Boakye Okyere Portia, Twumasi-Ankrah Sampson, Newton Sam, Nkansah Darko Samuel, Owusu Ansah Michael, Darko Eric, Agyapong Francis, Jeon Hyon Jin, Adu-Sarkodie Yaw, Marks Florian, Owusu-Dabo Ellis
School of Public Health, College of Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Department of Statistics and Actuarial Science, College of Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
JMIR Public Health Surveill. 2025 Aug 28;11:e67544. doi: 10.2196/67544.
Typhoid fever, a significant global health problem, demonstrates a multifaceted transmission pattern. Knowledge of the factors driving its transmission is critical for developing effective control strategies and optimizing resource allocation.
This review aimed to comprehensively synthesize evidence on risk factors associated with typhoid fever transmission from 1928 to 2024.
We searched PubMed, Scopus, Google Scholar, and Semantic Scholar databases using keywords related to risk, contributors, determinants, and causes of typhoid fever. We followed a registered protocol to support our search and triangulated the results.
Overall, we retrieved 1614 articles, of which 219 were reviewed. Of these, 109 addressed multiple, non-mutually exclusive typhoid fever risk factors. Unsurprisingly, of the total articles reviewed on risk factors, approximately 70.6% (77/109) originated from the Asian continent (51/109, 46.8%) and the African continent (26/109, 23.9%). Half of the articles (55/109, 50.5%) focused on risk factors related to demographic and socioeconomic transmission, while 44% (48/109) of the articles examined foodborne transmission. Additional risk factors included water, sanitation, and hygiene practices: waterborne transmissions (45/109, 41.3%) and sanitation and hygiene practices (34/109, 31.2%), travel-related risk (19/109, 17.4%), antimicrobial use (14/109, 12.8%), climate-related factors (15/109, 13.8%), environment-related factors (9/109, 8.3%), typhoid carriers (11/109, 10.1%), and host-related risk factors (6/109, 5.5%).
This review identifies demographic and socioeconomic factors as key drivers of typhoid transmission, underscoring the need for targeted interventions. Strengthening street food regulation in urban Asia and investing in water infrastructure in rural Africa can significantly mitigate risk. Integrating water, sanitation, and hygiene interventions with typhoid vaccines can reduce immediate exposure while enhancing long-term immunity. Prioritizing these strategies in schools and high-risk communities is essential for sustainable typhoid control. Future research should focus on longitudinal studies to assess risk factor causality and vaccine impact, guiding more effective public health interventions.
伤寒热是一个重大的全球健康问题，呈现出多方面的传播模式。了解其传播驱动因素对于制定有效的控制策略和优化资源分配至关重要。
本综述旨在全面综合1928年至2024年期间与伤寒热传播相关的风险因素的证据。
我们使用与伤寒热风险、促成因素、决定因素和病因相关的关键词，在PubMed、Scopus、谷歌学术和语义学者数据库中进行搜索。我们遵循注册协议来支持我们的搜索，并对结果进行三角验证。
总体而言，我们检索到1614篇文章，其中219篇进行了综述。其中，109篇涉及多个并非相互排斥的伤寒热风险因素。不出所料，在关于风险因素的综述文章总数中，约70.6%（77/109）来自亚洲大陆（51/109，46.8%）和非洲大陆（26/109，23.9%）。一半的文章（55/109，50.5%）关注与人口统计学和社会经济传播相关的风险因素，而44%（48/109）的文章研究了食源性传播。其他风险因素包括水、环境卫生和个人卫生习惯：水源性传播（45/109，41.3%）以及环境卫生和个人卫生习惯（34/109，31.2%）、与旅行相关的风险（19/109，17.4%）、抗菌药物使用（14/109，12.8%）、与气候相关的因素（15/109，13.8%）、与环境相关的因素（9/109，8.3%）、伤寒带菌者（11/109，10.1%）以及与宿主相关的风险因素（6/109，5.5%）。
本综述确定人口统计学和社会经济因素是伤寒传播的关键驱动因素，强调了有针对性干预措施的必要性。加强亚洲城市的街头食品监管以及在非洲农村投资水基础设施可以显著降低风险。将水、环境卫生和个人卫生干预措施与伤寒疫苗相结合，可以减少即时接触，同时增强长期免疫力。在学校和高风险社区优先实施这些策略对于可持续控制伤寒至关重要。未来的研究应侧重于纵向研究，以评估风险因素的因果关系和疫苗影响，从而指导更有效的公共卫生干预措施。
