Increase Knowledge On Salmonella And Reduce Incidences Of Typhoid Fever Outbreak In Kano State Nigeria Ms. Mairo V.

1. Increase Knowledge On Salmonella And Reduce Incidences Of Typhoid Fever Outbreak In Kano State Nigeria Ms. Mairo V. Bello, MPH student Walden University PUBH 6165-2 Instructor: Dr. Patrick Tschida� Winter Qtr 12/05/2011-02/26/2012

2. Content Introduction Description of Kano State Why Address Salmonella in Kano State of Nigeria Intervention Objective Definitions Source Of Salmonella Group Work (Analysis of Issues and mapping) Prevention Who Must Take Action Treatment Conclusion

3. Introduction A major Role of public health is the promotion of healthy behaviors, communities�and�environments through: non-medical methods like hand washing�with soap to prevent many contagious diseases.� treating a disease or controlling a�pathogen such as Salmonella�can be vital to preventing the spread to others during an outbreak or contamination of food or water supplies. Children are the worst hit during such out breaks. Kerr, M. C.; Wang, J. T. H.; Castro, N. A.; Hamilton, N. A.; Town, L.; Brown, D. L.; Meunier, F. A.; Brown, N. F. et al. (2010). "Inhibition of the PtdIns(5) kinase PIKfyve disrupts intracellular replication of Salmonella".�The EMBO Journal�29�(8): 1331�1347. doi:10.1038/ emboj 2010.28.�PMC�2868569.PMID�20300065.� Introduction According to Kerr et al(2010)One of the role of public health is the promotion of healthy behaviors, communities�and�environments. We can prevent a lot of diseases through simple, non-medical methods. For example, hand washing�with soap can prevent many contagious diseases.�In other cases, treating a disease or controlling a�pathogen (infectious agents or germs) such as Salmonella�can be vital to preventing the spread to others, such as during an outbreak of�infectious disease, or contamination of food or water supplies. Children are the worst hit during such out breaks.Introduction According to Kerr et al(2010)One of the role of public health is the promotion of healthy behaviors, communities�and�environments. We can prevent a lot of diseases through simple, non-medical methods. For example, hand washing�with soap can prevent many contagious diseases.�In other cases, treating a disease or controlling a�pathogen (infectious agents or germs) such as Salmonella�can be vital to preventing the spread to others, such as during an outbreak of�infectious disease, or contamination of food or water supplies. Children are the worst hit during such out breaks.

4. Describing Kano State A population of 9.4 million(2006 census); 44 local government areas(LGAs), predominant Muslim society; fertility rate at 8.1; 2% contraceptive prevalence rate, HIV/AIDS prevalence rate of 3.4 percent (Sentinel Survey 2008), average age at first marriage 15, infant 75 per 1000 live birth(neo natal 40 per 1000 and post neonatal mortality at 35 per1000 births); child under five is 157 per 1000 live birth. (NDHS 2008 pg119) Describing Kano State Kano state has a population of 9.4 million according to Nigerian 2006 census, has 44 local government areas(LGAs), has a predominant Muslim society. NDHS puts fertility rate in Kano at 8.1 with only 2% contraceptive prevalence rate, HIV/AIDS prevalence rate of 3.4 percent(National HIV Seroprevalence Sentinel Survey 2008), average age at first marriage 15 , infant 75 per 1000 live birth(neo natal 40 per 1000 and post neonatal mortality at 35 per1000 births); child under five is 157 per 1000 live birth. About 50% of women utilize antenatal care but only 13% deliver in health facilities. (NDHS 2008 pg119) Describing Kano State Kano state has a population of 9.4 million according to Nigerian 2006 census, has 44 local government areas(LGAs), has a predominant Muslim society. NDHS puts fertility rate in Kano at 8.1 with only 2% contraceptive prevalence rate, HIV/AIDS prevalence rate of 3.4 percent(National HIV Seroprevalence Sentinel Survey 2008), average age at first marriage 15 , infant 75 per 1000 live birth(neo natal 40 per 1000 and post neonatal mortality at 35 per1000 births); child under five is 157 per 1000 live birth. About 50% of women utilize antenatal care but only 13% deliver in health facilities. (NDHS 2008 pg119)

5. Why Kano State Nigeria Every Year Kano state gets an outbreak of Cholera (Usman, et al.2005) and Typhoid is a continues occurring illness in the state with 36652 case between 2003-2005 (NBS,2009) Usman A, Sarkinfada F, Mufunda J, Nyarango P, Mansur K, Daiyabu TM.(2005). Recurrent cholera epidemics in Kano--northern Nigeria. Cent Afr J Med. 2005 Mar-Apr;51(3-4):34-8. http://www.ncbi.nlm.nih.gov/pubmed/17892230 NATIONAL BUREAU OF STATISTICS(NBS) 2009 SOCIAL STATISTICS IN NIGERIA TABLE4.21 CASES OF WATER BORNE DISEASES (TYPHOD FEVER), 2003 -2005

6. Why Kano State Nigeria 1995 Salmonella was identified in the challawa water, which is the source of water supply for the state (Abdullahi et al, 1995) In 2009 13 out of 150 fruit sample test had Salmonella In 2010 of 300 children studied 41 (14%) had Salmonella (Abdullahi,2010) In a study of Sickle Cell anaemia patients, predominant infective agents include Salmonella species, Plasmodium falciparum and Escherichia coli Abdullahi, M. (2010). Incidence and antimicrobial susceptibility pattern of salmonella species in children attending some hospitals in kano metropolis, kano state �Nigeria. Bayero Journal of Pure and Applied Sciences > Vol 3, No 1 (2010) ISSN: 2006-6996. www.ajol.info/index.php/bajopas/article/view/58787 Chukwu, OO. Olabode, OA. Chukwuedo, AA. Umoh, EG. Esiekpe, MK.(2009). Salmonella typhimurium which was the most predominant followed by Salmonella typhi and Salmonella paratyphi. East Afr J Public Health. 2009 Apr;6(1):51-4. http://www.ncbi.nlm.nih.gov/pubmed/20000065 Ahmed, SG, & Uraka, A.(2010). Eosinopenia as a marker of infection in patients with sickle cell anaemia: A preliminary report. International Journal of Biomedical and Health Sciences 0794-4748/2010 $12.00 + 0.00. Vol. 6, No. 1, June 30, 2010. African Studies on Population and Health. IJBHS 2010015/6202. Printed in Nigeria http://www.asopah.org http://www.klobex.org/journals/ijbhs/ijbhs6/ijbhs620210015.pdf Abdullahi, A. and Kawo, A.H. (1995): The Effect of Some Physical and Chemical factors on theMicrobial Population in relation to Eutrophication and Purification(pollution) of Salanta river, Sharada Industrial Area, Paper Presented at the 9th-10th Annual conference of the Nigeria Association for Aquatic Science, University of Agriculture, Abeokuta. Why Kano State of Nigeria A study of 300 children aged 20 � 24 months from six hospitals in Kano metropolis found 24 were from males and 17 from females to be infected with Salmonella typhimurium which was the most predominant followed by Salmonella typhi and Salmonella paratyphi.(Abdullihi,2010). 150 fruits samples were test and the bacterial distribution were; Escherichia coli 69 (46.00%), Staphylococcus aureus 29 (19.33%), Salmonella species 13 (8.67%), Proteus species 18 (12.00%), Enterobacter aerogenes 3 (2.00%), Klebsiella pneumoniae 2 (1.33%) and Pseudomonas aeruginosa 2 (1.33%). (Chukwu, et al 2009). According to Abdullahi et al, (1993) while the presence of bacteria in water could cause cholera, typhoid and dysentery. The Salmonella species known to cause deadly typhoid was identified in the challawa water in addition to chlorono-bacterium. According to Ahmed, SG, & Uraka, A.(2010)in a of sickle cell anaemia patients, the infective agents and clinical presentations among the infected SCA patients are predominantly causative agents were Streptococcus pneumoniae, Salmonella species, Plasmodium falciparum and Escherichia coli. Why Kano State of Nigeria A study of 300 children aged 20 � 24 months from six hospitals in Kano metropolis found 24 were from males and 17 from females to be infected with Salmonella typhimurium which was the most predominant followed by Salmonella typhi and Salmonella paratyphi.(Abdullihi,2010). 150 fruits samples were test and the bacterial distribution were; Escherichia coli 69 (46.00%), Staphylococcus aureus 29 (19.33%), Salmonella species 13 (8.67%), Proteus species 18 (12.00%), Enterobacter aerogenes 3 (2.00%), Klebsiella pneumoniae 2 (1.33%) and Pseudomonas aeruginosa 2 (1.33%). (Chukwu, et al 2009). According to Abdullahi et al, (1993) while the presence of bacteria in water could cause cholera, typhoid and dysentery. The Salmonella species known to cause deadly typhoid was identified in the challawa water in addition to chlorono-bacterium. According to Ahmed, SG, & Uraka, A.(2010)in a of sickle cell anaemia patients, the infective agents and clinical presentations among the infected SCA patients are predominantly causative agents were Streptococcus pneumoniae, Salmonella species, Plasmodium falciparum and Escherichia coli.

7. Intervention Control measures to combat infections cause by salmonella such as typhoid include health education and antibiotic treatment. A vaccine is available, although it is not routinely recommended except for those who will have prolonged exposure to potentially contaminated food and water in high-risk areas. The vaccine does not provide full protection from infection (WHO,2001). World Health Organization (WHO).(2001). Sanitation and Health unit (WSH), Water-related Diseases. Typhoid and paratyphoid enteric fevers http://www.who.int/water_sanitation_health/diseases/typhoid/en/

8. Intervention This Intervention will adopt a multi sectoral approach to a stakeholders Dialogue, local education to encourage people actions.