Household water treatment uptake during a public health response to a large Typhoid Fever outbreak in Harare, Zimbabwe

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Authors

Imanishi, Maho
Kweza, Patience F.
Slayton, Rachel B.
Urayai, Tanaka
Ziro, Odrie
Mushayi, Wellington
Francis-Chizororo, Monica
Kuonza, Lazarus R.
Ayers, Tracy
Freeman, Molly M.

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American Society of Tropical Medicine and Hygiene

Abstract

Locally manufactured sodium hypochlorite (chlorine) solution has been sold in Zimbabwe since 2010. During October 1, 2011–April 30, 2012, 4,181 suspected and 52 confirmed cases of typhoid fever were identified in Harare. In response to this outbreak, chlorine tablets were distributed. To evaluate household water treatment uptake, we conducted a survey and water quality testing in 458 randomly selected households in two suburbs most affected by the outbreak. Although 75% of households were aware of chlorine solution and 85% received chlorine tablets, only 18% had reportedly treated stored water and had the recommended protective level of free chlorine residuals. Water treatment was more common among households that reported water treatment before the outbreak, and those that received free tablets during the outbreak (P < 0.01), but was not associated with chlorine solution awareness or use before the outbreak (P > 0.05). Outbreak response did not build on pre-existing prevention programs.

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Keywords

Harare, Zimbabwe, Household water treatment uptake, Water treatment, Sodium hypochlorite (chlorine), Household water treatment and safe storage (HWTS), Typhoid fever, Salmonella enterica serovar Typhi

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Citation

Iminashi, M, Kweza, PF, Slayton, RB, Urayai, T, Ziro, O, Mushayi, W, Francis-Chizororo, M, Kuonza, LR, Ayers, T, Freeman, MM, Govore, E, Duri, C, Chonzi, P, Mtapuri-Zinyowera, S, Manangazira, P, Kilmarx, PH, Mintz, E & Lantagne, D 2014, 'Household water treatment uptake during a public health response to a large Typhoid Fever outbreak in Harare, Zimbabwe', American Journal of Tropical Medicine and Hygiene, vol. 90, no. 5, pp. 945-954.