High prevalence of typhoidal Salmonella enterica serovars excreting food handlers in Karachi-Pakistan: a probable factor for regional typhoid endemicity

Background: Typhoid fever is the persistent cause of morbidity worldwide. Salmonella enterica serovar\u2019s carriers among food handlers have the potential to disseminate this infection on large scale in the community. The purpose of this study was to determine the prevalence of typhoidal S. enterica serovars among food handlers of Karachi. Methods: This cross-sectional study was conducted in Karachi metropolis. A total of 220 food handlers were recruited on the basis of inclusion criteria from famous food streets of randomly selected five towns of Karachi. Three consecutive stool samples were collected from each food handler in Carry Blair transport media. Culture, biochemical identification, serotyping, and antimicrobial susceptibility tests for S. enterica serovars were done. Results: Out of 220 food handlers, 209 consented to participate, and among them, 19 (9.1 %) were positive for S. enterica serovars. Serotyping of these isolates showed that 9 (4.3 %) were typhoidal S. serovars while 10 (4.7 %) were non-typhoidal S. serovars. Of the typhoidal S. serovars, 7 were S. enterica serovar Typhi and 1 each of S. enterica serovar Paratyphi A and B. The resistance pattern of these isolates showed that 77.7 % were resistant to ampicillin and 11.1 % to cotrimoxazole. All typhoidal S. enterica serovars isolates were sensitive to chloramphenicol, ceftriaxone, cefixime, nalidixic acid, and ofloxacin. Conclusions: Carrier rate of typhoidal S. enterica serovars in food handlers working in different food streets of Karachi is very high. These food handlers might be contributing to the high endemicity of typhoid fever in Karachi, Pakistan

Use of the Health Belief Model for the Assessment of Public Knowledge and Household Preventive Practices in Karachi, Pakistan, a Dengue-Endemic City.

Prevention is most effective in reducing dengue infection risk, especially in endemic countries like Pakistan. Evaluation of public awareness and health beliefs regarding dengue fever (DF) is important for devising disease control strategies. This study assessed dengue knowledge, health beliefs, and preventive practices against DF in different socioeconomic groups of Karachi, Pakistan.In this community-based cross-sectional study, 6 randomly selected towns were visited, 2 persons (man and woman) per household were interviewed using a structured questionnaire, and household practices were observed. Information regarding DF was shared through a printed pamphlet. Multivariate logistic regression analysis of variables associated with dengue knowledge and practices was conducted.We interviewed 608 Karachi residents (mean age: 33.2 ± 13.35 years); 7.7%, 71.9%, and 20.4% had a high, middle, and low socioeconomic status, respectively. The mean knowledge score was 6.4 ± 2.10 out of 14. The mean preventive practices score was 9 ± 1.8 out of 17. Predictors of dengue knowledge were perceived threat (odds ratio [OR] = 1.802; 95% confidence interval [CI] = 1.19-2.71; p = 0.005), self-efficacy (OR = 2.910; 95% CI = 1.77-4.76; p = 0.000), and television as an information source (OR = 3.202; 95% CI = 1.97-5.17; p = 0.000). Predictors of dengue preventive practices were perceived threat (OR = 1.502; 95% CI = 1.02-2.19; p = 0.036), self-efficacy (OR = 1.982; 95% CI = 1.34-2.91; p = 0.000), and dengue knowledge (OR = 1.581; 95% CI = 1.05-2.37; p = 0.028).Public knowledge about DF is low in Karachi. Knowledge, threat perception, and self-efficacy are significant predictors of adequate dengue preventive practices. Prevention and control strategies should focus on raising awareness about dengue contraction risk and severity through television. Health messages should be designed to increase individual self-efficacy

Use of the Health Belief Model for the Assessment of Public Knowledge and Household Preventive Practices in Karachi, Pakistan, a Dengue-Endemic City

<div><p>Background</p><p>Prevention is most effective in reducing dengue infection risk, especially in endemic countries like Pakistan. Evaluation of public awareness and health beliefs regarding dengue fever (DF) is important for devising disease control strategies. This study assessed dengue knowledge, health beliefs, and preventive practices against DF in different socioeconomic groups of Karachi, Pakistan.</p><p>Methodology</p><p>In this community-based cross-sectional study, 6 randomly selected towns were visited, 2 persons (man and woman) per household were interviewed using a structured questionnaire, and household practices were observed. Information regarding DF was shared through a printed pamphlet. Multivariate logistic regression analysis of variables associated with dengue knowledge and practices was conducted.</p><p>Principal Findings</p><p>We interviewed 608 Karachi residents (mean age: 33.2 ± 13.35 years); 7.7%, 71.9%, and 20.4% had a high, middle, and low socioeconomic status, respectively. The mean knowledge score was 6.4 ± 2.10 out of 14. The mean preventive practices score was 9 ± 1.8 out of 17. Predictors of dengue knowledge were perceived threat (odds ratio [OR] = 1.802; 95% confidence interval [CI] = 1.19–2.71; p = 0.005), self-efficacy (OR = 2.910; 95% CI = 1.77–4.76; p = 0.000), and television as an information source (OR = 3.202; 95% CI = 1.97–5.17; p = 0.000). Predictors of dengue preventive practices were perceived threat (OR = 1.502; 95% CI = 1.02–2.19; p = 0.036), self-efficacy (OR = 1.982; 95% CI = 1.34–2.91; p = 0.000), and dengue knowledge (OR = 1.581; 95% CI = 1.05–2.37; p = 0.028).</p><p>Conclusions</p><p>Public knowledge about DF is low in Karachi. Knowledge, threat perception, and self-efficacy are significant predictors of adequate dengue preventive practices. Prevention and control strategies should focus on raising awareness about dengue contraction risk and severity through television. Health messages should be designed to increase individual self-efficacy.</p></div

Associations of Information Sources with Dengue Knowledge, Preventive Practices, Perceived Threat, and Self-Efficacy.

<p>Associations of Information Sources with Dengue Knowledge, Preventive Practices, Perceived Threat, and Self-Efficacy.</p

Univariate Analysis of the Association of Dengue Preventive Practices with Demographic and Other Determinants (N = 608).

<p>Univariate Analysis of the Association of Dengue Preventive Practices with Demographic and Other Determinants (N = 608).</p

Multivariate Logistic Regression Analysis of Variables Associated with Dengue Preventive Practices.

<p>Multivariate Logistic Regression Analysis of Variables Associated with Dengue Preventive Practices.</p

History of Dengue Fever in the Past 2 Years and Its Association with Dengue Knowledge, Practices, and Health Beliefs.

<p>Bars represent percentages of respondents with high perceived threat of dengue, self-efficacy, adequate dengue knowledge, and preventive practices scores according to the history of dengue fever in the past 2 years. P-values shown in bold indicate a significant association.</p

Willingness to Support the Government Campaign and Its Association with Demographics, Dengue Knowledge, Practices, and Health Beliefs.

<p>Bars represent the willingness to support the government campaign for dengue prevention according to demographic characteristics, perceived threat of dengue, self-efficacy, and preventive practices. P-values shown in bold indicate a significant association.</p