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Risk factors for typhoid fever in a slum in Dhaka, Bangladesh

Published online by Cambridge University Press:  08 August 2006

P. K. RAM ,
A. NAHEED ,
W. A. BROOKS ,
M. A. HOSSAIN ,
E. D. MINTZ ,
R. F. BREIMAN  and
S. P. LUBY
P. K. RAM
Affiliation:
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA School of Public Health and Health Professions, University at Buffalo, State University of New York, NY, USA
A. NAHEED
Affiliation:
Programme on Infectious Diseases and Vaccine Sciences, ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh
W. A. BROOKS
Affiliation:
Programme on Infectious Diseases and Vaccine Sciences, ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh
M. A. HOSSAIN
Affiliation:
Programme on Infectious Diseases and Vaccine Sciences, ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh
E. D. MINTZ
Affiliation:
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
R. F. BREIMAN
Affiliation:
Programme on Infectious Diseases and Vaccine Sciences, ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh
S. P. LUBY
Affiliation:
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA Programme on Infectious Diseases and Vaccine Sciences, ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh
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Abstract

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We systematically investigated risk factors for typhoid fever in Kamalapur, a poor urban area of Bangladesh, to inform targeted public health measures for its control. We interviewed patients with typhoid fever and two age-matched controls per case about exposures during the 14 days before the onset of illness. The municipal water supply was used by all 41 cases and 81of 82 controls. In multivariate analysis, drinking unboiled water at home was a significant risk factor [adjusted odds ratio (aOR) 12·1, 95% CI 2·2–65·6]. Twenty-three (56%) cases and 21 (26%) controls reported that water from the primary source was foul-smelling (aOR 7·4, 95% CI 2·1–25·4). Eating papaya was associated with illness (aOR 5·2, 95% CI 1·2–22·2). Using a latrine for defecation was significantly protective (aOR 0·1, 95% CI 0·02–0·9). Improved chlorination of the municipal water supply or disinfecting drinking water at the household level may dramatically reduce the risk of typhoid fever in Kamalapur. The protective effect of using latrines, particularly among young children, should be investigated further.

Type
Research Article
Information
Epidemiology & Infection , Volume 135 , Issue 3 , April 2007 , pp. 458 - 465
Copyright
2006 Cambridge University Press