Typhoid fever in Fiji: a reversible plague?

Abstract

The country of Fiji, with a population of approximately 870 000 people, faces a growing burden of several communicable diseases including the bacterial infection typhoid fever. Surveillance data suggest that typhoid has become increasingly common in rural areas of Fiji and is more frequent amongst young adults. Transmission of the organisms that cause typhoid is facilitated by faecal contamination of food or water and may be influenced by local behavioural practices in Fiji. The Fijian Ministry of Health, with support from Australian Aid, hosted a meeting in August 2012 to develop comprehensive control and prevention strategies for typhoid fever in Fiji. International and local specialists were invited to share relevant data and discuss typhoid control options. The resultant recommendations focused on generating a clearer sense of the epidemiology of typhoid in Fiji and exploring the contribution of potential transmission pathways. Additionally, the panel suggested steps such as ensuring that recommended ciprofloxacin doses are appropriate to reduce the potential for relapse and reinfection in clinical cases, encouraging proper hand hygiene of food and drink handlers, working with water and sanitation agencies to review current sanitation practices and considering a vaccination policy targeting epidemiologically relevant populations.

Whole Genome Sequence Analysis of Salmonella Typhi Isolated in Thailand before and after the Introduction of a National Immunization Program

“…This observation suggests that the reduction in S . Typhi infections was not attributable to improvements in infrastructure and hygiene practices only [5, 14, 20, 23]. While the inactivated S .…”

Role of Environmental Factors in Shaping Spatial Distribution ofSalmonella entericaSerovar Typhi, Fiji

“…In the past 2 decades, Fiji has observed a steady increase in confirmed typhoid fever cases ( 16 – 18 ). However, little is known about the geospatial distribution and underlying risk factors of typhoid fever in Fiji.…”

“…Fiji had outbreaks of typhoid fever and leptospirosis after devastation and flooding caused by cyclones ( 16 , 18 , 40 , 43 ). Our multivariate model demonstrated an increased risk for Salmonella Typhi infection for persons living closer to the modeled flooding areas.…”

“…During 1991–2000, <5 typhoid cases/100,000 persons were reported per year, mostly in Vanua Levu ( 14 , 15 ). However, since 2005, the number of typhoid fever cases has been increasing ( 16 ), reaching a peak of >50 cases/100,000 persons/year after widespread destruction and flooding caused by Cyclone Tomas in 2010. As a result, the Fiji Ministry of Health increased surveillance and implemented additional prevention strategies, such as vaccination against typhoid fever in the worst affected regions ( 17 , 18 ).…”

Temporal and thematic trends in water, sanitation and hygiene (WaSH) research in Pacific Island Countries: a systematic review

“…The Solomon Islands, with an estimated 5% of the regional population has the 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 The third objective of this review was to identify emergent themes within the peer-reviewed literature and suggest areas in greater need of research. The literature suggests that without enough water for handwashing and personal hygiene there is a greater risk of exposure to enteric pathogens (Bukenya & Nwokolo 1990;Greenwell et al 2013;Prüss Ustün et al 2014), and inadequate animal husbandry practices increase this risk (Berlioz-Arthaud et al 2007;Guerrier et al 2013;Thompson et al 2014). The literature also implicitly characterizes some of the extreme challenges associated with WaSH service delivery in the region, such as how droughts and water shortages impact the freshwater lenses of lowlying coral atolls (Ghassemi et al 1990;Griggs & Peterson 1993;Koda et al 2013), as well as some understanding of the potentially-worsening conditions caused by climate change (Rapaport 1990;Roy & Connell 1991;White et al 2007).…”