Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
PLoS One. 2018 Feb 23;13(2):e0193348. doi: 10.1371/journal.pone.0193348. eCollection 2018.
On May 2, 2009 an outbreak of typhoid fever began in rural villages along the Malawi-Mozambique border resulting in 748 illnesses and 44 deaths by September 2010. Despite numerous interventions, including distribution of WaterGuard (WG) for in-home water treatment and education on its use, cases of typhoid fever continued. To inform response activities during the ongoing Typhoid outbreak information on knowledge, attitudes, and practices surrounding typhoid fever, safe water, and hygiene were necessary to plan future outbreak interventions. In September 2010, a survey was administered to female heads in randomly selected households in 17 villages in Neno District, Malawi. Stored household drinking water was tested for free chlorine residual (FCR) levels using the N,N diethyl-p-phenylene diamine colorimetric method (HACH Company, Loveland, CO, USA). Attendance at community-wide educational meetings was reported by 56% of household respondents. Respondents reported that typhoid fever is caused by poor hygiene (77%), drinking unsafe water (49%), and consuming unsafe food (25%), and that treating drinking water can prevent it (68%). WaterGuard, a chlorination solution for drinking water treatment, was observed in 112 (56%) households, among which 34% reported treating drinking water. FCR levels were adequate (FCR ≥ 0.2 mg/L) in 29 (76%) of the 38 households who reported treatment of stored water and had stored water available for testing and an observed bottle of WaterGuard in the home. Soap was observed in 154 (77%) households, among which 51% reported using soap for hand washing. Educational interventions did not reach almost one-half of target households and knowledge remains low. Despite distribution and promotion of WaterGuard and soap during the outbreak response, usage was low. Future interventions should focus on improving water, sanitation and hygiene knowledge, practices, and infrastructure. Typhoid vaccination should be considered.
2009 年 5 月 2 日，马拉维-莫桑比克边境农村地区爆发伤寒疫情，截至 2010 年 9 月，共报告发病 748 例，死亡 44 例。尽管采取了许多干预措施，包括分发 WaterGuard（WG）进行家庭水处理和使用教育，但伤寒病例仍在继续。为了在正在进行的伤寒疫情中提供信息，需要了解有关伤寒、安全用水和卫生方面的知识、态度和实践，以便为未来的疫情干预做好规划。2010 年 9 月，在马拉维 Neno 区的 17 个村庄中，随机选择家庭的女性户主进行了一项调查。使用 N,N 二乙基对苯二胺比色法（HACH 公司，美国科罗拉多州拉夫兰）测试家庭储存饮用水的游离氯残留（FCR）水平。56%的家庭应答者报告参加了社区范围的教育会议。应答者报告称，伤寒是由卫生条件差（77%）、饮用水不安全（49%）和食用不安全食物（25%）引起的，而处理饮用水可以预防伤寒（68%）。WaterGuard 是一种用于饮用水处理的氯化溶液，在 112 个家庭（56%）中观察到，其中 34%的家庭报告处理饮用水。在报告处理储存水且有储存水可供测试和家中有观察到 WaterGuard 瓶的 38 个家庭中，有 29 个（76%）的 FCR 水平充足（FCR≥0.2mg/L）。在 154 个家庭（77%）中观察到肥皂，其中 51%的家庭报告使用肥皂洗手。教育干预措施未能覆盖近一半的目标家庭，知识水平仍然较低。尽管在疫情应对期间分发和推广了 WaterGuard 和肥皂，但使用率仍然很低。未来的干预措施应侧重于提高水、环境卫生和个人卫生知识、实践和基础设施。应考虑接种伤寒疫苗。
