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Article

Environmental Foundations of Typhoid Fever in the Fijian Residential Setting

1
Centre for Ecosystem Management, Edith Cowan University, Joondalup, WA 6027, Australia
2
School of Public Health, University of Sydney, Sydney, NSW 2006, Australia
3
Wildlife Conservation Society, Suva, Fiji
4
College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji
5
New Vaccines Group, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
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Department of Preventative and Social Medicine, University of Otago, Dunedin 9054, New Zealand
7
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1H9SH, UK
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Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC 3000, Australia
9
Fiji Centre for Communicable Disease Control, Fiji Ministry of Health and Medical Services, Suva, Fiji
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(13), 2407; https://doi.org/10.3390/ijerph16132407
Received: 17 May 2019 / Revised: 28 June 2019 / Accepted: 29 June 2019 / Published: 6 July 2019
(This article belongs to the Section Infectious Disease Epidemiology)
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. View Full-Text
Keywords: typhoid fever; drainage; residential setting; Fiji; water and soil typhoid fever; drainage; residential setting; Fiji; water and soil
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MDPI and ACS Style

Jenkins, A.P.; Jupiter, S.D.; Jenney, A.; Rosa, V.; Naucukidi, A.; Prasad, N.; Vosaki, G.; Mulholland, K.; Strugnell, R.; Kama, M.; Crump, J.A.; Horwitz, P. Environmental Foundations of Typhoid Fever in the Fijian Residential Setting. Int. J. Environ. Res. Public Health 2019, 16, 2407. https://doi.org/10.3390/ijerph16132407

AMA Style

Jenkins AP, Jupiter SD, Jenney A, Rosa V, Naucukidi A, Prasad N, Vosaki G, Mulholland K, Strugnell R, Kama M, Crump JA, Horwitz P. Environmental Foundations of Typhoid Fever in the Fijian Residential Setting. International Journal of Environmental Research and Public Health. 2019; 16(13):2407. https://doi.org/10.3390/ijerph16132407

Chicago/Turabian Style

Jenkins, Aaron P., 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. 2019. "Environmental Foundations of Typhoid Fever in the Fijian Residential Setting" International Journal of Environmental Research and Public Health 16, no. 13: 2407. https://doi.org/10.3390/ijerph16132407

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