Host Risk Factors for Typhoid Fever in Children (A Case Study of North Sumatera Province)

Bruh, Rasidah Huraini; Hadisaputro, Suharyo; Budhi, Kamilah; Sakundarno, Mateus; Widjanarko, Bagoes

doi:10.1166/asl.2017.9162

Cited by 2 publications

(5 citation statements)

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“…Lack of hygiene (n = 15) was significantly associated with higher odds of typhoid (OR = 2.2, 95% CI = 1.9-2.6) with a heterogeneity of I 2 = 36% (Table 3, Figure 6). 20,22,[24][25][26]34,37 Good hygiene (n = 8, OR = 0.52, 95% CI = 0.40-0.67, I 2 = 82%) was significantly associated with lower odds of typhoid (Table 3, Figure 6). 19,23,24,32 There was no change in the direction of association or significance in the sensitivity analysis of lack of hygiene.…”

Section: Resultsmentioning

confidence: 97%

“…Of 22 studies, 11 (50%) used the WHO definition of typhoid to identify cases (Supplemental Table 1). Among studies that did not use the WHO definition of typhoid, cases were defined by seropositive results, [19][20][21][22][23][24] urine-positive results, 24 clinical diagnosis, [25][26][27] or clinical diagnosis in the setting of a negative malarial test. 28 A total of 13 factors were identified under the five WASH groups defined as impacting typhoid transmission, including six predicted protective factors and seven predicted risk factors (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…Hygiene includes behaviors that promote cleanliness, such as handwashing with soap and water. 22,23 Hygiene is defined by the JMP as "conditions and practices that help maintain health and prevent spread of disease including handwashing,. .…”

Section: Resultsmentioning

confidence: 99%

“…12 The protective food practices category (n = 8) was significantly associated with lower odds of typhoid (OR = 0.74, 95% CI = 0.55-1.0) with a heterogeneity of I 2 = 80%, 19,24,25,33 whereas the risky food practices category (n = 15) was significantly associated with higher odds of typhoid (OR = 1.7, 95% CI = 1.5-2.0, I 2 = 63%) (Table 4, Figure 7). 20,22,24,34 Neither the direction nor the significance of the association of protective or risky food practices changed in sensitivity analysis (Supplemental Table 3).…”

Section: Resultsmentioning

confidence: 99%

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Associations among Water, Sanitation, and Hygiene, and Food Exposures and Typhoid Fever in Case–Control Studies: A Systematic Review and Meta-Analysis

Brockett

Wolfe

Hamot

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Typhoid fever transmission occurs through ingestion of food or water contaminated with Salmonella Typhi, and case-control studies are often conducted to identify outbreak sources and transmission vehicles. However, there is no current summary of the associations among water, sanitation, and hygiene (WASH); and food exposures and typhoid from case-control studies. We conducted a systematic review and meta-analysis of case-control studies to evaluate the associations among typhoid fever and predicted WASH or food exposure risk factors (13), and protective factors (7). Overall, 19 manuscripts describing 22 case-control studies were included. Two studies were characterized as having low risk of bias, one as medium risk, and 19 as high risk. In total, nine of 13 predicted risk factors were associated with increased odds of typhoid (odds ratio [OR] = 1.4-2.4, I 2 = 30.5-74.8%.), whereas five of seven predicted protective factors were associated with lower odds of typhoid (OR = 0.52-0.73, I 2 = 38.7-84.3%). In five types of sensitivity analyses, two (8%) of 26 summary associations changed significance from the original analysis. Results highlight the following: the importance of household hygiene transmission pathways, the need for further research around appropriate food interventions and the risk of consuming specific foods and beverages outside the home, and the absence of any observed association between sanitation exposures and typhoid fever. We recommend that typhoid interventions focus on interrupting household transmission routes and that future studies provide more detailed information about WASH and food exposures to inform better targeted interventions.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Associations among Water, Sanitation, and Hygiene, and Food Exposures and Typhoid Fever in Case–Control Studies: A Systematic Review and Meta-Analysis

Brockett

Wolfe

Hamot

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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“…This implies that some of the included studies that do not control for other WASH factors can not differentiate the impacts of different WASH components. Some studies controlled for other WASH factors [ 22 – 26 , 30 – 33 , 36 – 38 , 40 , 44 ], but we did not conduct separate analyses of these due to the small number of estimates available. While the estimates do not seem to vary much between the studies that account for other WASH factors and those that do not, future studies need to pay attention to the multicollinearity among the WASH variables.…”

Section: Discussionmentioning

confidence: 99%

Associations of water, sanitation, and hygiene with typhoid fever in case–control studies: a systematic review and meta-analysis

Kim,

Goucher,

Tadesse

et al. 2023

BMC Infect Dis

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Background Water, sanitation, and hygiene (WASH) play a pivotal role in controlling typhoid fever, as it is primarily transmitted through oral-fecal pathways. Given our constrained resources, staying current with the most recent research is crucial. This ensures we remain informed about practical insights regarding effective typhoid fever control strategies across various WASH components. We conducted a systematic review and meta-analysis of case-control studies to estimate the associations of water, sanitation, and hygiene exposures with typhoid fever. Methods We updated the previous review conducted by Brockett et al. We included new findings published between June 2018 and October 2022 in Web of Science, Embase, and PubMed. We used the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool for risk of bias (ROB) assessment. We classified WASH exposures according to the classification provided by the WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation, and Hygiene (JMP) update in 2015. We conducted the meta-analyses by only including studies that did not have a critical ROB in both Bayesian and frequentist random-effects models. Results We identified 8 new studies and analyzed 27 studies in total. Our analyses showed that while the general insights on the protective (or harmful) impact of improved (or unimproved) WASH remain the same, the pooled estimates of OR differed. Pooled estimates of limited hygiene (OR = 2.26, 95% CrI: 1.38 to 3.64), untreated water (OR = 1.96, 95% CrI: 1.28 to 3.27) and surface water (OR = 2.14, 95% CrI: 1.03 to 4.06) showed 3% increase, 18% decrease, and 16% increase, respectively, from the existing estimates. On the other hand, improved WASH reduced the odds of typhoid fever with pooled estimates for improved water source (OR = 0.54, 95% CrI: 0.31 to 1.08), basic hygiene (OR = 0.6, 95% CrI: 0.38 to 0.97) and treated water (OR = 0.54, 95% CrI: 0.36 to 0.8) showing 26% decrease, 15% increase, and 8% decrease, respectively, from the existing estimates. Conclusions The updated pooled estimates of ORs for the association of WASH with typhoid fever showed clear changes from the existing estimates. Our study affirms that relatively low-cost WASH strategies such as basic hygiene or water treatment can be an effective tool to provide protection against typhoid fever in addition to other resource-intensive ways to improve WASH. Trial registration PROSPERO 2021 CRD42021271881.

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Host Risk Factors for Typhoid Fever in Children (A Case Study of North Sumatera Province)

Cited by 2 publications

References 0 publications

Associations among Water, Sanitation, and Hygiene, and Food Exposures and Typhoid Fever in Case–Control Studies: A Systematic Review and Meta-Analysis

Associations among Water, Sanitation, and Hygiene, and Food Exposures and Typhoid Fever in Case–Control Studies: A Systematic Review and Meta-Analysis

Associations of water, sanitation, and hygiene with typhoid fever in case–control studies: a systematic review and meta-analysis

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