Abstract:

Background: Clusters of suspected typhoid cases were recorded in Kadoma City between February 2014 and April 2014. The clusters were at a camp for uniformed forces, a public hospital and a private hospital. Concern by Kadoma residents necessitated the need to investigate the sudden increase in suspected typhoid cases. We then set out to describe the clusters in terms of person, place and time, identify the possible causative organism and source of infection.

Methods: A descriptive cross sectional study was conducted. Interviews with 34 randomly selected cases from the three clusters were done. Municipal water samples were collected for quality analysis. We collected stool specimens and hand swabs from kitchen staff at the 2 hospitals. We also collected kitchen working surface swabs and conducted a sanitary survey.

Results:  Males constituted 56% of the cases. Abdominal pains (32%), diarrhoea (29%) and fever (21%) were common among cases with a positive stool culture. Loss of appetite (26%), abdominal pains (26%) and diarrhoea (24%) were common among cases confirmed by the Widal test. The water treatment plant had quality control measures in place. Two out of 8 hand swabs had E coli isolated and 1 had Salmonella typhi isolated. Four cooks were shedding Salmonella typhi in stool. No faecal coliforms were isolated in the water samples. There were numerous sewer blockages at the uniformed forces camp.

Conclusion: The outbreak was propagated. Food handlers were shedding Salmonella typhi. Hand washing practices were poor. We recommended that the food handlers be removed from the kitchen and monitored. Sewer blockages in the compounds were attended to. Continued surveillance of cases and mobilization of resources in the City was also done.

Keywords: Typhoid fever, Clusters, Kadoma City, Zimbabwe

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