Environmental Foundations of Typhoid Fever in the Fijian Residential Setting

Aaron P. Jenkins, Stacy D. Jupiter, Adam Jenney, Varanisese Rosa, Alanieta Naucukidi, Namrata Prasad, Gandercillar Vosaki, Kim Mulholland, Richard Strugnell, Mike Kama, John A. Crump and Pierre Horwitz
Additional contact information
Aaron P. Jenkins: Centre for Ecosystem Management, Edith Cowan University, Joondalup, WA 6027, Australia
Stacy D. Jupiter: Wildlife Conservation Society, Suva, Fiji
Adam Jenney: College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
Varanisese Rosa: New Vaccines Group, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
Alanieta Naucukidi: New Vaccines Group, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
Namrata Prasad: Department of Preventative and Social Medicine, University of Otago, Dunedin 9054, New Zealand
Gandercillar Vosaki: Wildlife Conservation Society, Suva, Fiji
Kim Mulholland: New Vaccines Group, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
Richard Strugnell: Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC 3000, Australia
Mike Kama: Fiji Centre for Communicable Disease Control, Fiji Ministry of Health and Medical Services, Suva, Fiji
John A. Crump: Department of Preventative and Social Medicine, University of Otago, Dunedin 9054, New Zealand
Pierre Horwitz: Centre for Ecosystem Management, Edith Cowan University, Joondalup, WA 6027, Australia

IJERPH, 2019, vol. 16, issue 13, 1-20

Abstract: Proximal characteristics and conditions in the residential setting deserve greater attention for their potential to influence typhoid transmission. Using a case-control design in Central Division, Republic of Fiji, we examined bacterial (coliform and Escherichia coli ) contamination and chemical composition of water and soil as potential vehicles of exposure to Salmonella Typhi, combining observational analysis of residential living conditions, geospatial analysis of household locations, and factor analysis to explore multivariate associations with the risk of developing typhoid fever. Factors positively associated with typhoid infection related to drainage [phosphate (OR 4.235, p = 0.042) and E. coli concentrations (OR 2.248, p = 0.029) in toilet drainage soil, housing [external condition (OR 3.712, p < 0.001)], drinking water contamination (OR 2.732, p = 0.003) and sanitary condition (OR 1.973, p = 0.031). These five factors explained 42.5% of the cumulative variance and were significant in predicting typhoid infection. Our results support the hypothesis that a combination of spatial and biophysical attributes of the residential setting influence the probability of typhoid transmission; in this study, factors associated with poor drainage, flooding, and sanitary condition increase local exposure to contaminated water and soil, and thereby infection. These findings extend testing of causal assumptions beyond the immediate domestic domain, enhance the scope of traditional case control epidemiology and allow greater specificity of interventions at the scale of the residential setting.

Keywords: typhoid fever; drainage; residential setting; Fiji; water and soil (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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