Assignment
fanny shimas
PU535AssingmentUnit911.docxRunning head: TYPHOID FEVER
TYPHOID FEVER
Waterborne Disease: Typhoid Fever
Abstract
Typhoid fever is a waterborne disease that continues to pose a major public health concern in different parts of the world, particularly in the underdeveloped nations of Southeast Asia, South Central Asia, and Sub Saharan African. While the prevalence rate of the disease is low in developed countries such as the United States, all countries must take proactive measures to eradicate the causative agent implicated in the development of typhoid fever and ensure improved quality of life. All countries can achieve this through coming up with responsive public health laws and policies.
Table of Contents
Abstract 2 Introduction 4 Literature Review Stick to the secrion you were given in the instructions dont add or substract 4 Incidence 4 Pathophysiology, Pathogenesis, and Biological Mechanisms 5 Patterns and Mode of Transmission 6 Conclusion and Recommendations 7 References 9
Introduction
A waterborne disease that can have detrimental public health effects in some parts of the globe if left untreated is typhoid fever. Although not very common in the developed countries, typhoid fever affects many people in the developing countries, with Keddy (2018) estimating that there currently exists as many as 16-30 million cases annually, almost exclusively in the developing nations. The mortality rate from the disease stands at approximately 10% of the affected people globally. Typhoid fever has a complex pathophysiology, pathogenesis, and mode of transmission. The public health policy proposed for the management of typhoid comprises of the water, sanitation, and hygiene (WASH) strategies combined with a stringent typhoid vaccination policy advocated by the World Health Organization. These public health policies can be particularly efficacious in underdeveloped countries where the typhoid epidemic is highest.( this could be developed in the body of the essay there is nothing that talked about public health policy in the eesay).The purpose of this report is to document the trends in the incidence, pathophysiology, pathogenesis, and biological mechanisms of typhoid fever, and its mode of transmission while proposing some recommendations that can aid in combating the disease.
Literature Review
Incidence (in APA italic)
A number of scholarly sources have dissected the incidence of typhoid fever in different parts of the globe. For example, a comprehensive review by Yasin, Jabeen, Nisa, Tasleem, and Khan (2018) established that approximately 27 million new cases of typhoid happen every year globally, with mortality in the range of 200,000. The researchers add that the most notable mortality rates and bleakness are in Southeast and South Central Asia. Gotuzzo (2018) shares similar sentiments, stating that the estimated number of typhoid fever cases is 15-20 million yearly, mainly in South East Asia, China, India, and Africa. According to the researcher, (cite which resercher by name and citation) the incidences in Indonesia and Papua New Guinea may reach 1200/100,000 population while in North America, Europe, and other developed countries have low incidences of <10/100,000 population.
Unlike Yasin et al. (2018) and Gotuzzo (2018), Buckle, Walker, and Black (2012) conducted a systematic review to approximate the global morbidity and mortality from typhoid fever for 2010. In this review, which relied upon studies published in Scopus and PubMed databases, the researchers found out that the estimated total number of typhoid episodes in 2010 was 13.5 million while the “adjusted estimate accounting for the low sensitivity of blood cultures for isolation of the bacteria was 26.9 million” (Buckle et al., 2012, p. 6).(follow up all quotes with some kind of conlusion or analysis explanation not just the citation.
Pathophysiology, Pathogenesis, and Biological Mechanisms (use headings and subheading in APA syle)
Empirical and theoretical studies have also highlighted the pathophisiological, pathogenesis, and biological mechanisms implicated in the development of typhoid fever. Researches by Crump (2019) and Keddy (2018) both affirm that the pathogen implicated in the development of the disease is Salmonella enteric serovar typhi (S. Typhi). This pathogen is nonsporulating, flagellated, non-capsulated, Gram-negative anaerobic bacilli. In his review, Crump (2019) provides a comprehensive overview of the chain of infection of S. Typhi in humans. The researcher contends that humans are the reservoirs of S. Typhi, with the pathogen having limited capability of multiplying outside the human host.
A systematic review by Paul and Bandyopadhyay (2017) revealed that the pathogenesis of S. Typhi and pathopsyciology of typhoid fever is a complex process that proceeds through various stages. As the researchers point out, the process begins with an incubation period of 7-14 days, which in many cases is asymptomatic. During this phase, bacteria (S. Typhi) invade macrophages and subsequently spread all through the spleen, liver, and reticuloendothelial system (Paul & Bandyopadhyay, 2017). The organism then multiplies in these organs for a period ranging from one to three weeks. Rupture of the infected cells then takes place, thereby liberating S. Typhi into the bile and causing infection of the small intestine’s lymphoid tissue particularly in the ileum. Mucosal invasion causes the cells in the epithelial to synthesize and release various proinflammatory cytokines.
Contrary to the assertions by Paul and Bandyopadhyay (2017), Yasin et al. (2018) refer to the pathology of typhoid fever in Payer’s patches that assume four phases corresponding approximately to the weeks of disease progression is the individual with typhoid fever has not received treatment. Phase 1 as identified by the researchers is hyperplasia of lymphoid follicles while Phase 2 is necrosis of lymphoid follicles, which occurs during the second week and involves the mucosa as well as the submucosa. Yasin et al. (2018) equate Phase 3 with the ulceration in the bowel’s long axis with the possibility of hemorrhage and perforation while in Phase 4 healing takes place and does not produce strictures from the fourth week onwards.
Patterns and Mode of Transmission (this was not one of the section according to the instructions) Do not add what was not asked this is confusing to the reader)
Existing literature has also delved into the patterns and modes of transmission for S. Typhi. The study by Crump (2019) established that the mode of transmission of S. Typhi is predominantly indirect and largely vehicle-borne via contaminated water, which serves as the vehicle for S. Typhi. Keddy (2018) from a different dimension asserts that transmission can occur in two broad categories, short-cycle transmission and long-cycle transmission. In the short-cycle transmission, fecal shedding contaminates water in the immediate environment, with transmission mediated through inadequate sanitary measures and inadequate hygiene (Keddy, 2018). On the contrary, in long-cycle transmission, contamination occurs in the broader environment, for example pollution by human feces of untreated water supplies. Paul and Bandyopadhyay (2017) in a comprehensive review of typhoid fever found out that the portal of entry for S. Typhi is the mouth, usually by ingestion of focally contaminated food or water. The disease intensity increases with the amount of the ingested dose.
Conclusion and Recommendations
(Furthermore, your supervisor asks that you discuss and evaluate the basis of public health laws, policies, or regulations related to this disease. You must assess how our current understanding of the disease serves as a basis for public health laws, policies, or
regulations related to this disease.
Your supervisor asks that you present your findings in a professional report, with the following sections: abstract, introduction, literature review, conclusions, and recommendations)
The incidence and prevalence of typhoid fever continues to pose a major public health concern in different parts of the globe. This is particularly true in the developing countries such as those located in Southeast and South Central Asia, Africa, and parts of Oceania. From the literature review, it has become apparent that in these developing countries, typhoid is a leading cause of mortality and morbidity. The pathogen implicated in the development of the disease, S. Typhi, infects individuals through feces found in contaminated water or food. Apart from poor water hygiene, other notable drivers of the typhoid fever disease include weak government regulations to improve sanitation in order to fight the incidence of the disease. The following recommendations may be beneficial in fighting typhoid fever not only in the developing countries but also in the developed countries:
Increasing rates of vaccination in high-risk areas where people have a higher susceptibility to contracting typhoid fever – As cited by Bentsi-Enchill and Hombach (2019), the WHO contends that vaccination provides an effective shorter-term control strategy, is more affordable to governments, and does not require substantial behavioral change. The WHO has updated its policy on the oral live attenuated Ty21a and parenteral unconjugated VI polysaccharide typhoid vaccines, emphasizing their programmatic use for controlling epidemic and endemic typhoid fever in areas where the disease has remained a major public health concern. According to Bentsi-Enchill and Hombach (2019), the use of oral live attenuated Ty21a and parenteral unconjugated VI polysaccharide typhoid vaccines in two large pilot projects in Asia provided evidence of vaccine safety and effectiveness while also demonstrating feasibility to the communities targeted.
The other recommendation pertains to the implementation of the WASH program advocated by the WHO. WASH stands for the acronym water, sanitation, and hygiene, which calls on governments to come up with realistic policies for improving sanitation and taking other hygiene measures to prevent the spread of communicable, waterborne diseases such as typhoid fever. Focus here should be on providing continuous, effective disinfection groundwater systems with the goal of eliminating all sources of contamination (Bentsi-Enchill & Hombach, 2019).
References
Bentsi-Enchill, A. D., & Hombach, J. (2019). Revised global typhoid vaccination policy. Clinical Infectious Diseases, 68(1), S31-S33.
Buckle, G. C., Walker, C. L., & Black, R. E. (2012). Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010. Journal of Global Health, 2(1), 1-9.
Crump, J. (2019). Progress in typhoid fever epidemiology. Clinical Infectious Diseases, 68(1), S4-S9.
Gotuzzo, E. (2018). Typhoid fever: A current problem. International Journal of Infectious Diseases, 73, 46-47.
Keddy, K. H. (2018). 21st-century typhoid fever—progression of knowledge but regression of control? The Lancet Infectious Diseases, 18(12), 1296-1298.
Paul, U. K., & Bandyopadhyay, A. (2017). Typhoid fever: A review. International Journal of Advances in Medicine, 4(2), 300-306.
Yasin, N., Jabeen, A., Nisa, I., Tasleem, U., & Khan, H. (2018). A review: Typhoid fever. Journal of Bacteriology and Infectious Diseases, 2(3), 1-7.
