Typhoid &water Bill Brieger | 14 Mar 2023 06:21 pm
Typhoid fever in Lagos, Nigeria
By Peace Ige, and originally posted in the Social and Behavioral Foundations of Primary Health Care Blog.
In Nigeria, typhoid fever continues to be a significant disease, and its prevalence is on the rise. The disease is transmitted through the oral consumption of contaminated food or water and can also be spread through personal contact due to unsanitary practices (Enabulele et al., 2016). The increasing incidence of antibiotic-resistant strains of the bacteria makes treating typhoid fever challenging. The lack of proper surveillance, limited laboratory capacity, and inadequate data availability in Nigeria make it difficult to assess the actual prevalence of typhoid fever. 
There needs to be more reliable and consistent data on the incidence of typhoid fever in Lagos and Nigeria, making it challenging to assess the disease’s prevalence accurately. This under-reporting is due to several reasons, including using antibiotics before confirmatory laboratory tests and patients’ failure to seek medical attention, as laboratory services are often not affordable (Enabulele et al., 2016).
According to a study published in The American Journal of Tropical Medicine and Hygiene (primary article), the lack of epidemiological data tracking regarding typhoid fever in sub-Saharan Africa prompted the World Health Organization (WHO) to call for a continent-wide approach to generate more accurate disease incidence and antimicrobial susceptibility data in 2008. The study emphasizes the importance of antibiotic resistance as a significant health security issue, as S. Typhi has developed resistance to multiple drugs, making it difficult to treat.
Typhoid fever remains endemic in Lagos, Nigeria, and the larger sub-Saharan Africa region, posing a significant public health challenge. To address this issue, coordinated efforts are needed from all stakeholders. Strengthening surveillance systems to collect accurate data on typhoid fever incidence, prevalence, and antimicrobial susceptibility is critical (Enabulele et al., 2016). This requires government funding to improve laboratory infrastructure and trained personnel. Accessible data can guide policy decisions and interventions. Improving sanitation and hygiene practices is also vital to combating typhoid fever.
The government should invest in improving access to potable water, wastewater management systems, and community education on personal hygiene practices. Public and private sector partnerships can be established to improve water and sanitation infrastructure in vulnerable communities. Increased vaccination campaigns are a cost-effective intervention in reducing the incidence of typhoid fever. The Nigerian government should increase the coverage of the typhoid fever vaccine in Lagos state, especially for vulnerable populations such as children and those in low-income communities.
A robust public health campaign should promote vaccine uptake and raise awareness of typhoid fever and its causes. A multi-sectoral approach is needed to address the root causes of typhoid fever in Lagos. Collaboration between the government, healthcare providers, the private sector, and other stakeholders is necessary to ensure the implementation of effective interventions. Advocacy efforts are necessary to ensure political commitment and support for policies addressing typhoid fever in Lagos. By implementing these strategies, Lagos can reduce the incidence and impact of typhoid fever on its population.
Lagos, Nigeria, must take responsibility for addressing the issue of typhoid fever and external support. The World Health Organization (WHO) has already called for a continental approach to generate accurate disease incidence and antimicrobial susceptibility data, and Nigeria must take advantage of this support. One of the critical areas where external support is essential is strengthening the healthcare system’s capacity for surveillance and diagnosis of typhoid fever. This includes improving laboratory facilities and providing training for healthcare workers.
Support from organizations such as WHO and the Centers for Disease Control and Prevention (CDC) can help develop effective policies and programs to control the spread of typhoid fever. Another area where external support is critical is promoting research into new and effective treatments for typhoid fever. This includes developing new antibiotics and vaccines and studying the disease’s epidemiology and ecology to understand better how it spreads and can be prevented.
External support is essential in helping to raise awareness of the issue of typhoid fever and its impact on public health in Nigeria. By working with local communities and stakeholders, external organizations can help to educate people about the disease, how it is spread, and how it can be prevented. This can create a sense of urgency around the issue and mobilize local communities and governments to take action.
The bluish line in the graph shows the rate of S. Typhi that can resist ampicillin. The orange line shows Chlora6mphenicol-resistant S. Typhi. Co-trimoxazole-resistant Staphylococcus typhi prevalence is shown by the gray line. S. the yellow line shows Typhi tetracycline resistance. The dark blue line shows the proportion of S. Typhi resistant to ciprofloxacin. The green line shows cefuroxime-resistant S. Typhi.
In 2003, cefuroxime entered clinical use. The red line shows the proportion of S. Typhi strains resistant to cefotaxime. In 2008, cefotaxime was made available to the public. In conclusion, typhoid fever remains a significant public health issue in Lagos, Nigeria. The persistence of the disease can be attributed to poor surveillance, inadequate data availability, restricted laboratory capacity, and resource and financial limitations that contribute to poor quality water, sanitation, and hygiene infrastructure.
The adoption of proper measures can significantly reduce the incidence of typhoid fever in Lagos. The Lagos State Government and stakeholders in Nigeria must show more commitment and will to provide the necessary means to combat the endemic disease. The involvement of external forces such as WHO, CDC, and other international organizations in promoting the eradication of the disease is essential. Their support in generating more accurate disease incidence and antimicrobial susceptibility data, improving laboratory capacity, and providing resources for disease surveillance and control is a significant step toward eradicating the disease.”
All stakeholders must work together to ensure the necessary measures are taken to end the endemic disease. With proper measures in place, we can significantly reduce the incidence of typhoid fever in Lagos, Nigeria, and ultimately eradicate the disease.