Majority of Nigerians have heard of the disease called Typhoid fever and not a few with fever claim to have malaria and typhoid fever at the same time. I may not be wrong if I say that many who go for laboratory test when feverish come back with the result of typhoid and malaria. However the diagnosis of typhoid fever cannot be reliably be made with only one test, about three tests are required to show actual change in titre.

However, typhoid fever is actually common in developing countries with poor water and sanitation facilities.
Globally, the disease affects millions of people annually, mostly in Asia, sub-Saharan Africa and South America, killing millions.
The disease is endemic -common- in Nigeria with huge socio-economic burden due to work and school absenteeism and also cost of medicare.
1. What Causes Typhoid Fever?
Typhoid fever is caused by a bacterium called Salmonella Typhi; there are three types of the bacterium: O, H and Vi. The bacterium can thrive in extreme temperatures-freezing temperatures and very hot and dry conditions, thus it survives in ice, frozen foods and dust.
Man is the reservoir of the agent and can continue to spread the disease even long after he has recovered from the illness and in a few unfortunate cases he can continue to spread it for life.
2. How Does Typhoid Spread?
Typhoid fever spreads through contaminated food and water. The agent is passed out in the stool of an infected person, it may also be present in his urine, spite or vomit.
Food can be contaminated by flies which can carry the agent from the stool of an infected person or by the hands of infected person while preparing food if not well washed after using the toilet.
Water can be contaminated by stool of an infected person if the source of drinking water is exposed where open defeacation is practiced in the absence of toilets.
Un-boiled milk if contaminated is also a means of spread.
3. When Do You Suspect You May Have Typhoid Fever?
Typhoid is characterized by high fever, vomiting and diarrhea; see a doctor if you have these symptoms for adequate examination and tests.
4. What Can Put You at Risk.
The disease affects all ages but those between the ages of 6 and 19 years are more affected. It is uncommon before the age of 2 years.
It is commoner in poor populations and localities where safe drinking water and proper toilets
are in short supply.
Body resistance also has a role to play as the disease is less common in older people.
Both sexes are affected equally but women are known to continue to spread the disease much longer than men after recovery.
5. Possible Complications of Typhoid Fever.
Complications of typhoid include internal bleeding, perforation of the intestines and death. In untreated cases, death is about 10 percent but with appropriate treatment death is about 1 percent. Mild and slightly severe cases respond well to treatment.
6. Prevention 
Typhoid can be prevented by:
    a. Vaccination.
    b. Personal hygiene- wash hands with water and soap after using the toilet
    c. Provision of safe drinking water.
    d. Boil all drinking water.
    e. Food hygiene-cook food thoroughly, wash fruits and vegetables thoroughly
    f. Use of proper toilets, avoid open defeacation.

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