burden (Pang, 2008). In view of the above, this research aims to assess inhabitants of Banowa Community, Borno State's knowledge and risk perception about typhoid fever.

1.2 Statement Of The Problem

Typhoid fever is a bacterial disease that is transmitted by the fecal-oral route (Keddy et al., 2016; Shukla et al., 2014). The illness is often acquired by the ingestion or consumption of bacteria-contaminated food or beverages, which are frequently spread by flies from infected persons' excrement or urine (Keddy et al., 2016; Shukla et al., 2014). In Onikokoro Community, these flies spread disease to people's houses not just as a consequence of the bad environmental circumstances, but also as a result of certain villagers' habit of open defecation. In low- and middle-income nations, the disease has been a serious public health problem.

Furthermore, inadequate knowledge and risk perception about typhoid fever contributed to the disease's protracted spread in the population. The purpose of this research is to determine residents of Banowa Community in Borno State's knowledge and risk perception about typhoid fever.

1.3 Objectives Of The Study

The overall aim of this study is to critically assess knowledge and risk perception towards typhoid fever among residents of Banowa Community, Borno State. Hence, the study will be channeled to the following specific objectives;

1.        Determine the prevalence of typhoid fever in Banowa Community.

2.        Ascertain the knowledge of Banowa Community dwellers towards typhoid fever.

3.        Identify the risk factors and practices associated with typhoid fever.

1.4 Research Question

The study will be guided by the following questions;

1.        What is the prevalence of typhoid fever in Banowa Community?

2.        What is the knowledge of Banowa Community dwellers towards typhoid fever?

3.        What are the risk factors and practices associated with typhoid fever in the community?

1.5 Significance Of The Study

The relevance of this research is in attempting to close a gap in the literature by increasing knowledge of typhoid fever and its associated risk factors among villagers in Banowa Community. The outcomes of this study and a better understanding of these risk variables would not only increase villagers' knowledge of proper hygiene practices linked with typhoid fever, but may also assist researchers in facilitating positive social change among them. The findings from individuals' unique perspectives may give chances for encouraging good social change with the objective of adopting proposals for enhancing hygiene and sanitary conditions. The implications for social change include a better understanding of disease perceptions, a better understanding of the effects of open defecation on the practice of eating and sleeping on the floor, and a policy decision to provide toilet facilities and potable water in the community to mitigate the disease's effect on the population.

1.6 Scope Of The Study

This study is structured to generally assess knowledge and risk perception towards typhoid fever among residents of Banowa Community, Borno State. However, the study will further determine the prevalence of typhoid fever in Banowa Community,  ascertain the knowledge of Banowa Community dwellers towards typhoid fever, and identify the risk factors and practices associated with typhoid fever.

The respondents for this study will therefore be obtained from residents of Banowa Community, Borno State.

1.7 Limitation Of The Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

1.8 Definition Of Terms

Prevalence: Is a measure of the frequency of existing disease at a given time.

Typhoid fever: This is a bacterial infection due to Salmonella typhi.

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