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Typhoid Fever Global and Public Health Impact

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Typhoid Fever Global and Public Health Impact Sade Adeneye MPH Student Walden University PUBH 6165-2 Environmental Health Instructor: Rebecca Heick – PowerPoint PPT presentation

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Title: Typhoid Fever Global and Public Health Impact


1
Typhoid Fever Global and Public Health Impact
  • Sade Adeneye MPH Student
  • Walden University
  • PUBH 6165-2 Environmental Health
  • Instructor Rebecca Heick
  • Winter, 2010

2
Introduction
  • Typhoid fever is a life threatening illness that
    is caused by the bacterium Salmonella typhi.
  • Typhoid fever is more common in developing
    countries, and greatly impacts morbidity and
    mortality
  • Need for improved diagnostic and treatment
    measures globally.
  • No adequate surveillance, monitoring and
    reporting system of disease occurrence
  • WHO(2003). Background document The diagnosis
    treatment and prevention of typhoid fever.
    Communicable Disease Surveillance and Response
    Vaccines and Biologicals. Retrieved from

3
  • Varying information on annual worldwide morbidity
    and mortality occurrences
  • Some researchers estimate global morbidity and
    mortality annual rates are between 200,000 and
    600,000, while others say it could be in the
    millions.
  • Merican, I. (1997). Typhoid fever present and
    future. Medical Journal of Malaysia. 52(3)
    299-308
  • Bhutta, Z.A., Threlfall, J. (2009). Addressing
    the global disease burden of Typhoid Fever. JAMA
    302(8) 898-899
  • Passey, M. (1995). The new problem of typhoid
    fever in Papua New Guinea how do we deal with
    it. Papua New Guinea Medical Journal, Dec 38(4)
    300-304
  • Irepepolu, O.H., Entonu, P.E., Agwale, S.M.
    (2008). A review of the disease burden, impact
    and prevention of typhoid fever in Nigeria. West
    African Journal of Medicine, July 27(3)127-133.

4
Salmonella Typhi bacteria
5
Geographical distribution of Typhoid Fever
http//www.spmsd.co.uk/upload/public/docImages/1/t
yphoid_feverI.gif
6
Etiology
  • Salmonella typhi bacteria is carried in
    bloodstream and intestines.
  • Exposure is through contact with sewage, water or
    food, or persons carrying S.typhi bacteria.
  • Contaminated food or beverages are major sources
    of infection (i.e. milk, ice-cream).
  • Bacterial cells multiply and migrate systemically
    to other organs of the body throughout the
    infection process.
  • Fecal-oral mode of transmission
  • CDC - Centers for Disease Control and Prevention,
    (2008). National Typhoid and Paratyphoid Fever
    Surveillance
  • CDC - Centers for Disease Control and Prevention
    (2009), Typhoid Fever

7
Symptoms of typhoid fever
  • Varying levels of intensity of infection
  • Fever (up to 104 degrees Fahrenheit)
  • Stomachache
  • Headache
  • Vomiting
  • General body weakness
  • Selvaraj, I. (2009). Typhoid Fever Control
    Measures

8
(No Transcript)
9
  • Incubation period is 1-2 weeks
  • Infected individuals could remain contagious for
    awhile
  • Become carriers
  • Typhoid Mary Mallon
  • National Institute of Health, (2001). Typhoid
    fever in the United States. NIH Backgrounder

10
Diagnosis
  • Isolation of bacterial cultures from
  • blood
  • stool
  • urine
  • Widal serology test
  • Measures titers of antigens seen as early as week
    1
  • Chang, H.J., Lynm, C., Glass, R.M. (2009).
    Typhoid Fever. Journal of American Medical
    Association. 302(8), pg 914

11
Diagnosis contd.
  • Bone Marrow aspirate cultures
  • Locating carriers through sewer swab technique
  • Selvaraj, I. (2009). Typhoid Fever Control
    Measures

12
  • Age group
  • Affects all ages
  • Significant cause of death in children between
    ages 1-5years
  • Sex More common in males than females.
  • Population Disease of low socioeconomic class
    and status.
  • Selvaraj, I. (2009). Typhoid Fever Control
    Measures
  • Sinha, et.al, (1999). Typhoid fever in children
    aged less than 5 years. Lancet 354(9180)
    734-737
  • Irepepolu, O.H., Entonu, P.E., Agwale, S.M.
    (2008). A review of the disease burden, impact
    and prevention of typhoid fever in Nigeria. West
    African Journal of Medicine, July 27(3)127-133.

13
Contamination and transmission
14
Prevention and Treatment
  • Constant washing of hands
  • Avoid eating risky foods or drinks (especially
    for travelers)
  • Drink water from sanitary sources, i.e. bottled
    or filtered
  • Handle food safely
  • Boil or cook food thoroughly
  • Prophylactic attenuated Salmonella typhi vaccine
    (available for travelers)
  • CDC - Centers for Disease Control and Prevention,
    (2008). National Typhoid and Paratyphoid Fever
    Surveillance
  • World Health Organization (2003). Background
    document The diagnosis treatment and prevention
    typhoid fever. Communicable Disease Surveillance
    and Response Vaccines and Biologicals.
  • Duszczyk, E., Talarek, E. (2008). Routine and
    recommended vaccinations for travelers.
    International Maritime Health, 59(1-4) 116 123
  • Bhunia, R., and co. ((2009). Recent advances in
    typhoid fever. Malaria Weekly publication.
    Atlanta August 3, pg 22.

15
Prevention and Treatment Contd.
  • Education of food handlers
  • Medications
  • Chloramphenicol
  • Quinolones
  • Ceftiaxone
  • Ampicillin
  • Ciprofloxacin
  • Bhunia, R., and co. ((2009). Recent advances in
    typhoid fever. Malaria Weekly publication.
    Atlanta August 3, pg 22.

16
Treatment Challenges
  • Resistance to treatment with new strains of
    bacteria
  • Overuse of antimicrobials has caused treatment
    failures
  • Lack of appropriate diagnostic facilities,
    technology and manpower
  • Reduced or lack of access to appropriate
    medications
  • World Health Organization (2005). Drug-resistant
    Salmonella.
  • Threlfall, E.J., Ward, L.R., Rowe, B., et al.
    (1992). Widespread occurrence of multiple
    drug-resistant Salmonella Typhi in India.

17
Guidelines for Vaccine Providers
  • Inform the people on the importance of vaccine
  • Use community health centers as meeting points
  • Visit homes with fliers for awareness campaign
  • Use students to reach their parents
  • Make posters with pictures of victims of Typhoid
    fever
  • Visit local leaders and seek their cooperation
    and support
  • Ensure that professionalism is the watch word

18
Conclusion
  • 400 cases annually in the United States
  • 12.5 millions persons globally
  • Typhoid fever is a global and public health issue
  • Implications of lack of effective reporting
    system
  • Benefits of global policies
  • CDC - Centers for Disease Control and Prevention,
    (2008). National Typhoid and Paratyphoid Fever
    Surveillance
  • World Health Organization (2005). Drug-resistant
    Salmonella

19
Challenges in Nigeria
  • Program and policy development
  • Integrity and specific goals of the program
  • Implementation, enforcement, and participation by
    community
  • Integrity of program coordinators
  • Lack of desire for maintenance or sustenance

20
Additional resources for your reference
  • Pfizer drug trial misconduct information, can be
    found at http//www.business-humanrights.org/Categ
    ories/Lawlawsuits/Lawsuitsregulatoryaction/Lawsuit
    sSelectedcases/PfizerlawsuitreNigeria
  • Additional information on governance and public
    service delivery, can be found at
    http//www.ifpri.cgiar.org/publication/decentraliz
    ation-and-public-service-delivery-nigeria
  • Article on the Healthcare system in Nigeria, can
    be found at http//www.kwenu.com/publications/orab
    uchi/poor_healthcare.htm
  • Additional information on healthcare and welfare
    in developing nations can be found at
    http//www.who.int/bulletin/volumes/88/1/09-067868
    /en/

21
References
  • Bhunia, R., and co. ((2009). Recent advances in
    typhoid fever. Malaria Weekly publication.
    Atlanta August 3, pg 22. Retrieved from
    ProQuest Health and Medical database accessed
    through Walden Library.
  • Bhutta, Z.A., Threlfall, J. (2009). Addressing
    the global disease burden of Typhoid Fever.
    JAMA 302(8) 898-899. Retrieved from
  • http//jama.ama-assn.org/cgi/content/extract/302
    /8/898
  • CDC - Centers for Disease Control and Prevention
    (2009), Typhoid Fever. http//www.cdc.gov/ncidod/
    dbmd/diseaseinfo/TyphoidFever_g.html
  • CDC - Centers for Disease Control and Prevention,
    (2008). National Typhoid and Paratyphoid Fever
    Surveillance. Retrieved from http//www.cdc.gov/
    nationalsurveillance/typhoid_surveillance.html
  • Chang, H.J., Lynm, C., Glass, R.M. (2009).
    Typhoid Fever. Journal of American Medical
    Association. 302(8), pg 914

22
References Contd.
  • Duszczyk, E., and Talarek, E. (2008). Routine
    and recommended vaccinations for travelers.
    International Maritime Health, 59(1-4) 116
    123. Retrieved from http//www.ncbi.nlm.nih.gov/
    pubmed/19227745
  • House, D., Wain, J., Ho, A.V., Diep, T.S., Chinh,
    N.T., Bay, P.V. et al. (2001). Serology of
    Typhoid Fever In An Area of Endemicity And Its
    Relevance To Diagnosis. Journal of Clinical
    Microbiology, 39(3) 1002-1007, retrieved on
    October 3, 2009, from http//jcm.asm.org/cgi/rep
    rint/39/3/1002
  • Irepepolu, O.H., Entonu, P.E., Agwale, S.M.
    (2008). A review of the disease burden, impact
    and prevention of typhoid fever in Nigeria.
    West African Journal of Medicine, July
    27(3)127-133.
  • Merican, I. (1997). Typhoid fever present and
    future. Medical Journal of Malaysia. 52(3)
    299-308 Retrieved from http//www.ncbi.nlm.nih.go
    v/pubmed/10968104
  • National Institute of Health, (2001). Typhoid
    fever in the United States. NIH Backgrounder.
    Retrieved from http//www.nichd.nih.gov/news/rel
    eases/typhoid_background.cfm
  • Passey, M. (1995). The new problem of typhoid
    fever in Papua New Guinea how do we deal with
    it? Papua New Guinea Medical Journal, Dec 38(4)
    300-304. Retrieved from www.ncbi.nlm.nih.gov/pu
    bmed/9522872

23
References Contd.
  • Selvaraj, I. (2009). Typhoid Fever Control
    Measures
  • Retrieved from www.pitt.edu/super7/23011-24001
    /23121.ppt
  • Sinha, et.al, (1999). Typhoid fever in children
    aged less than 5 years. Lancet 354(9180)
  • 734-737
  • Threlfall, E.J., Ward, L.R., Rowe, B., et al.
    (1992). Widespread occurrence of multiple
    drug-resistant Salmonella Typhi in India. Eur J.
    clinical Microbiology of Infectious Disease, Nov
    11(11) 990-993
  • World Health Organization (2009). Initiative for
    vaccine research Typhoid Fever. Retrieved
    from http//www.who.int/vaccine_research/disease
    s/diarrhoeal/en/index7.html
  • World Health Organization (2003). Background
    document The diagnosis treatment and prevention
    of typhoid fever. Communicable Disease
    Surveillance and Response Vaccines and
    Biologicals. Retrieved from
  • http//www.who.int/vaccines-documents/DocsPDF03
    /www740.pdf
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