Environmental Transmission of Typhoid Fever in an Urban Slum
| العنوان: | Environmental Transmission of Typhoid Fever in an Urban Slum |
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| المؤلفون: | Judd L. Walson, Daniel Macharia, Adam Akullian, Grace John-Stewart, Jonathan Wakefield, Godfrey Bigogo, Eric Ng’eno, Barry S. Fields, Leonard Cosmas, Maina Mugoh, Alastair Matheson, Joel M. Montgomery |
| المصدر: | PLoS Neglected Tropical Diseases PLoS Neglected Tropical Diseases, Vol 9, Iss 12, p e0004212 (2015) |
| بيانات النشر: | Public Library of Science, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Male, Urban Population, Sanitation, Disease, Salmonella typhi, 0302 clinical medicine, Poverty Areas, 11. Sustainability, Medicine, 030212 general & internal medicine, Child, Aged, 80 and over, education.field_of_study, Geography, lcsh:Public aspects of medicine, 1. No poverty, Middle Aged, 3. Good health, Infectious Diseases, Child, Preschool, Female, Risk assessment, Research Article, Adult, lcsh:Arctic medicine. Tropical medicine, Adolescent, lcsh:RC955-962, 030231 tropical medicine, Population, Risk Assessment, Typhoid fever, Young Adult, 03 medical and health sciences, Environmental health, Disease Transmission, Infectious, Humans, Typhoid Fever, education, Aged, Spatial Analysis, business.industry, Infant, Newborn, Public Health, Environmental and Occupational Health, Case-control study, Infant, Correction, lcsh:RA1-1270, medicine.disease, Kenya, Infectious disease (medical specialty), Case-Control Studies, Immunology, business |
| الوصف: | Background Enteric fever due to Salmonella Typhi (typhoid fever) occurs in urban areas with poor sanitation. While direct fecal-oral transmission is thought to be the predominant mode of transmission, recent evidence suggests that indirect environmental transmission may also contribute to disease spread. Methods Data from a population-based infectious disease surveillance system (28,000 individuals followed biweekly) were used to map the spatial pattern of typhoid fever in Kibera, an urban informal settlement in Nairobi Kenya, between 2010–2011. Spatial modeling was used to test whether variations in topography and accumulation of surface water explain the geographic patterns of risk. Results Among children less than ten years of age, risk of typhoid fever was geographically heterogeneous across the study area (p = 0.016) and was positively associated with lower elevation, OR = 1.87, 95% CI (1.36–2.57), p Author Summary Typhoid fever, a serious bloodstream infection caused by the bacterium Salmonella Typhi, is commonly associated with direct, person-to-person transmission as a result of improper hygiene and unsafe food/water handling practices. Recent evidence, however, suggests that individuals may be indirectly exposed to typhoid through contact with fecal contamination in their immediate environment. In this study we investigated the role of environmental sources in the transmission of typhoid fever across an urban slum in Kenya by mapping the occurrence of cases in both children and adults. We tested the hypothesis that cases (relative to non-cases) cluster in low elevation areas as a result of the downstream flow and accumulation of fecal waste. We found that cases of typhoid fever among children tended to be concentrated in the downstream area. In adolescents and adults, on the other hand, there was little evidence of a geographic pattern in the risk of typhoid fever. These results provide evidence that environmental transmission of typhoid fever contributes to the risk of disease in children but not adults and adolescents, an observation most likely attributed to the fact that children are more likely to be exposed to fecal contamination through outside play. Interventions to improve local sanitation may therefore provide particular benefit to children who are at most risk of exposure to and acquisition of typhoid fever from environmental sources. |
| اللغة: | English |
| تدمد: | 1935-2735 1935-2727 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b85210253f9d0221469ae9ecfb8cb775Test http://europepmc.org/articles/PMC4669139Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b85210253f9d0221469ae9ecfb8cb775 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19352735 19352727 |
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