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THE ROLE OF NURSES IN MANAGEMENT OF TYPHOID IN WEST AFRICA

CHAPTER ONE

INTRODUCTION

1.1      Background of the Study

One of the principal diseases causing morbidity and mortality in the tropical regions is typhoid fever. Typhoid fever is a serious acute febrile syndrome that is very common in tropical countries. (Nguri, 2011). The mode of transmission of Typhoid fever is through food ingestion. It could also be as a result of contamination of food with infected persons feces which has the presence of Salmonella enteric serovar Typhi (Magnum & Magnum, 2014). There is the movement of the bacteria resulting from perforation into the intestinal. This results in macrophages phagocytizing it. The family of the Genus Salmonella is the Entero bacteria facultative Gram-negative bacilli. It is identified by a biochemical test and antigen structure. Patients infected with Typhoid fever demonstrate the features of high fever, myaliga, headache, stomach pain, sore throat, and diarrhoea. In some instances, the term "enteric fever" collective represent all typhoid and paratyphoid cases (Kanungu, Dutta & Sur, 2008).

In most cases, when Typhoid fever is not attended to early, it may end in the death of the individual. Heyman reports as cited from the Centre for Disease Control and Prevention that, globally their e over 17 million cases of Typhoid which results in more than 600,000 deaths yearly. In the developing world, Nguri (2011) reports that, is threat affecting about 12.5 million persons annually. Notwithstanding, in most situations, the effect of the incidence and the actual health effect of Typhoid remains unexplored within the Sub 2 Saharan region. Marks et al (2010) report that key among the barriers to knowing the effect and incidence of Typhoid within the Sub-Saharan Africa is the issue of lack of diagnostic laboratories. As a result, there are wrong diagnosis as fatal Typhoid Fever is often interpreted as malaria (Evans et al, 2004; Reddy,2010).

1.2       Statement of the Problem

Typhoid Fever ranks among the first twenty causes of outpatient illness. This according to Sorry (2009) as cited by Marks (2010) accounts for 0.92% of hospital admissions. In the literature on Typhoid Fever, little has been documented in Nigeria. A study conducted by Marks (2010)  at the Agogo Presbyterian Hospital in the Ashanti Region of Ghana using 1,456 children provides further insights into researching into the diagnosis of Typhoid Fever. In this study, using Blood culture method, it was established that Children<2 years of age had the highest proportion of positive blood cultures (164/1,456). Typhoid fever was low among children <2 years of age (7/1018, 0.7%).Though the blood culture method was able to record high incidence figure, the authors admit the low sensitivity of standard microbiologic methods which was given as being up to 50%.As a result the results were prone to under diagnosing moderate bacteremia in Salmonella infections (Gilman et al., 1975; Wain et al., 2001).