Risk factors for typhoid fever: A desk review

Background and Aim: Typhoid fever, a significant global health problem, demonstrates a multifaceted transmission pattern. Knowledge of the factors driving the transmission of infection is critical for developing effective control strategies and resource allocation. This comprehensive desk review aimed at synthesizing evidence from 1928 to 2023 on risk factors associated with typhoid fever transmission. Method: We conducted article searches in PubMed, Scopus, Google Scholar, and Semantic Scholar, using keywords related to risk, contributors, determinants, causes etc. associated with typhoid fever. We followed a registered protocol to support our search and triangulated the results. Results: We retrieved 1614 articles, of which 216 were reviewed. Of these articles reviewed, 106 provided data on typhoid fever risk factors. Unsurprisingly, of the total articles reviewed on risk factors, about 72% (76/106) originated from the Asian (48.1%, 51/106) and African (23.6%, 25/106) continents. A higher proportion, 47.2% (50/106) of the articles indicated risk factors related to socio-economic and housing transmission. Additional risk factors included foodborne transmissions (45.3%, 48/106), WASH: Waterborne transmissions (42.5%, 45/106), Sanitation and Hygiene practices (32.1%, 34/106), travel-related risk (16.0%, 17/106), antimicrobial agents (13.2%, 14/106), climate (13.2%, 14/106), environmental (8.5%, 9/106), typhoid carriers (10.4%, 11/106), and host risk (5.7%, 6/106) factors to disease transmission. Conclusion: These findings highlight the necessity for targeted and combined interventions including improved sanitation infrastructure, enhanced WASH practices and the use of vaccines in endemic areas. Implementing effective strategies informed by this review can aid clinicians, public health experts, and policymakers in efficiently mitigating the burden of typhoid fever.