Typhoid affects between 11 million and 20 million people globally, but mainly in poor countries of this world that have have incessant water and food contamination.
BY Dr Johannes Marisa
The World Health Organisation (WHO) estimates that more than 150 000 people succumb to typhoid every year. Many diseases have stricken communities for a long time, but they could easily be halted had all hands expeditiously joined to combat them.
Today, the world is in tatters with Covid-19, a virus that has brewed misery since December 2019 when it was first discovered in Wuhan province of China.
More than 3,5 million people have succumbed to this villainous virus and judging by what is happening today, mortality is still far from over. The trend can go for a long time in cycles and sooner than later, all of us may be caught in the noose.
Typhoid has come with sporadic attacks especially in Harare and it is a pity that in 2018 alone, the ministry of Health and Child Care recorded more than 4 000 cases of typhoid, with more than 25% occurring in children under 5 years of age.
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What causes typhoid?
Typhoid is a bacterial disease caused by Salmonella, a gram negative, tod-shaped, flagellated bacterium whose only reservoir is the human body. Contamination comes either via water or food, a phenomenon which looks obvious considering the state of towns and cities in many of the third world countries.
What are the common symptoms of typhoid?
Typhoid, malaria and Covid-19 share many of the symptoms so it is wise to suspect these diseases with some of the symptoms below:
- Fever
- Headache
- Generalised body weakness
- Vomiting
- Diarrhoea
- Loss of appetite
- Rigors and chills
Diagnosis
Diagnosis of typhoid will be a combination of examination and laboratory tests.There is the WIDAL test, which is a screening test and has been in use since 1928. The test has to be validated with stool microscopy, culture and sensitivity to show isolated bacterium. However, peripheral health institutions in Zimbabwe may have challenges with stool studies, hence poor data collation about typhoid.
It is this week that Zimbabwe is doing a campaign about the new typhoid conjugate vaccine which is set to be given to children between nine months and 15 years of age. This is a milestone for our country as Zimbabwe becomes the second country in Africa to access such a vaccine after Liberia which had its first touch just in April this year.
Government has done its part in order to contain such water-borne diseases, but looking up to medical solutions on issues that need a whole array of measures is not just unfair, but unfortunate. Yes, children are going to get protection from typhoid attacks through the vaccine, however, what efforts have all the key stakeholders put in place to avoid the incessant indubitable outbreaks? This should be the time for both collaborative and complementary efforts in the cities if diseases like cholera and typhoid are to be stemmed.
Prevention has always been deemed more important than cure and that is an incontrovertible truth. It is a pity that towns and cities are failing on public health issues as if they do not have health departments. One wonders why the entire health department superintends over a collapsed health delivery service that puts the health of everyone at risk. Questions still linger in our brains and we expect robust answers if we are to expect a candid health delivery service in cities.
Yes, typhoid conjugate vaccine is now celebrated in Zimbabwe, but what are we doing about the following issues?
n The perennial water shortages that have bedeviled many councils. Forty-one years after independence, we still have the same water reservoirs which used to be there when the population in Harare was less than 70 000.
n Sewer reticulation, which has been very poor with interminable bursts and contamination of water bodies especially in Harare. We cannot have a city experiencing the same problems yearly yet city fathers, directors and engineers are withdrawing salaries every month. One wonders whether some of these employees were selected and recruited on merit or it was merely because of patronage, favouritism or nepotism.
n The nauseating garbage in streets is a source of food contamination. Mbare Musika is an eyesore today with uncollected garbage filling up trenches and pavements, a situation which can be a precursor to diarrhoeal diseases like dysentery, cholera and typhoid. Why do we wait for outbreaks to come first yet we can cleverly run around now while it is still shiny? Do we still have proper leadership or management in public offices that can deliver services to the people?
n Perennial corruption in local governance is bleeding the nation at large. A lot of money is lost through corruption and the culprits continue roaming around. The poor get poorer while the rich get richer. Some cases do not even reach prosecution because the corrupt and rich use all the resources at their disposal to remain free. This is Africa for us and the corruption scourge seems to go unabated.
While we appreciate government efforts in acquiring the vaccines, what have you done as an individual or an organisation to bring health to our country? Collaborative efforts are what we desire! It is sooner than later when you will realise that health service is important.
- Dr Johannes Marisa is a public health practitioner who can be accessed on doctormarisa@gmail.com.