IMPACT OF WATER, SANITATION AND HYGIENE (WASH) INTERVENTION ON TYPHOID INCIDENCE IN KHYBER PAKHTUNKHWA PAKISTAN

Abstract

Typhoid fever, a bacterial infection caused by Salmonella Typhi, remains a significant public health concern in developing Asian countries, including Sri Lanka, India, and Pakistan. Pakistan has estimated 11 million cases and 60,000 deaths annually. The disease is primarily transmitted through contaminated water, food, and poor sanitation, highlighting the need for improved hygiene and infrastructure. Furthermore, the emergence of antibiotic-resistant Salmonella Typhi strains has complicated treatment, emphasizing the importance of effective antibiotics and vaccines in controlling and preventing typhoid fever. Objective: The aim of our research to find the impact of water, sanitation and hygiene intervention on typhoid patients. Materials and Methods: This was a cross-sectional study with a sample size of 400 participants calculated through calculator.net website .Data was collected through questionnaire which was structured questionnaire .It was ethically approved by BMC research society .Data was analyzed through SPSS v-27. Results: The study included 400 participants with 53.3% males and 46.8% females. Urban residents comprised 53.8% of the sample, while 46.3% were from rural areas. A personal history of typhoid was reported by 23.0% (n=92) of participants. The most common timeframe for previous illness was 1–2 years ago (10.8%), followed by within the last year (3.5%), within the past 6 months (2.5%), and currently experiencing symptoms (1.0%). Family history of typhoid was more prevalent, with 48.3% reporting one or more affected family members. Most commonly, one (25.5%) or two (13.5%) family members were affected, with a smaller percentage reporting three or more. Water sources were primarily tap (46.0%) and well water (45.0%), with 9.0% relying on bottled water. Only 41.8% reported treating their drinking water. Sanitation conditions showed 73.5% used flush toilets, 21.3% pit latrines, and 5.3% other types. Half had access to a functioning sewer system, and 55.3% had proper drainage; 20.3% reported no drainage system. Hygiene practices were generally positive, with 83.8% regularly washing hands before meals and after using the toilet, and 78.8% using a clean towel for hand drying. Regarding treatment, 30.8% used antibiotics, 12.5% received combined treatment (antibiotics, rest, hospitalization), while 52.3% had never received treatment, likely reflecting those who had never contracted typhoid or had limited healthcare access. Conclusion: This study highlights the significant burden of typhoid fever in Khyber Pakhtunkhwa, Pakistan, and emphasizes the need for improved water, sanitation, and hygiene (WASH) practices to control its transmission. Effective WASH interventions can significantly reduce the incidence of typhoid fever, saving lives and reducing healthcare costs.