Evaluation of Impact of Health Education Intervention on Knowledge and Management of Typhoid Fever among Patent Medicine Vendors in Ebonyi, Nigeria

Evaluation of Impact of Health Education Intervention on Knowledge and Management of Typhoid Fever among Patent Medicine Vendors in Ebonyi, Nigeria | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluation of Impact of Health Education Intervention on Knowledge and Management of Typhoid Fever among Patent Medicine Vendors in Ebonyi, Nigeria Simon C. Udeh, Babatunde I. Omotowo, Chukwuemerie P. Okoye, Blessing N. Eneh, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7819784/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract BACKGROUND Typhoid fever is a disease of public health concern in Nigeria. The incidence rate of typhoid fever in Ebonyi was 309 cases per 100,000 populations in 2018. The patent medicine vendor (PMVs) is a person who sells medicines in Nigeria without formal pharmaceutical education and dispensing training. However, they are licenced to sell only over-the-counter drugs. This study was carried out to evaluate the impact of health education interventions on knowledge and management practices related to typhoid fever on PMVs. METHODS A quasi-experimental study designed with experimental and control groups was carried out to evaluate the impact of a health education intervention on typhoid fever among PMVs. A multistage sampling technique was used to select the participants. A self-administered questionnaire written in English was used to obtain information from the respondents. The data were analysed via the Statistical Package for Social Sciences version 26, and descriptive statistics were used to calculate frequencies, means, standard deviations, and proportions. RESULTS A total of 162 samples were analysed. The results revealed that 95.5% (6.8 ± 2.49) of the participants in the experimental group had poor knowledge of typhoid fever at baseline, and 46.8% (4.12 ± 1.58) had poor knowledge of management practices. The results also revealed that the control group recorded poor knowledge and management practices at baseline. The 3-month post intervention evaluation results revealed that knowledge of the experimental group improved to 56%, with mean/SD score of 10.2 ± 2.05, whereas good management practices improved to 94.4%, with mean/SD score 5.68 ± 0.58. The results also revealed poor knowledge of antibiotic and antimicrobial resistance and generally poor knowledge of the correct use of antibiotics to treat typhoid fever and the duration of treatment among the study experimental group. CONCLUSION The overall increase in knowledge after 3 months of intervention was 4.12 ± 1.58, indicating that health education remains the key to improving knowledge. However, further studies must focus on the correct use of antibiotics for treatment to reduce burden of antibiotic resistance in the study area. Typhoid fever PMVs Health education Intervention Ebonyi Nigeria Figures Figure 1 Figure 2 INTRODUCTION Typhoid fever is a significant public health concern in Nigeria. According to the World Health Organization, Nigeria is one of the countries with the highest burden of typhoid fever, with an estimated 10.9 million cases and 116,000 deaths reported annually 1 . Typhoid fever is a life-threatening infection caused by the bacterium Salmonella Typhi. It's a significant public health problem globally, especially in developing countries like Nigeria and Africa 2 , 3 , 4 In Ebonyi State, typhoid fever cases have been increasing in recent years, with a peak incidence rate of 309 cases per 100,000 population in 2018 5 . Typhoid fever is a bacterial infection caused by the bacterium Salmonella enteric serotype Typhi. It is primarily a disease of developing countries, particularly those with poor sanitation and hygiene. In these areas, typhoid fever is a significant public health problem, with an estimated 10–20 million cases and 128,000–161,000 deaths annually worldwide 6 . The infection is transmitted by ingesting contaminated food or water or by contact with an infected person 7 . Enteric fevers are distributed worldwide, although they are endemic in communities where sanitation and personal hygiene standards are low. Humans are the only reservoir of infection. The disease incubation period is usually 1–2 weeks, during which time an infected person may not show any symptoms but can still spread the bacteria to others. The signs and symptoms typically include a high fever, often more significant than 103°F or h39.4°C, headache, weakness, loss of appetite, fatigue, confusion or delirium, abdominal pain, constipation or diarrhoea, and a rash. These symptoms can vary in severity and may last up to four weeks. Complications such as intestinal perforation, bleeding, and even death 8 are possible. Urbanization and climate change can potentially increase the global burden of typhoid. In addition, the increasing antibiotics resistance is making the treatment and spread faster in communities that lack access to safe drinking water or adequate sanitation. Patent medicine vendors (PMVs) are people who sell medicines in Nigeria without formal pharmaceutical education and dispensing training, and they are essential informal community-based providers of health care 9 , 10 . They are commonly found in urban and rural settings and play a significant role in rural healthcare delivery, where accessibility to formal pharmaceutical facilities is limited 11 . PMVs sell over–the–counter medications, and other healthcare-related products, such as antimalaria and pain relief drugs. A total of 37 relevant previous studies were reviewed in this study. The search for literature conducted shows that there was no similar study that has been conducted on typhoid knowledge, management practices in form of health education intervention for the PMVs in Ebonyi. However, there are other studies where infectious and non-communicable diseases were accessed based on knowledge and the impact of health education but not directly on knowledge and management of typhoid fever. This shows an existing knowledge gap among the PMVs regarding the knowledge and management of typhoid fever in Abakaliki. Therefore, conducting a health education intervention among PMVs in Ebonyi is essential to improve the knowledge gap and skills regarding preventing, diagnosing, and treating common illnesses like typhoid fever. This study was carried out to evaluate the impact of health education interventions on knowledge and management practices related to typhoid fever on PMVs. The intervention will provide PMVs with up-to-date information on the signs and symptoms of typhoid fever, appropriate diagnostic tests, and effective treatment options. METHODOLOGY Study Area This study was carried out in Ebonyi State, south-eastern Nigeria and its consists of three senatorial zones, namely, Ebonyi North, Ebonyi Central and Ebonyi South. The state's estimated population as of the 2006 national population census was 2,176,947, and the population density was 393 12 . The State accounts for 1.6% of Nigeria's total population. The primary economic activity of residents is farming in rural areas. The literacy rate in Ebonyi State is 59.5, with urban-rural disparity 13 The patent medicine vendors in Ebonyi State has approximately twenty-seven (27) units across the state. Unpublished data from the PCN Ebonyi State chapter shows that approximately one thousand eight hundred and seventy registered and licenced PMVs exist in the state. Study Design A quasi-experimental study designed with intervention and control group was carried out. We collected baseline data for evaluating the knowledge and management practices of typhoid fever among the PMVs. The baseline data on knowledge and management practices were obtained via self-administered semi structured questionnaire cast in English language in a paper form before and after the test. The control group was selected from another PMVs unit in Ezza North areas to avoid bias. The experimental group was trained on basic knowledge of typhoid fever, whereas the control group was trained on tuberculosis. The list of the registered premises in the selected LGA was obtained from the Pharmacy Council of Nigeria (PCN) Ebonyi branch, and permission to administer the intervention was obtained from the patent medicine vendor associations in the selected LGA. Study Population The participants of this study are the patent medicine vendors who reside in Abakiliki central Ebonyi state, Nigeria and are registered with PCN in Ebonyi, currently practicing, and operating retail shops. Inclusion Criterion The study included all the registered and practicing Patent Medicine Vendors in Abakaliki Central LGA who met the selection criteria. Exclusion Criteria Mobile patent medicine vendors in the study area will be excluded. Study Period The study was conducted from October 2023 to December 2023 Sample size determination The sample size was based on the assumption that the prevailing level of typhoid fever-related knowledge and practices among the patent medicine vendors was known at the time of the study. The prevalence of typhoid fever knowledge was assumed to be 50%, with an absolute allowable error of 5% on either side. The sample size was determined using the formula for intervention studies. 14 n = [Z1 – α √ (2P (1 – P) + Z1 – β √ (P1 (1 – P1) + P2 (1 – P2) ]2 ] (P2 – P1)2 n = the estimated minimum sample size required for the study Z1 – α = percentage point of the standard normal deviation corresponding to the two-sided significance level of 1.96 (for α = 5% or 0.05). Z1 – β = one-sided percentage point of the standard normal deviate corresponding to 90% = 1.28 P = Combined intervention rate (P1 + P2) P1 = Pre-intervention rate (72.0%) from previous study 15 P2 = Post-intervention rate (96.7%) from previous study 15 The total sample size used in this study was 162 patent medicine vendors. This includes 111 trained experimental groups and 51 control group untrained. The control group was used to compare the statistical significance of the intervention. Sampling Techniques A multistage sampling technique was used in this study. In the first stage, three senatorial zones were selected. In the second stage, a simple random sampling technique was used to select the Ebonyi central senatorial zone from the sample frame of three zones. In the third stage, simple random sampling was used to select Abakaliki LGA for the intervention or experimental study, whereas Ezza North LGA was selected for the control group. In the fourth stage, one hundred and eleven (111) experimental groups were selected by a systematic sampling method of one in 2 from the sample frame of 220 registered PMVs in that LGA, and those who declined were replaced by the next in the list. The fifty-one (51) control group was selected via simple random sampling by balloting from the list of registered PMVs in that unit. All the participants were 18 years and above. Study Instruments Typhoid fever questionnaire originally developed by 16, 17 was adapted and modified to suit the specific objectives of this study. Adjustment were made to tailor the questionnaire to the context and preference of the research participants. Scoring method The knowledge level about typhoid fever was assessed by requesting respondents to answer 13 questions. The knowledge score was calculated as one for every "correct response" and zero for every "incorrect response" or "Do not know." The total score ranged from 0 to 13. Respondents with scores of ≥ 80 percent were considered to have good knowledge about typhoid fever. The mean knowledge score was calculated by calculating the mean of the total score of the participants. The practice level related to typhoid fever management consisted of 6 questions. The practice score was calculated as one for every "correct response" and zero for every "incorrect response" or "Do not know. The total score ranged from 0 to 6. Respondents with scores ≥ 80 percent were considered to have good management practices. The modified Bloom’s cut off for KAP studies were used above to categorize the knowledge and management scores, where 80–100 is considered high 60–79 is considered moderate < 60 is considered low or poor. But in this study, two categorization (Good/poor) was used to justify good knowledge for both group. Statistical analysis Data were collected before and after the intervention on knowledge and management of typhoid fever using questionnaire in the English language. The collected data were analysed using Statistical Package for Social Sciences (SPSS) version 26. Descriptive statistics were calculated and independent sample t test were used to compare the means of both groups while person chi square were used to determine the associations between variables. P value of ≤ 0.05 were considered significant. Ethical Consideration The ethical approval to conduct this study was obtained from the Ethics Committee of the University of Nigeria Teaching Hospital Enugu (NHREC/05/01/2008B-FWA00002458-1RB00002323) and permission from the associations of patent medicine vendors in Enugu State. Also, written consent was obtained from the participants after due explanation of the survey and assurance of anonymity and confidentiality. RESULTS Total of 162 questionnaires analysed at baseline, including 111 for the intervention group and 51 for the control group. Three months post intervention, 107 questionnaires were analysed for the intervention group, and 51 were analysed for the control group. The Table 1 shows sociodemographic characteristics of the two groups at baseline and there were no significant difference between them at baseline. Most respondents were less than 40 years old in both groups. Most participants in both groups had completed primary and secondary education. Over 90% of the participants in the experimental and control groups were business owners, and over one-third of the participants in each group had been in the patent medicine business for between one and five years. Table 2 revealed that both group at baseline have not had any previous training on typhoid fever hence about 95% reported that they need training to improve their knowledge. Tables 3 and 4 , shows knowledge and management practices both groups at baseline with no statistical difference between among them but however, there were statistical significant difference of p = 0.030 among the groups on whether they ask their customers how long they experience signs and symptoms of typhoid fever. Table 1 Sociodemographics of the study groups Variables Intervention Group (n = 111) Control group (n = 51) Test statistic value(x 2 ) P value Age 60 6(5.4%) 0(0.0%) Total 111 51 Mean ± SD 31.8 ± 10.9 32.3 ± 11.3 Sex Male 37(33.3%) 23(45.1%) 2.074 0.150 Female 74(66.7%) 28(54.9%) Total 111 51 Education None 1(0.9%) 2(3.9%) 2.025 0.567 Primary 6(5.4%) 3(5.9%) Secondary 85(76.6%) 36(70.6%) Post-Secondary 19(17.1%) 10(19.6%) Total 111 51 Marital status Single 42(37.8%) 20(39.2%) 0.809 0.847 Married 67(60.4%) 30(58.8%) Separated 1(0.9%) 0(0.0%) Divorced/widowed 10.9%) 1(2.0%) Total 111 51 Status in business Owner 100(90.1%) 49(96.1%) 2.126 0.345 Apprentice 8(7.2%) 2(3.9%) Others 3(2.7%) 0(0.0%) Total 111 51 Duration in Business 5years 33(29.7%) 20(39.2%) Total 111 51 Table 2 Respondent’s awareness and training about typhoid fever at baseline Responses Intervention group (n = 111) Control group (n = 51) P value Ever heard of typhoid fever NO 0(0.0%) 0(0.0%) - YES 110(99.1%) 51%(100%) Where did you first get information about typhoid fever Printed media 6(5.4%) 2(3.9%) 0.407 Radio &TV 11(9.9%) 6(11.8%) Social media 1(0.9%) 3(5.9%) Health Professionals 82(73.9%) 36(70.6%) Family and friends 11(9.9%) 4(7.8%) Ever been trained on typhoid fever before? NO 102(91.9%) 44(86.3%) 0.266 YES 9(8.1%) 7(13.7%) Table 3 Participants’ knowledge of typhoid fever at baseline Responses on Knowledge Intervention group n = 111 (%) Control n = 51 (%) P value What is typhoid fever? + A Bacterial disease Incorrect responses I don’t know 34 (30.6%) 32 (28.8%) 45 (40.6%) 14(27.5%) 25(49.0%) 12(23.5%) 0.030 Ever seen a person sick from typhoid fever before? + Yes Not sure 107 (96.4%) 4 (3.6%) 50(98.0%) 1(2.0%) 0.574 Signs/symptoms of typhoid fever? + Cough, fever, headache, pains, general ill feeling, rash Fever, headache, vomiting, dehydration, coughing blood I don’t know 56(50.5%) 51(45.9%) 4(3.6%) 30(58.8%) 17(33.3%) 4(7.8%) 0.217 Cause of typhoid fever? + Bacterial infection Virus infection Fungal infection Food and water Drinking raw milk I don’t know 56(50.5%) 9(8.1%) 0(0.0%) 22(19.8%) 1(0.9%) 23(20.7%) 31(60.8%) 3(5.9%) 0(0.0%) 13(25.5%) 0(0.0%) 4(7.8%) 0.250 Mode of transmission of typhoid fever Airborne Food/Water I don’t know 26(23.4%) 55(49.5%) 30(27.1%) 14(27.5%) 32(62.7%) 5(9.8%) 0.046 Typhoid fever is preventable? + Yes No I don’t know 75(67.6%) 10(9.0%) 26(23.4%) 33(64.7%) 15(29.4%) 3(5.9%) 0.000* If yes,What is the mode of prevention? + Vaccine/Hygeine Medication Medical checks I dont know 45(60.0%) 16(21.3%) 0(0%) 14(18.7%) 17(51.5%) 7(21.2%) 1(3.0%) 8(24.2%) 0.102 Do you think there is a vaccine for typhoid fever? + Yes No I dont know 62(55.9%) 23(20.7%) 26(23.4%) 22(43.1%) 22(43.1%) 7(13.7%) 0.011* + Correct responses *Significant difference between groups Table 4 Participant’s management practice of typhoid fever at baseline Test subjects (n = 111) Control (n = 51) p value Typhoid fever is treatable Yes No I don’t know 90(81.1%) 1(9.9%) 10(9.0%) 47(92.2%) 2(3.9%) 3(3.9%) 0.193 Your response when your customers complain of typhoid fever I treat them first I refer them to the lab first I refer them to the hospital first 53(47.7%) 51(45.9%) 7(6.3%) 28(54.9%) 19(37.3%) 4(7.8%) 0.377 Antibiotics used to treat typhoid fever? Correct responses Incorrect responses/not sure 89(80.2%) 22(19.8%) 45(88.2%) 6(11.8%) 0.208 Treatment duration for typhoid fever customers? 5-14days 14days Not sure 64(57.7%) 11(9.9%) 36(32.4%) 33(64.7%) 5(9.8%) 13(25.5%) 0.655 Do you ask your customers how long they have experienced signs and symptoms of typhoid fever before treating them? Yes no Sometimes 88(79.3%) 2(1.8%) 21(18.9%) 41(80.4%) 5(9.8%) 5(9.8%) 0.030* Can you differentiate the signs and symptoms of typhoid fever from that of malaria? Yes No 74(66.7%) 37(33.3%) 34(66.7%) 17(33.3) 1.000 Table 5 Participants’ knowledge of typhoid fever at post intervention Responses on Knowledge Intervention group n = 107 (%) Control n = 51 (%) P Value What is typhoid fever? (open ended) A Bacterial disease Incorrect responses I don’t know 60(56.1%) 26(24.3) 21(19.6%) 17(33.3%) 17(33.3%) 15(33.3%) 0.025* Mode of transmission of typhoid fever Airborne Food/Water I don’t know 11(10.3%) 90(84.1%) 6(5.6%) 12(23.5%) 34(66.7%) 5(9.8%) 0.041* Is typhoid fever infectious? Yes No I don’t know 92(86.0%) 12(11.2%) 3(2.8%) 33(64.7%) 12(23.5%) 6(11.8%) 0.006* Is typhoid fever a serious infection? Yes No I don’t know 88(82.2%) 15(14.0%) 4(3.7%) 33(64.7%) 13(25.5%) 5(9.8%) 0.045* Typhoid fever spread easily from person to person? + Yes No I don’t know 64(59.8%) 43(40.2%) 0(0.0%) 13(25.5%) 38(74.5%) 0(0.0%) 0.000* Is typhoid fever is preventable? + Yes No I don’t know 91(85.0%) 16(15.0%) 0(0.0%) 36(70.6%) 15(29.4%) 0(0.0%) 0.032* If yes, What is the mode of prevention? + Vaccine/Hygeine Medication Medical checks I dont know 78(85.7%) 11(12.1%) 0(0.0%) 2(2.2%) 20(55.6%) 1(2.8%) 1(2.8%) 14(38.9%) 0.000* Do you think there is a vaccine for typhoid fever? + Yes No I dont know 77(72.0%) 22(20.5%) 8(7.5%) 21(41.2%) 22(43.1%) 8(15.7%) 0.001* If yes, What is the name of the vaccine for typhoid fever? + Correct responses(Typbar, Vac-T,Zyvac TCV, Tyvax-CV) Incorrect responses I dont know 65(84.4%) 3(3.9%) 9(11.7%) 3(14.3%) 5(23.8%) 13(61.9%) 0.000* Can typhoid fever be transmitted through sexual contact with infected persons? Yes + No I dont know 17(15.9%) 83(77.6%) 7(6.5% 14(27.5%) 34(66.7%) 3(5.9%) 0.231 Have you seen a person sick from typhoid fever before? + Yes Unsure 106(99.1%) 1(0.9%) 48(94.1%) 3(5.9%) 0.064 What are the signs/symptoms of typhoid fever? + Cough, fever, headache, pains, general ill feeling, rash Fever, headache, vomiting, dehydration, coughing blood I don’t know 84(78.5%) 20(18.7%) 15(14.0%) 30(58.8%) 17(33.4%) 4(7.8%) 0.002* What is the cause of typhoid fever? + Bacteria infection Virus infection Fungal infection Food and water Drinking raw milk I dont know 73(68.2%) 4(3.7%) 1(0.9%) 24(22.4%) 3(2.8%) 2(1.9%) 33(64.7%) 3(5.9%) 0(0.0%) 11(21.6%) 0(0.0%) 4(7.8%) 0.349 + Correct responses *Significant difference between groups The Table 5 shows the differences in the participants' responses 3 months after the health education intervention. Table 5 revealed that there were statistically significant difference between the intervention group and the control group in terms of correct knowledge of what typhoid fever is ( p = 0.025), mode of transmission of typhoid fever ( p = 0.041), whether typhoid fever is infectious ( p = 0.006), whether typhoid fever infection can spread quickly from person to person ( p = 0.000), whether typhoid fever is a severe infection ( p = 0.045), the correct mode of prevention of typhoid fever ( p = 0.000 ), whether typhoid fever is infectious ( p = 0.001), correct knowledge of the name of typhoid fever vaccine ( p = 0.000) and correct knowledge of signs and symptoms of typhoid fever ( p = 0.002). Table 6 Participant’s management practices for typhoid fever at post intervention Variable Test subjects n = 107 Control n = 51 p value Typhoid fever is treatable Yes No I don’t know 107(100.0%)) 0(0.0%) 0(0.0%) 47(92.2%) 2(3.9%)) 2(3.9%) 0.000* Your response when your customers complain of typhoid fever I treat them first I refer them to the lab first I refer them to the hospital first 15(14.0%) 91(85.0%) 1(0.9%) 28(54.9%) 19(37.3%) 4(7.8%) 0.000* Treatment duration of typhoid fever? 5-14days 14days Not sure 105(98.1%) 0(0.0%) 2(1.9%) 33(64.7%) 4(7.8%) 14(27.5%) 0.000* Do you ask your customers how long they have experienced signs and symptoms of typhoid fever before treating them? Yes No Sometimes 100(93.5%) 7(6.5%) 0(0.0%) 41(80.4%) 5(9.8%) 5(9.8%) 0.003* Can you differentiate the signs and symptoms of typhoid fever from that of malaria? Yes No 102(95.3%) 5(4.7%) 33(64.7%) 18(35.3%) 0.000* What antibiotics is used to treat typhoid fever? Correct responses Incorrect responses Not sure 103(96.3%) 2(1.9%) 2(1.9%) 45(88.2%) 0(0.0%) 6(11.8%) 0.020* Table 6 shows the results of 3months after the health education intervention, which revealed a statistically significant difference between the responses of the intervention group and the control group in terms of correct knowledge of whether typhoid fever is treatable ( p = 0.000), what to do when customers show signs and symptoms of typhoid fever ( p = 0.000), duration of treatment (p = 0.000), whether they ask their customers how long they have experienced signs and symptoms of typhoid fever before treating them (p = 0.003), whether they can differentiate the signs and symptoms of typhoid fever from those of malaria (p = 0.000) and correct name of antibiotics used to treat typhoid fever among those who had treated typhoid fever in both groups (p = 0.020). Table 7 Effects of health interventions on knowledge of typhoid fever Knowledge Categories Scores INTERVENTION GROUP Baseline n = 111 Post intervention (n = 107) Diff Statistic (P value) Good Knowledge ≥ 80% 5(4.5%) 56(52.3%) 47.8% X 2 = 61.9 (p = 0.000*) Poor knowledge < 80% 106(95.5%) 51(47.7%) Mean scores ± SD 6.8 ± 2.49 10.2 ± 2.05 3.40 t= -11.259 (p = 0.000*) CONTROLS Baseline n = 51 Post intervention (n = 51) Diff Statistic (P value) Good Knowledge ≥ 80% 1(2.0%) 5(9.8%) 7.8% X 2 = 2.833 (p = 0.092) Poor knowledge < 80% 50(98.0%) 46(90.2%) Mean scores ± SD 6.92 ± 2.46 7.08 ± 2.54 0.16 t= -0.317 (P = 0.704) X 2 - Pearson chi-square value Table 7 compares knowledge of typhoid fever between the two groups at baseline and 3 months after the health education intervention. The mean knowledge score of the intervention group and control group at baseline was 6.8 ± 2.49 and 6.92 ± 2.46, respectively, and at 3 months post intervention, the mean score was 10.2 ± 2.05 and 7.08 ± 2.54, respectively. The general level of good knowledge of typhoid fever at baseline 4.5% of the intervention compared with 2.0% of the control group. However, after health education intervention, good knowledge increased to 52.3% for the intervention group compared with 9.8% in the control group. The improvement in knowledge level was found to be statistically significant in the intervention group (p ≤ 0.001), whereas in the control group, the improvement was not considered significant (p = 0.092). The Fig. 1 shows the effects of health education intervention at baseline and post intervention and how health education improved good knowledge from 5% to 56% among the experimental group on knowledge test of typhoid fever. Table 8 Effects of health interventions on management of typhoid fever Management Categories Scores INTERVENTION GROUP Baseline n = 111 Post intervention (n = 107) diff Statistic (P value) Good practice ≥ 80% 59(53.2%) 101(94.4%) 41.2% X 2 = 47.45 (p = 0.000*) Poor practice < 80% 52(46.8%) 6(5.6%) Mean practice scores ± SD 4.12 ± 1.58 5.68 ± 0.58 1.56 t= -9.664 (p = 0.000*) CONTROLS Baseline n = 51 Post intervention (n = 51) diff Statistic (Pvalue) Good practice ≥ 80% 26(51.0%) 27(52.9%) 1.9% X 2 = 0.039 (p = 0.843) Poor practice < 80% 25(49.0%) 24(47.1%) Mean practice scores ± SD 4.24 ± 1.37 4.31 ± 1.41 0.07 t= -0.286 (P = 0.786) The Table 8 revealed the mean practice scores of the intervention group and control group at baseline were 4.12 ± 1.58 and 4.24 ± 1.37, respectively, and at 3 months post intervention, the mean scores were 5.68 ± 0.58 and 4.31 ± 1.41, respectively. The general level of knowledge in management practice of typhoid fever at baseline were 46.8% in the intervention group compared to 49.0% among control group. However, after health education intervention, good knowledge improved to 94.4% for intervention. The improvement in management practice level was statistically significant in the intervention group (p = 0.000), whereas in the control group, the improvement was not significant (p = 0.843). The Fig. 2 represents the effect of health education intervention on management practices of typhoid fever among both groups. This shows that management skills improved from 46.8% at baseline to 94.4% post intervention at p = 0.000. Table 9 Mean scores of the intervention and control groups at baseline and three months after intervention on the knowledge and management of typhoid fever. Variables Baseline 3-month Post intervention T- value p value Knowledge of Typhoid fever Intervention group 6.8 ± 2.49 10.2 ± 2.05 – 11.259 0.000* Control 6.92 ± 2.46 7.08 ± 2.54 – 0.317 0.704 Management of Typhoid fever Intervention group 4.12 ± 1.58 5.68 ± 0.58 -9.664 0.000* Control 4.24 ± 1.37 4.31 ± 1.41 -0.286 0.465 The Table 9 shows the study participants' mean knowledge and practice scores at baseline and 3 months after the health education intervention. The mean knowledge score improved significantly in the intervention group from 6.8 at baseline to 10.2 post intervention (p = 0.000), whereas in the control group, the mean knowledge score, which improved by 0.16, was statistically insignificant (p = 0.704). On the other hand, the mean practice score improved by 1.56 in the intervention group (p = 0.000) and 0.07 in the control group (p = 0.786). There was a difference between the mean scores at baseline and 3 months post intervention in the knowledge and management of typhoid fever between the experimental and control groups. This difference in the mean scores was statistically significant only in the intervention group (p < 0.05). In contrast, in the control group, there were slight improvements in knowledge and practice scores, but these improvements were not statistically significant. Table:10: Relationship between participants characteristics and knowledge post intervention Table 10 shows that the education level of the participants had no significant association with knowledge of typhoid fever post-intervention (p > 0.05). Also, the duration of business had no significant relationship with knowledge of typhoid fever ( p > 0.05 Variables N Knowledge Categories post intervention P-value Poor Knowledge Good knowledge Educational level None 1 1(100%) 0(0.0%) 0.165 Primary 6 0(0%) 6(100%) Secondary 83 29(34.9%) 54(65.1%) Post-Secondary 17 6(35.3%) 11(64.7%) Duration in Business 5years 33 10(30.3%) 23(69.7%) DISCUSSION This study evaluated the impact of health education interventions on knowledge and management of typhoid fever among patent medicine vendors, assessed baseline knowledge and management practices, instituted health education interventions, and appraised the impact of health education. Prior to this interventional training, 91.9% and 86.3% of the experimental and control groups, respectively, had not had any training on typhoid fever as shown in Table 2 The results show that most experimental and control group study participants are less than 40 years old and have been in business for 1–5 years. These findings are similar to those of a previous study carried out in Enugu among PMVs, where similar age groups and durations of business were reported 15 . However, age and educational level were not significantly associated with knowledge and management, as reported in this study in table 1and 2 Approximately 76% of the experimental participants and 70.6% of the control participants had attended at least secondary education. These findings are in accordance with the Pharmaceutical Council of Nigeria (PCN) convention that the minimum educational attainment of PMVs in Nigeria should be primary education, and other similar studies attributed poor knowledge to the level of education and the need for continual training 18 , 15 , 19 , 20 . The prevalence of typhoid fever was relatively high, at 99.1% and 100%, respectively, among the two groups reported in this study. Most experimental and control groups received information about typhoid fever from healthcare professionals and did not have any previous training as reported in Table 2 These findings follow those of two previous studies performed in Enugu, where PMVs were reported to have obtained significant health information about tuberculosis through healthcare professionals 10 , 15 . This is possible because the practice among the PMVs is that new members who want to learn the trade must learn the apprenticeship from their senior colleagues to gain the appropriate experience and to be inducted into the business within specific regions. These findings are similar to those of other studies carried out in Enugu and Lagos, where the participants’ primary sources of information on typhoid and TB were healthcare workers 21 , 22 , 15 , 19 . Typhoid fever knowledge includes the ability to recognize and understand the etiology, causes, signs, and symptoms; identify transmission routes; and prevent and manage the disease 6 , 8 , 23 , 24 , 22 . Preintervention, the experimental group reported poor knowledge of typhoid fever, with a mean score of 6.8 ± 2.49, and poor management practices, with a mean score of 4.12 ± 1.58 as shown in Tables 3 and 4 . This high level of poor knowledge can explain why most respondents need training to improve their knowledge. This poor knowledge corroborates the findings of a study assessing the impact of knowledge and management practices of tuberculosis among patent medicine vendors in Enugu, Nigeria, which reported that most respondents had poor knowledge at baseline 15 . This similarity may be explained by the fact that appropriate authorities or regulatory bodies are not paying critical attention to these unskilled healthcare professionals to train them for better practices; this study has closed the gap by providing educational intervention training. Similarly, these findings corroborate the BMC publication in Lagos, Nigeria, that PMVs are more accessible to rural communities. Because of this, they are more likely to misdiagnose their patients and administer unprofessional treatment 25 , 26 , 27 . Poor knowledge leads to inappropriate administration of antibiotics, contributing to the high prevalence and incidence of antimicrobial and antibiotic resistance in Nigeria. This justified the study published by the Nigerian Journal of Infectious Diseases and other studies on the molecular characterization of multidrug-resistant Salmonella enterica serovar Typhi 28 , 29 , 30 . A previous study carried out in Gombe metropolis on the epidemiology of typhoid fever in Nigeria reported the same results 31 . This poor knowledge and management practices of typhoid fever, as seen in the results at baseline, agree with the relevant studies cited here and the need to close the gap with an effective health education intervention. In general, the statistical test revealed that both groups were similar at baseline except for a few questions, such as correct knowledge of what typhoid fever is and whether typhoid fever is preventable, where the control group answered those questions more correctly. The results of the 3-month postintervention assessment revealed that the educational intervention positively increased the respondents' knowledge and management practices regarding typhoid fever as shown in Tables 5 and 6 . This implies that the education intervention increased the knowledge of the experimental group from a baseline of 4.5% (6.8 ± 2.49) to 52.3% (10.2 ± 2.05, P = 0.000), as reported in tables 7and 8. A significant difference were also observed in the overall mean score between the experimental group at baseline and control groups; the experimental group had a higher overall mean score than the control group as reported in Table 9 . This further revealed that the experimental group participants were able to retain their knowledge after 3 months. After intervention, a significant increase was noted in the mean knowledge score and the proportion of participants with overall good knowledge of typhoid fever (52.3%) but not in the control group. This finding is consistent with previous studies carried out in Ebonyi, Enugu and Kano, which reported a significant increase in knowledge after educational intervention on typhoid fever, malaria, and other health-related conditions among PMVs and other healthcare workers in Ebonyi 15 , 32 , 33 , 34 . The results also revealed a significant increase in the mean score and proportion of the participants on management or treatment practices after 3 months compared with the baseline score of 4.12 ± 1.68 (46.8%), which is considered poor, to 5.68 ± 0.58 (94.4%) good management practices. This finding shows that at 3 months post intervention, the PMVs were able to ask their patients for corrections and refer them to the laboratory to confirm signs and symptoms before administering drugs following laboratory recommendations. The improvement in management practices among the experimental group at baseline compared with that at post intervention was statistically significant at p = 0.000. While there was no difference among the experimental and control groups at baseline, a slight increase in the mean score and proportion was observed among the control group after 3 months. However, this increase was not significant at p = 0.786 and 4.24 ± 1.37/4.31 ± 1.41. According to the findings of this study, compared with those of the control group, the knowledge and management practices of PMVs related to typhoid fever increased or improved following their adherence to the educational training content. The present study shows that a well-organized model-based educational intervention can improve knowledge, management practices, prevention, and control of typhoid fever and other related diseases in Ebonyi State. Thus, this study validates the beneficial effects of health education interventions among patent medicine vendors. These findings are compatible with previous studies carried out by Oyo/Bayelsa, Enugu and Ebonyi, who reported improvements in knowledge and treatment practices among PMVs and other healthcare workers in Nigeria 25 , 15 – 34 . However, this study also validates the findings of previous studies performed in Lagos state, Nigeria, which reported that PMV's unprofessional practices and knowledge were associated with the high prevalence, incidence, and mortality of typhoid fever in Nigeria 35 , 36 .. Thus, the convincing effects of this intervention may not be expected in this short period of 3 months but will fully reduce the prevalence, incidence, and mortality of typhoid fever in Ebonyi. Additionally, this study revealed unskilled or inadequate use of antibiotics among both groups at baseline, which is a significant risk factor for multidrug resistance or antimicrobial resistance. This finding is similar to those of previous studies carried out in Lagos, Nigeria, that reported the characteristics and risk of multidrug resistance 35 , 28 . Three months postintervention, this attitude improved because of the educational intervention in the experimental group. However, this was not further compared because it is not part of this study's objectives. However, this suggests that further implementing all inclusive, cost-effective health educational interventions will effectively improve the skills and knowledge of the PMVs in their line of business. In summary, the results of this study, the previous studies cited and the references show that the health education intervention improved the knowledge of the patent medicine vendors in Ebonyi State central LGA 3 months post intervention. Therefore, the null hypothesis that there is no statistically significant difference between health education intervention and knowledge improvement was rejected because knowledge of PMVs improved after 3 months post intervention; therefore, an alternate hypothesis was accepted in this study. Strengths and limitation The strengths of this study were the use of an interventional experimental design, sampling technique, and an adapted questionnaire to evaluate the effectiveness of a health education intervention delivered in a group setting. The sample size was calculated using the standard formula increasingly adopted by health experts to evaluate population health intervention. The findings of these studies are also consistent with those of previous studies Additionally, the intervention was theoretically and practically based and visually delivered. However, the study has several limitations but one major limitation is the cost of funding because this study was self-funded CONCLUSION AND RECOMMENDATIONS Conclusions The health education intervention conducted among patent medicine vendors in Ebonyi state improved their knowledge and management practices of typhoid fever. The positive outcomes observed within three months post intervention indicate the potential for sustainable and behavioral change among this group. Therefore, further studies are needed to continue training patent medicine vendors and address other gaps in their knowledge and practices related to other diseases, such as malaria, tuberculosis, hepatitis, and HIV/AIDS. Collaboration with regulatory bodies, government agencies, and other key partners is essential to ensure the continued success of health education interventions among patent medicine vendors. Recommendation: On the basis of the findings reported in this study, I recommend the following: Further training sessions are needed to sustain the gains of this study and to continuously improve the knowledge and skills of patent medicine vendors in Ebonyi State. In addition, I recommend training PMVs on the appropriate use of antibiotics and the risk of multidrug resistance. This is vital in addressing other related disease conditions they might be managing. The need for the PCN to step up monitoring to regularly supervise the activities of the PMVs and abnormalities observed can be corrected immediately. Advocate for the inclusion of standardized health education programs for patent medicine vendors in ongoing public health initiatives in Nigeria. Declarations Authors Contributions Simon C.Udeh, Proposal design, Curation, discussion Babatunde I. Omotowo, design of the study, data curation, mentoring Chukwuemerie D. Okoye, Community entry assisted, training of participants and data collection. Blessing N. Eneh,data cleaning and entry and analysis Susan C.Udeh , Data analysis and curation Authors Information Simon C. Udeh 1 , Babatunde I. Omotowo 1 , Chukwuemerie D. Okoye 2 , Blessing N. Eneh 2 , Susan C.Udeh 2 . 1 Department of Epidemiology and Medical Statistics, Institute of Public Health, University of Nigeria, Enugu State, Nigeria 1 Department of Epidemiology and Medical Statistics, Institute of Public Health, University of Nigeria, Enugu State, Nigeria 2 Ebonyi State College of Nursing Sciences, Uburu , Ebonyi State, Nigeria 2 Enugu State College of Nursing, Awgu, Enugu State, Nigeria 2 Department of Epidemiology and Medical Statistics, Institute of Public Health, University of Nigeria, Enugu, Nigeria Questionnaire The questionnaire used was adapted and modified to suit the specific objective of this study. Adjustments were made to tailor the questionnaire to the context and preferences of the research participants Ethical approval Ethical approval from the Research Ethics Committee of the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria with reference number UNTH/NHREC/2023/09/792. Additional permission were obtained from the associations of patent medicine vendors in Ebonyi State. The study adhered to the principles of the Declaration of Helsinki. Participants were informed of their right to withdraw at any time without consequences. All data were anonymised, stored securely, and accessible only to the research team. Consent to Participate Informed consent was obtained from all individual participants included in the study Consent for publication Not applicable. Availability of data and materials: The datasets used and /or analysed during the current study are available from the corresponding author on reasonable request Competing Interests: The authors declared that they have no competing interests Funding Not applicable Clinical Trial number Not applicable Acknowledgements We extend our gratitude to all the study participants for their valuable contributions to this study Authors Contributions Simon C.Udeh, Conceptualized , designed the study, developed the questionnaire, instituted the health education, participated in data collection and interpretation and drafted the initial manuscript. Babatunde I. Omotowo , Contributed in designing of the study, reviewed the literature, reviewed the collected data and mentoring. Chukwuemerie D. Okoye, Contributed in community entry, Instituted the health education training and data collection. Blessing N. Eneh, Contributed in data cleaning, entry analysis and data analysis. Susan C.Udeh , - Conducted Data analysis, critically reviewed the manuscript for intellectual content and all authors approved the final version for submission. References World Health Organization. Typhoid fever Nigeria. https://www.who.int/csr/don/21-November-2018-typhoid-nigeria/en/ . [Accessed May 8, 2023.]. World Health Organization (WHO).Typhoid Fever. https//.www.who.int/new-room/factsheet details/typhoid . [Accessed May, 29 2023]. A.Adewale O, Ojo A, Samule. A Systematic Review and meta-analysis of the prevalence of typhoid fever in Africa, 2000–2020.Front public Health. 2021; 9: 56703610.3389 fpubh.2021.567036 Ibrahim MM, Tafida AU, Abubakar U. Epidemiology of typhoid fever in Nigeria: A systematic review and meta-analysis of the incidence, prevalence and risk factors. J Infect Public Health. 2018;11(6):749–58. 10.101016/jiph.2018.05.005. Ogbodo OP, Onwe OE. Typhoid Fever. A Review of the clinical epidemiological, and public health aspects in Nigeria. Asian Pac J Trop Med. 2019;12(9):405–13. 10.4103/1995-7645.26754 . World Health Organization. (2018). Typhoid fever. Retrieved from https://www.who.int/newsroom/fact-shets/detail/typhoid-fever . [Accessed May 8 2023. A.Adewale O, Ojo A, Samule. A Systematic Review and meta-analysis of the prevalence of typhoid fever in Africa, 2000–2020.Front public Health. 2021; 9: 56703610.3389 fpubh.2021.567036 : Center for Disease Control and Prevention. Typhoid Fever, Symptoms, Signs. https//www.cdc.gov/typhoid-fever/symptoms.html . [Accessed May 9 2023.]. Goodman C, Brieger RW, Unwind A, Mills A, Meek S, Greer G. Medicine sellers and malaria treatment in Sub-Saharan Africa: what do they do and how can their practice be improved? Am J Trop Med Hygiene. 2007;77(6):203–18. Aniebue PN, Aguwa EN, Obi EI. Universal Precautions awareness and practice of patent medicine vendors in Enugu metropolis, South East Nigeria. Niger Med J. 2010; (51):30–4. Okoro RN, Okafor I, Azubuike EG, Nweke P. The role of patent medicine vendors in healthcare delivery in Nigeria: Implications for achieving universal health coverage. BMC Health Serv Res. 2018;18:357. National Population Census Abuja. Federal Government of Nigeria. 2006. https://www.jstor.org/stable/25434601 . Accessed 17th May 2023. National Bureau of Statistics (NBS). National literacy survey 2018.National Bureau of statistics.www.nigeriastat.gov.ng. Accessed 25th May 2023. Kirkwood BR, Sterne JAC. Essential medical statistics. 2nd ed. Massachusetts: Blackwell Science. 2003; 420–421. Simon CU, Brain OO, Fidelia EO. Effect of health education on knowledge of Tuberculosis among patent medicine vendors in Nigeria. Int J Epidemiol. 2021. v50.https:doi.org/10.1093/ije/dyab168.672 . Odikamnoro OO, Ikeh IM, Okoh FN, Ebiriekwe SC, Nnadozie IA. Incidence of Malaria/Typhoid co-infection among population in Uwana Community, Afikpo North LGA, Ebonyi State, Southeastern Nigeria. Afr J Infect Dis. 2018;12(1):33–8. 10.21010/ajid.v12i1.6 . Wondemagegn M, Chalachew GA, Kidist A, Solomon G, Fenkil T, Asamrew W et al. Seroconfirmed Typhoid Fever and Knowledge, Attitude, and Practices among Febrile Patients Attending at Injibara General Hospital, Northwest Ethiopia. BioMed Res Int 2021 Article ID 8887266, 8 pages https://doi.org/10.1155/2021/8887266 Pharmacists Council of Nigeria. Guidelines on the issuance of Patent and Proprietary Medicines Vendor’s Licence. 2003. Available online at http://www.tjpr.org http://dx.doi.org/10.4314/tjpr.v13i123 . [Accessed May 9 2023]. Okeke TA, Okafor IP, Okezie EO. Effect of health education on knowledge and treatment of typhoid fever among patent medicine vendors in Lagos State, Nigeria. J Health Med Sci. 2017;1(1):1–9. Tobin CL, Adeniji FO. Knowledge and Practice of PMVs in River State, Nigeria: Implications for malaria control in rural and suburban communities. Indian J Pharma Pract.2012: 5–34. Obi IE, Nwagbo D. C.N. Onwasigwe. Tuberculosis knowledge, perception, altitude and practice among patent medicine vendors in south–east. Nigeria . J Coll Med2010;(15):29–36. Sowunmi A. .Akinyemi. Typhoid fever in Nigeria: An update. J Infect Public Health. 2018;11(6):736–736. 10.1016/j.jiph.2018.04.012 . World Health Organization. Typhoid Fever. https://www.who.int/en/news-room/fact-sheet/details/typhoid fever . [Accessed on 8 May 2023.]. Nigeria Center for Disease Control (NCDC) guidelines on the prevention. and control of typhoid fever: https://ncdc.gov.ng/themes/common/docs/protocls/46_1527071105.pdf . {Accessed May 9 2023}. Oladimeji Oladipo AOS, Adedayo AO, Sarah MB, Opeyemi Oladunni. Micheal Alliu. Patent Medicine Vendors and the Treatment of Malaria and Typhoid Fever in Rural Nigeria. Malar J. 2019;18(1):103. 10.1186/s 12936.019-2732-z. Akinyemi KO, Atapu AD, Adetona AO. Antibiotic use and Practices in Private Hospitals in Lagos, Nigeria. Afr J Infect Dis. 2017;11(1 supp):109–19. 10.21010/ajid.v111i1s.13 . Adewole OO, Fagade OE, Ogunniyi A. Typhoid fever in Nigeria: A revisit. The Pan Africa Medical Journal,29. 10.11604/pamj.supp.2018.29.1.13667 Ogbolu DO, O.A.Alli OO, Akanbi. Molecular characterization of multidrug-resistant Salmonella enterica serovar Typhi isolates from lagos, Nigeria. J Infect Dev Ctries. 2012;6(9):726–34. 10.3855/jidc.2159 . Ogbolu DO, Alli OA, Ogunleye VF, Olusoga-Ogbolu FF. Typhoid fever incidence rates in lagos, Nigeria: A 4year retrospective study (2011–2014). J Infect Dev Ctries. 2016;10(12):1287–1293. Doi:3855/jidc.8269. Ogbolu DO, Daini OA, Ogunledun A. Typhoid fever in lagos, Nigeria: incidence, clinical and microbiological characteristics, treatment and outcome. PLoS ONE. 2018;13(7):e0202037. 10.1371/Journal.pone.0202037 . Ibrahim MM, Tafida AU, Abubakar U. Epidemiology of typhoid fever in Nigeria: A systematic review and meta-analysis of the incidence, prevalence and risk factors. J Infect Public Health. 2018;11(6):749–58. 10.101016/jiph.2018.05.005. Ifeoma OP, Theodora AO, Emmanuel OO. Impact of health education on knowledge and management of typhoid fever among patent medicine vendors in Ebonyi State, Nigeria. J Public Health Afr. 2018;9(2):842. Mukhtar AA, Ibrahim MTO, Muhammed HA, Abubakar SB. Impact of health education on the knowledge, diagnosis and treatment of typhoid fever among patent medicine vendors in kano State, Nigeria. J Community Med Prim Health Care. 2019;31(1):164–72. Ifeyinwa CA, Ijeoma ON, Henry CU, Abel EE, Onyedika EC, Ngozi IU. at el. Evaluation of the effect of an educational intervention on knowledge and adherence to HIV quideline among frontline health workers in Alex Ekwueme Federal University Teaching hospital Abakaliki. African journal of Health Sciences. 2020;20(3):1080–1089. https//dx.doi.org/10.4314/ajhs,20v3.10 Akinyemi KO, Iwalokun BA, Foli F. Prevalence of typhoid fever and antimicrobial susceptibility patterns of Salmonella typhi from patients attending a tertiary hospital in Lagos, Nigeria. Infect Drug Resist. 2015;8:231. 10.2147/IDR.S89102 . Crump JA. Progress in typhoid fever epidemiology. Clin Infect Dis. 2019;68(Suppl 1):S4–9. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 12 Dec, 2025 Reviews received at journal 11 Dec, 2025 Reviews received at journal 07 Dec, 2025 Reviews received at journal 07 Dec, 2025 Reviewers agreed at journal 05 Dec, 2025 Reviewers agreed at journal 02 Dec, 2025 Reviewers agreed at journal 30 Nov, 2025 Reviewers invited by journal 03 Nov, 2025 Editor assigned by journal 28 Oct, 2025 Submission checks completed at journal 14 Oct, 2025 First submitted to journal 14 Oct, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7819784","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":544045420,"identity":"b5e35e67-bf4a-4573-9f1b-02f1c0f442bf","order_by":0,"name":"Simon C. 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According to the World Health Organization, Nigeria is one of the countries with the highest burden of typhoid fever, with an estimated 10.9\u0026nbsp;million cases and 116,000 deaths reported annually\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Typhoid fever is a life-threatening infection caused by the bacterium Salmonella Typhi. It's a significant public health problem globally, especially in developing countries like Nigeria and Africa\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eIn Ebonyi State, typhoid fever cases have been increasing in recent years, with a peak incidence rate of 309 cases per 100,000 population in 2018\u003csup\u003e5\u003c/sup\u003e. Typhoid fever is a bacterial infection caused by the bacterium Salmonella enteric serotype Typhi. It is primarily a disease of developing countries, particularly those with poor sanitation and hygiene. In these areas, typhoid fever is a significant public health problem, with an estimated 10\u0026ndash;20\u0026nbsp;million cases and 128,000\u0026ndash;161,000 deaths annually worldwide \u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. The infection is transmitted by ingesting contaminated food or water or by contact with an infected person\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eEnteric fevers are distributed worldwide, although they are endemic in communities where sanitation and personal hygiene standards are low. Humans are the only reservoir of infection. The disease incubation period is usually 1\u0026ndash;2 weeks, during which time an infected person may not show any symptoms but can still spread the bacteria to others.\u003c/p\u003e\u003cp\u003eThe signs and symptoms typically include a high fever, often more significant than 103\u0026deg;F or h39.4\u0026deg;C, headache, weakness, loss of appetite, fatigue, confusion or delirium, abdominal pain, constipation or diarrhoea, and a rash. These symptoms can vary in severity and may last up to four weeks. Complications such as intestinal perforation, bleeding, and even death \u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e are possible.\u003c/p\u003e\u003cp\u003eUrbanization and climate change can potentially increase the global burden of typhoid.\u003c/p\u003e\u003cp\u003eIn addition, the increasing antibiotics resistance is making the treatment and spread faster in communities that lack access to safe drinking water or adequate sanitation.\u003c/p\u003e\u003cp\u003ePatent medicine vendors (PMVs) are people who sell medicines in Nigeria without formal pharmaceutical education and dispensing training, and they are essential informal community-based providers of health care\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. They are commonly found in urban and rural settings and play a significant role in rural healthcare delivery, where accessibility to formal pharmaceutical facilities is limited \u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. PMVs sell over\u0026ndash;the\u0026ndash;counter medications, and other healthcare-related products, such as antimalaria and pain relief drugs. A total of 37 relevant previous studies were reviewed in this study. The search for literature conducted shows that there was no similar study that has been conducted on typhoid knowledge, management practices in form of health education intervention for the PMVs in Ebonyi. However, there are other studies where infectious and non-communicable diseases were accessed based on knowledge and the impact of health education but not directly on knowledge and management of typhoid fever. This shows an existing knowledge gap among the PMVs regarding the knowledge and management of typhoid fever in Abakaliki.\u003c/p\u003e\u003cp\u003eTherefore, conducting a health education intervention among PMVs in Ebonyi is essential to improve the knowledge gap and skills regarding preventing, diagnosing, and treating common illnesses like typhoid fever. This study was carried out to evaluate the impact of health education interventions on knowledge and management practices related to typhoid fever on PMVs.\u003c/p\u003e\u003cp\u003eThe intervention will provide PMVs with up-to-date information on the signs and symptoms of typhoid fever, appropriate diagnostic tests, and effective treatment options.\u003c/p\u003e"},{"header":"METHODOLOGY","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy Area\u003c/h2\u003e\u003cp\u003eThis study was carried out in Ebonyi State, south-eastern Nigeria and its consists of three senatorial zones, namely, Ebonyi North, Ebonyi Central and Ebonyi South.\u003c/p\u003e\u003cp\u003eThe state's estimated population as of the 2006 national population census was 2,176,947, and the population density was 393\u003csup\u003e12\u003c/sup\u003e. The State accounts for 1.6% of Nigeria's total population. The primary economic activity of residents is farming in rural areas. The literacy rate in Ebonyi State is 59.5, with urban-rural disparity\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe patent medicine vendors in Ebonyi State has approximately twenty-seven (27) units across the state. Unpublished data from the PCN Ebonyi State chapter shows that approximately one thousand eight hundred and seventy registered and licenced PMVs exist in the state.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eStudy Design\u003c/h3\u003e\n\u003cp\u003eA quasi-experimental study designed with intervention and control group was carried out.\u003c/p\u003e\u003cp\u003eWe collected baseline data for evaluating the knowledge and management practices of typhoid fever among the PMVs. The baseline data on knowledge and management practices were obtained via self-administered semi structured questionnaire cast in English language in a paper form before and after the test. The control group was selected from another PMVs unit in Ezza North areas to avoid bias. The experimental group was trained on basic knowledge of typhoid fever, whereas the control group was trained on tuberculosis. The list of the registered premises in the selected LGA was obtained from the Pharmacy Council of Nigeria (PCN) Ebonyi branch, and permission to administer the intervention was obtained from the patent medicine vendor associations in the selected LGA.\u003c/p\u003e\n\u003ch3\u003eStudy Population\u003c/h3\u003e\n\u003cp\u003eThe participants of this study are the patent medicine vendors who reside in Abakiliki central Ebonyi state, Nigeria and are registered with PCN in Ebonyi, currently practicing, and operating retail shops.\u003c/p\u003e\n\u003ch3\u003eInclusion Criterion\u003c/h3\u003e\n\u003cp\u003eThe study included all the registered and practicing Patent Medicine Vendors in Abakaliki Central LGA who met the selection criteria.\u003c/p\u003e\n\u003ch3\u003eExclusion Criteria\u003c/h3\u003e\n\u003cp\u003eMobile patent medicine vendors in the study area will be excluded.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eStudy Period\u003c/h2\u003e\u003cp\u003eThe study was conducted from October 2023 to December 2023\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eSample size determination\u003c/h3\u003e\n\u003cp\u003eThe sample size was based on the assumption that the prevailing level of typhoid fever-related knowledge and practices among the patent medicine vendors was known at the time of the study. The prevalence of typhoid fever knowledge was assumed to be 50%, with an absolute allowable error of 5% on either side.\u003c/p\u003e\u003cp\u003eThe sample size was determined using the formula for intervention studies.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003en = \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e[Z1 \u0026ndash; α \u0026radic; (2P (1 \u0026ndash; P)\u0026thinsp;+\u0026thinsp;Z1 \u0026ndash; β \u0026radic; (P1 (1 \u0026ndash; P1)\u0026thinsp;+\u0026thinsp;P2 (1 \u0026ndash; P2) ]2\u003c/span\u003e]\u003c/p\u003e\n\u003ch3\u003e(P2 – P1)2\u003c/h3\u003e\n\u003cp\u003en\u0026thinsp;=\u0026thinsp;the estimated minimum sample size required for the study\u003c/p\u003e\u003cp\u003eZ1 \u0026ndash; α\u0026thinsp;=\u0026thinsp;percentage point of the standard normal deviation corresponding to the two-sided significance level of 1.96 (for α\u0026thinsp;=\u0026thinsp;5% or 0.05).\u003c/p\u003e\u003cp\u003eZ1 \u0026ndash; β\u0026thinsp;=\u0026thinsp;one-sided percentage point of the standard normal deviate corresponding to 90% = 1.28\u003c/p\u003e\u003cp\u003eP\u0026thinsp;=\u0026thinsp;Combined intervention rate (P1\u0026thinsp;+\u0026thinsp;P2)\u003c/p\u003e\u003cp\u003eP1\u0026thinsp;=\u0026thinsp;Pre-intervention rate (72.0%) from previous study\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eP2\u0026thinsp;=\u0026thinsp;Post-intervention rate (96.7%) from previous study \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe total sample size used in this study was 162 patent medicine vendors. This includes 111 trained experimental groups and 51 control group untrained. The control group was used to compare the statistical significance of the intervention.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eSampling Techniques\u003c/h2\u003e\u003cp\u003eA multistage sampling technique was used in this study. In the first stage, three senatorial zones were selected. In the second stage, a simple random sampling technique was used to select the Ebonyi central senatorial zone from the sample frame of three zones. In the third stage, simple random sampling was used to select Abakaliki LGA for the intervention or experimental study, whereas Ezza North LGA was selected for the control group. In the fourth stage, one hundred and eleven (111) experimental groups were selected by a systematic sampling method of one in 2 from the sample frame of 220 registered PMVs in that LGA, and those who declined were replaced by the next in the list. The fifty-one (51) control group was selected via simple random sampling by balloting from the list of registered PMVs in that unit. All the participants were 18 years and above.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eStudy Instruments\u003c/h2\u003e\u003cp\u003eTyphoid fever questionnaire originally developed by \u003csup\u003e16, 17\u003c/sup\u003e was adapted and modified to suit the specific objectives of this study. Adjustment were made to tailor the questionnaire to the context and preference of the research participants.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eScoring method\u003c/h2\u003e\u003cp\u003eThe knowledge level about typhoid fever was assessed by requesting respondents to answer 13 questions. The knowledge score was calculated as one for every \"correct response\" and zero for every \"incorrect response\" or \"Do not know.\" The total score ranged from 0 to 13. Respondents with scores of \u0026ge;\u0026thinsp;80 percent were considered to have good knowledge about typhoid fever. The mean knowledge score was calculated by calculating the mean of the total score of the participants. The practice level related to typhoid fever management consisted of 6 questions. The practice score was calculated as one for every \"correct response\" and zero for every \"incorrect response\" or \"Do not know. The total score ranged from 0 to 6. Respondents with scores\u0026thinsp;\u0026ge;\u0026thinsp;80 percent were considered to have good management practices. The modified Bloom\u0026rsquo;s cut off for KAP studies were used above to categorize the knowledge and management scores, where\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e80\u0026ndash;100 is considered high\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e60\u0026ndash;79 is considered moderate\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u0026lt;\u0026thinsp;60 is considered low or poor.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003cp\u003eBut in this study, two categorization (Good/poor) was used to justify good knowledge for both group.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eData were collected before and after the intervention on knowledge and management of typhoid fever using questionnaire in the English language. The collected data were analysed using Statistical Package for Social Sciences (SPSS) version 26. Descriptive statistics were calculated and independent sample t test were used to compare the means of both groups while person chi square were used to determine the associations between variables. P value of \u0026le;\u0026thinsp;0.05 were considered significant.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eEthical Consideration\u003c/h2\u003e\u003cp\u003e The ethical approval to conduct this study was obtained from the Ethics Committee of the University of Nigeria Teaching Hospital Enugu (NHREC/05/01/2008B-FWA00002458-1RB00002323) and permission from the associations of patent medicine vendors in Enugu State. Also, written consent was obtained from the participants after due explanation of the survey and assurance of anonymity and confidentiality.\u003c/p\u003e\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eTotal of 162 questionnaires analysed at baseline, including 111 for the intervention group and 51 for the control group. Three months post intervention, 107 questionnaires were analysed for the intervention group, and 51 were analysed for the control group.\u003c/p\u003e\u003cp\u003eThe Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows sociodemographic characteristics of the two groups at baseline and there were no significant difference between them at baseline. Most respondents were less than 40 years old in both groups. Most participants in both groups had completed primary and secondary education. Over 90% of the participants in the experimental and control groups were business owners, and over one-third of the participants in each group had been in the patent medicine business for between one and five years. Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e revealed that both group at baseline have not had any previous training on typhoid fever hence about 95% reported that they need training to improve their knowledge.\u003c/p\u003e\u003cp\u003eTables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, shows knowledge and management practices both groups at baseline with no statistical difference between among them but however, there were statistical significant difference of p\u0026thinsp;=\u0026thinsp;0.030 among the groups on whether they ask their customers how long they experience signs and symptoms of typhoid fever.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographics of the study groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention Group\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;111)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl group\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;51)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eTest statistic value(x\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e57(51.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20(39.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e8.085\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e0.089\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30\u0026ndash;39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25(22.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20(39.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e40\u0026ndash;49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14(12.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5(9.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e50\u0026ndash;59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9(8.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(11.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6(5.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003e31.8\u0026thinsp;\u0026plusmn;\u0026thinsp;10.9\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e32.3\u0026thinsp;\u0026plusmn;\u0026thinsp;11.3\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e37(33.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23(45.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e2.074\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.150\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e74(66.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28(54.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1(0.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2(3.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e2.025\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.567\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6(5.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(5.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e85(76.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36(70.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePost-Secondary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19(17.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10(19.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42(37.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20(39.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.809\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.847\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e67(60.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30(58.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSeparated\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1(0.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced/widowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1(2.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eStatus in business\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOwner\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e100(90.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e49(96.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e2.126\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.345\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eApprentice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8(7.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2(3.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3(2.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDuration in Business\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28(25.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10(19.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e1.962\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.580\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1-5years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50(45.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21(41.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;5years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e33(29.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20(39.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eRespondent\u0026rsquo;s awareness and training about typhoid fever at baseline\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResponses\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention group\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;111)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl group\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;51)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEver heard of typhoid fever\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNO\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYES\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e110(99.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e51%(100%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWhere did you first get information about typhoid fever\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrinted media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6(5.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2(3.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e0.407\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRadio \u0026amp;TV\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11(9.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(11.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial media\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1(0.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(5.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHealth Professionals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e82(73.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36(70.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFamily and friends\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e11(9.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4(7.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEver been trained on typhoid fever before?\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNO\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e102(91.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44(86.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.266\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYES\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9(8.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7(13.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eParticipants\u0026rsquo; knowledge of typhoid fever at baseline\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResponses on Knowledge\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention group\u003c/p\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;111\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;51\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003cp\u003evalue\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWhat is typhoid fever?\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eA Bacterial disease\u003c/p\u003e\u003cp\u003eIncorrect responses\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e34 (30.6%)\u003c/p\u003e\u003cp\u003e32 (28.8%)\u003c/p\u003e\u003cp\u003e45 (40.6%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14(27.5%)\u003c/p\u003e\u003cp\u003e25(49.0%)\u003c/p\u003e\u003cp\u003e12(23.5%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.030\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEver seen a person sick from typhoid fever before?\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eYes\u003c/p\u003e\u003cp\u003eNot sure\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e107 (96.4%)\u003c/p\u003e\u003cp\u003e4 (3.6%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e50(98.0%)\u003c/p\u003e\u003cp\u003e1(2.0%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.574\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSigns/symptoms of typhoid fever?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003e Cough, fever, headache, pains, general ill feeling, rash\u003c/p\u003e\u003cp\u003eFever, headache, vomiting, dehydration, coughing blood\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56(50.5%)\u003c/p\u003e\u003cp\u003e51(45.9%)\u003c/p\u003e\u003cp\u003e4(3.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30(58.8%)\u003c/p\u003e\u003cp\u003e17(33.3%)\u003c/p\u003e\u003cp\u003e4(7.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.217\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCause of typhoid fever?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eBacterial infection\u003c/p\u003e\u003cp\u003eVirus infection\u003c/p\u003e\u003cp\u003eFungal infection\u003c/p\u003e\u003cp\u003eFood and water\u003c/p\u003e\u003cp\u003eDrinking raw milk\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56(50.5%)\u003c/p\u003e\u003cp\u003e9(8.1%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003cp\u003e22(19.8%)\u003c/p\u003e\u003cp\u003e1(0.9%)\u003c/p\u003e\u003cp\u003e23(20.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e31(60.8%)\u003c/p\u003e\u003cp\u003e3(5.9%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003cp\u003e13(25.5%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003cp\u003e4(7.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.250\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMode of transmission of typhoid fever\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAirborne\u003c/p\u003e\u003cp\u003eFood/Water\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e26(23.4%)\u003c/p\u003e\u003cp\u003e55(49.5%)\u003c/p\u003e\u003cp\u003e30(27.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14(27.5%)\u003c/p\u003e\u003cp\u003e32(62.7%)\u003c/p\u003e\u003cp\u003e5(9.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.046\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTyphoid fever is preventable?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e75(67.6%)\u003c/p\u003e\u003cp\u003e10(9.0%)\u003c/p\u003e\u003cp\u003e26(23.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33(64.7%)\u003c/p\u003e\u003cp\u003e15(29.4%)\u003c/p\u003e\u003cp\u003e3(5.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIf yes,What is the mode of prevention?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eVaccine/Hygeine\u003c/p\u003e\u003cp\u003eMedication\u003c/p\u003e\u003cp\u003eMedical checks\u003c/p\u003e\u003cp\u003eI dont know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e45(60.0%)\u003c/p\u003e\u003cp\u003e16(21.3%)\u003c/p\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003cp\u003e14(18.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17(51.5%)\u003c/p\u003e\u003cp\u003e7(21.2%)\u003c/p\u003e\u003cp\u003e1(3.0%)\u003c/p\u003e\u003cp\u003e8(24.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.102\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDo you think there is a vaccine for typhoid fever?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eI dont know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e62(55.9%)\u003c/p\u003e\u003cp\u003e23(20.7%)\u003c/p\u003e\u003cp\u003e26(23.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e22(43.1%)\u003c/p\u003e\u003cp\u003e22(43.1%)\u003c/p\u003e\u003cp\u003e7(13.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.011*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003e+\u003c/sup\u003e Correct responses *Significant difference between groups\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eParticipant\u0026rsquo;s management practice of typhoid fever at baseline\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTest subjects\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;111)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;51)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003cp\u003evalue\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTyphoid fever is treatable\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e90(81.1%)\u003c/p\u003e\u003cp\u003e1(9.9%)\u003c/p\u003e\u003cp\u003e10(9.0%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e47(92.2%)\u003c/p\u003e\u003cp\u003e2(3.9%)\u003c/p\u003e\u003cp\u003e3(3.9%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.193\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYour response when your customers complain of typhoid fever\u003c/p\u003e\u003cp\u003eI treat them first\u003c/p\u003e\u003cp\u003eI refer them to the lab first\u003c/p\u003e\u003cp\u003eI refer them to the hospital first\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53(47.7%)\u003c/p\u003e\u003cp\u003e51(45.9%)\u003c/p\u003e\u003cp\u003e7(6.3%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28(54.9%)\u003c/p\u003e\u003cp\u003e19(37.3%)\u003c/p\u003e\u003cp\u003e4(7.8%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.377\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAntibiotics used to treat typhoid fever?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eCorrect responses\u003c/p\u003e\u003cp\u003eIncorrect responses/not sure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e89(80.2%)\u003c/p\u003e\u003cp\u003e22(19.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45(88.2%)\u003c/p\u003e\u003cp\u003e6(11.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.208\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTreatment duration for typhoid fever customers?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e5-14days\u003c/p\u003e\u003cp\u003e\u0026lt;5days/\u0026gt;14days\u003c/p\u003e\u003cp\u003eNot sure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e64(57.7%)\u003c/p\u003e\u003cp\u003e11(9.9%)\u003c/p\u003e\u003cp\u003e36(32.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33(64.7%)\u003c/p\u003e\u003cp\u003e5(9.8%)\u003c/p\u003e\u003cp\u003e13(25.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.655\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDo you ask your customers how long they have experienced signs and symptoms of typhoid fever before treating them?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eno\u003c/p\u003e\u003cp\u003eSometimes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e88(79.3%)\u003c/p\u003e\u003cp\u003e2(1.8%)\u003c/p\u003e\u003cp\u003e21(18.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41(80.4%)\u003c/p\u003e\u003cp\u003e5(9.8%)\u003c/p\u003e\u003cp\u003e5(9.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.030*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCan you differentiate the signs and symptoms of typhoid fever from that of malaria?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e74(66.7%)\u003c/p\u003e\u003cp\u003e37(33.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34(66.7%)\u003c/p\u003e\u003cp\u003e17(33.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eParticipants\u0026rsquo; knowledge of typhoid fever at post intervention\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResponses on Knowledge\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIntervention group\u003c/p\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;107\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;51\u003c/p\u003e\u003cp\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003cp\u003eValue\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWhat is typhoid fever? (open ended)\u003c/p\u003e\u003cp\u003eA Bacterial disease\u003c/p\u003e\u003cp\u003eIncorrect responses\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e60(56.1%)\u003c/p\u003e\u003cp\u003e26(24.3)\u003c/p\u003e\u003cp\u003e21(19.6%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17(33.3%)\u003c/p\u003e\u003cp\u003e17(33.3%)\u003c/p\u003e\u003cp\u003e15(33.3%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.025*\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMode of transmission of typhoid fever\u003c/p\u003e\u003cp\u003eAirborne\u003c/p\u003e\u003cp\u003eFood/Water\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11(10.3%)\u003c/p\u003e\u003cp\u003e90(84.1%)\u003c/p\u003e\u003cp\u003e6(5.6%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12(23.5%)\u003c/p\u003e\u003cp\u003e34(66.7%)\u003c/p\u003e\u003cp\u003e5(9.8%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.041*\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIs typhoid fever infectious?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e92(86.0%)\u003c/p\u003e\u003cp\u003e12(11.2%)\u003c/p\u003e\u003cp\u003e3(2.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33(64.7%)\u003c/p\u003e\u003cp\u003e12(23.5%)\u003c/p\u003e\u003cp\u003e6(11.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.006*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIs typhoid fever a serious infection?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e88(82.2%)\u003c/p\u003e\u003cp\u003e15(14.0%)\u003c/p\u003e\u003cp\u003e4(3.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33(64.7%)\u003c/p\u003e\u003cp\u003e13(25.5%)\u003c/p\u003e\u003cp\u003e5(9.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.045*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTyphoid fever spread easily from person to person?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e64(59.8%)\u003c/p\u003e\u003cp\u003e43(40.2%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13(25.5%)\u003c/p\u003e\u003cp\u003e38(74.5%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIs typhoid fever is preventable?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e91(85.0%)\u003c/p\u003e\u003cp\u003e16(15.0%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36(70.6%)\u003c/p\u003e\u003cp\u003e15(29.4%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.032*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIf yes, What is the mode of prevention?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eVaccine/Hygeine\u003c/p\u003e\u003cp\u003eMedication\u003c/p\u003e\u003cp\u003eMedical checks\u003c/p\u003e\u003cp\u003eI dont know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e78(85.7%)\u003c/p\u003e\u003cp\u003e11(12.1%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003cp\u003e2(2.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20(55.6%)\u003c/p\u003e\u003cp\u003e1(2.8%)\u003c/p\u003e\u003cp\u003e1(2.8%)\u003c/p\u003e\u003cp\u003e14(38.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDo you think there is a vaccine for typhoid fever?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eI dont know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e77(72.0%)\u003c/p\u003e\u003cp\u003e22(20.5%)\u003c/p\u003e\u003cp\u003e8(7.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e21(41.2%)\u003c/p\u003e\u003cp\u003e22(43.1%)\u003c/p\u003e\u003cp\u003e8(15.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIf yes, What is the name of the vaccine for typhoid fever?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eCorrect responses(Typbar, Vac-T,Zyvac TCV, Tyvax-CV)\u003c/p\u003e\u003cp\u003eIncorrect responses\u003c/p\u003e\u003cp\u003eI dont know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e65(84.4%)\u003c/p\u003e\u003cp\u003e3(3.9%)\u003c/p\u003e\u003cp\u003e9(11.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3(14.3%)\u003c/p\u003e\u003cp\u003e5(23.8%)\u003c/p\u003e\u003cp\u003e13(61.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCan typhoid fever be transmitted through sexual contact with infected persons?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eNo\u003c/p\u003e\u003cp\u003eI dont know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17(15.9%)\u003c/p\u003e\u003cp\u003e83(77.6%)\u003c/p\u003e\u003cp\u003e7(6.5%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14(27.5%)\u003c/p\u003e\u003cp\u003e34(66.7%)\u003c/p\u003e\u003cp\u003e3(5.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.231\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHave you seen a person sick from typhoid fever before?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eYes\u003c/p\u003e\u003cp\u003eUnsure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e106(99.1%)\u003c/p\u003e\u003cp\u003e1(0.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e48(94.1%)\u003c/p\u003e\u003cp\u003e3(5.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.064\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWhat are the signs/symptoms of typhoid fever?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003e Cough, fever, headache, pains, general ill feeling, rash\u003c/p\u003e\u003cp\u003eFever, headache, vomiting, dehydration, coughing blood\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e84(78.5%)\u003c/p\u003e\u003cp\u003e20(18.7%)\u003c/p\u003e\u003cp\u003e15(14.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e30(58.8%)\u003c/p\u003e\u003cp\u003e17(33.4%)\u003c/p\u003e\u003cp\u003e4(7.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.002*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWhat is the cause of typhoid fever?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003csup\u003e+\u003c/sup\u003eBacteria infection\u003c/p\u003e\u003cp\u003eVirus infection\u003c/p\u003e\u003cp\u003eFungal infection\u003c/p\u003e\u003cp\u003eFood and water\u003c/p\u003e\u003cp\u003eDrinking raw milk\u003c/p\u003e\u003cp\u003eI dont know\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e73(68.2%)\u003c/p\u003e\u003cp\u003e4(3.7%)\u003c/p\u003e\u003cp\u003e1(0.9%)\u003c/p\u003e\u003cp\u003e24(22.4%)\u003c/p\u003e\u003cp\u003e3(2.8%)\u003c/p\u003e\u003cp\u003e2(1.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33(64.7%)\u003c/p\u003e\u003cp\u003e3(5.9%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003cp\u003e11(21.6%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003cp\u003e4(7.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.349\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003csup\u003e+\u003c/sup\u003e Correct responses *Significant difference between groups\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows the differences in the participants' responses 3 months after the health education intervention. Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e revealed that there were statistically significant difference between the intervention group and the control group in terms of correct knowledge of what typhoid fever is (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.025), mode of transmission of typhoid fever (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.041), whether typhoid fever is infectious (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.006), whether typhoid fever infection can spread quickly from person to person (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000), whether typhoid fever is a severe infection (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.045), the correct mode of prevention of typhoid fever (\u003cem\u003ep\u0026thinsp;=\u0026thinsp;0.000\u003c/em\u003e), whether typhoid fever is infectious (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), correct knowledge of the name of typhoid fever vaccine (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000) and correct knowledge of signs and symptoms of typhoid fever (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eParticipant\u0026rsquo;s management practices for typhoid fever at post intervention\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTest subjects\u003c/p\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;107\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003cp\u003en\u0026thinsp;=\u0026thinsp;51\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e\u003cp\u003evalue\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTyphoid fever is treatable\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e107(100.0%))\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e47(92.2%)\u003c/p\u003e\u003cp\u003e2(3.9%))\u003c/p\u003e\u003cp\u003e2(3.9%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.000*\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYour response when your customers complain of typhoid fever\u003c/p\u003e\u003cp\u003eI treat them first\u003c/p\u003e\u003cp\u003eI refer them to the lab first\u003c/p\u003e\u003cp\u003eI refer them to the hospital first\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15(14.0%)\u003c/p\u003e\u003cp\u003e91(85.0%)\u003c/p\u003e\u003cp\u003e1(0.9%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28(54.9%)\u003c/p\u003e\u003cp\u003e19(37.3%)\u003c/p\u003e\u003cp\u003e4(7.8%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.000*\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTreatment duration of typhoid fever?\u003c/b\u003e\u003c/p\u003e\u003cp\u003e5-14days\u003c/p\u003e\u003cp\u003e\u0026lt;5days/\u0026gt;14days\u003c/p\u003e\u003cp\u003eNot sure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e105(98.1%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003cp\u003e2(1.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33(64.7%)\u003c/p\u003e\u003cp\u003e4(7.8%)\u003c/p\u003e\u003cp\u003e14(27.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDo you ask your customers how long they have experienced signs and symptoms of typhoid fever before treating them?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eSometimes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e100(93.5%)\u003c/p\u003e\u003cp\u003e7(6.5%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41(80.4%)\u003c/p\u003e\u003cp\u003e5(9.8%)\u003c/p\u003e\u003cp\u003e5(9.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.003*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCan you differentiate the signs and symptoms of typhoid fever from that of malaria?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e102(95.3%)\u003c/p\u003e\u003cp\u003e5(4.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33(64.7%)\u003c/p\u003e\u003cp\u003e18(35.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWhat antibiotics is used to treat typhoid fever?\u003c/b\u003e\u003c/p\u003e\u003cp\u003eCorrect responses\u003c/p\u003e\u003cp\u003eIncorrect responses\u003c/p\u003e\u003cp\u003eNot sure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e103(96.3%)\u003c/p\u003e\u003cp\u003e2(1.9%)\u003c/p\u003e\u003cp\u003e2(1.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e45(88.2%)\u003c/p\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003cp\u003e6(11.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.020*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e shows the results of 3months after the health education intervention, which revealed a statistically significant difference between the responses of the intervention group and the control group in terms of correct knowledge of whether typhoid fever is treatable (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000), what to do when customers show signs and symptoms of typhoid fever (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.000), duration of treatment (p\u0026thinsp;=\u0026thinsp;0.000), whether they ask their customers how long they have experienced signs and symptoms of typhoid fever before treating them (p\u0026thinsp;=\u0026thinsp;0.003), whether they can differentiate the signs and symptoms of typhoid fever from those of malaria (p\u0026thinsp;=\u0026thinsp;0.000) and correct name of antibiotics used to treat typhoid fever among those who had treated typhoid fever in both groups (p\u0026thinsp;=\u0026thinsp;0.020).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eEffects of health interventions on knowledge of typhoid fever\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKnowledge Categories\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eScores\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003eINTERVENTION GROUP\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBaseline n\u0026thinsp;=\u0026thinsp;111\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePost intervention (n\u0026thinsp;=\u0026thinsp;107)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eDiff\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eStatistic (P value)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGood Knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;80%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5(4.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56(52.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e47.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;61.9 (p\u0026thinsp;=\u0026thinsp;0.000*)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePoor knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;80%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e106(95.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e51(47.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean scores\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et= -11.259 (p\u0026thinsp;=\u0026thinsp;0.000*)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003e\u003cb\u003eCONTROLS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eBaseline n\u0026thinsp;=\u0026thinsp;51\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003ePost intervention (n\u0026thinsp;=\u0026thinsp;51)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003eDiff\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003eStatistic (P value)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGood Knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;80%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1(2.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5(9.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e7.8%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;2.833 (p\u0026thinsp;=\u0026thinsp;0.092)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePoor knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;80%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e50(98.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e46(90.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean scores\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6.92\u0026thinsp;\u0026plusmn;\u0026thinsp;2.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7.08\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et= -0.317\u003c/p\u003e\u003cp\u003e(P\u0026thinsp;=\u0026thinsp;0.704)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003eX\u003csup\u003e2\u003c/sup\u003e- Pearson chi-square value\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e compares knowledge of typhoid fever between the two groups at baseline and 3 months after the health education intervention.\u003c/p\u003e\u003cp\u003eThe mean knowledge score of the intervention group and control group at baseline was 6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49 and 6.92\u0026thinsp;\u0026plusmn;\u0026thinsp;2.46, respectively, and at 3 months post intervention, the mean score was 10.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.05 and 7.08\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54, respectively. The general level of good knowledge of typhoid fever at baseline 4.5% of the intervention compared with 2.0% of the control group. However, after health education intervention, good knowledge increased to 52.3% for the intervention group compared with 9.8% in the control group. The improvement in knowledge level was found to be statistically significant in the intervention group (p\u0026thinsp;\u0026le;\u0026thinsp;0.001), whereas in the control group, the improvement was not considered significant (p\u0026thinsp;=\u0026thinsp;0.092).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the effects of health education intervention at baseline and post intervention and how health education improved good knowledge from 5% to 56% among the experimental group on knowledge test of typhoid fever.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eEffects of health interventions on management of typhoid fever\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManagement Categories\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eScores\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003eINTERVENTION GROUP\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBaseline n\u0026thinsp;=\u0026thinsp;111\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePost intervention (n\u0026thinsp;=\u0026thinsp;107)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ediff\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eStatistic (P value)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGood practice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;80%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e59(53.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e101(94.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e41.2%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;47.45 (p\u0026thinsp;=\u0026thinsp;0.000*)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePoor practice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;80%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e52(46.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6(5.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean practice scores\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et= -9.664 (p\u0026thinsp;=\u0026thinsp;0.000*)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"4\" nameend=\"c6\" namest=\"c3\"\u003e\u003cp\u003e\u003cb\u003eCONTROLS\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003eBaseline n\u0026thinsp;=\u0026thinsp;51\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003ePost intervention (n\u0026thinsp;=\u0026thinsp;51)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003ediff\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cb\u003eStatistic (Pvalue)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGood practice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;80%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26(51.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27(52.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e1.9%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.039 (p\u0026thinsp;=\u0026thinsp;0.843)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePoor practice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;80%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e25(49.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e24(47.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean practice scores\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.31\u0026thinsp;\u0026plusmn;\u0026thinsp;1.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et= -0.286\u003c/p\u003e\u003cp\u003e(P\u0026thinsp;=\u0026thinsp;0.786)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e revealed the mean practice scores of the intervention group and control group at baseline were 4.12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58 and 4.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.37, respectively, and at 3 months post intervention, the mean scores were 5.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58 and 4.31\u0026thinsp;\u0026plusmn;\u0026thinsp;1.41, respectively.\u003c/p\u003e\u003cp\u003eThe general level of knowledge in management practice of typhoid fever at baseline were 46.8% in the intervention group compared to 49.0% among control group. However, after health education intervention, good knowledge improved to 94.4% for intervention. The improvement in management practice level was statistically significant in the intervention group (p\u0026thinsp;=\u0026thinsp;0.000), whereas in the control group, the improvement was not significant (p\u0026thinsp;=\u0026thinsp;0.843).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e represents the effect of health education intervention on management practices of typhoid fever among both groups. This shows that management skills improved from 46.8% at baseline to 94.4% post intervention at p\u0026thinsp;=\u0026thinsp;0.000.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cb\u003eMean scores of the intervention and control groups at baseline and three months after intervention on the knowledge and management of typhoid fever.\u003c/b\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBaseline\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3-month Post intervention\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eT- value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eKnowledge of Typhoid fever\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntervention group\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e10.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026ndash; 11.259\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e6.92\u0026thinsp;\u0026plusmn;\u0026thinsp;2.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e7.08\u0026thinsp;\u0026plusmn;\u0026thinsp;2.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026ndash; 0.317\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.704\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eManagement of Typhoid fever\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIntervention group\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e5.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-9.664\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.000*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e4.31\u0026thinsp;\u0026plusmn;\u0026thinsp;1.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-0.286\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.465\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe Table\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e shows the study participants' mean knowledge and practice scores at baseline and 3 months after the health education intervention. The mean knowledge score improved significantly in the intervention group from 6.8 at baseline to 10.2 post intervention (p\u0026thinsp;=\u0026thinsp;0.000), whereas in the control group, the mean knowledge score, which improved by 0.16, was statistically insignificant (p\u0026thinsp;=\u0026thinsp;0.704). On the other hand, the mean practice score improved by 1.56 in the intervention group (p\u0026thinsp;=\u0026thinsp;0.000) and 0.07 in the control group (p\u0026thinsp;=\u0026thinsp;0.786).\u003c/p\u003e\u003cp\u003eThere was a difference between the mean scores at baseline and 3 months post intervention in the knowledge and management of typhoid fever between the experimental and control groups. This difference in the mean scores was statistically significant only in the intervention group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). In contrast, in the control group, there were slight improvements in knowledge and practice scores, but these improvements were not statistically significant.\u003c/p\u003e\u003cp\u003e\u003cb\u003eTable:10: Relationship between participants characteristics and knowledge post intervention\u003c/b\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab10\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 10\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eshows that the education level of the participants had no significant association with knowledge of typhoid fever post-intervention (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Also, the duration of business had no significant relationship with knowledge of typhoid fever ( p\u0026thinsp;\u0026gt;\u0026thinsp;0.05\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eN\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eKnowledge Categories post intervention\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePoor Knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eGood knowledge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1(100%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0(0.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.165\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0(0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6(100%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e29(34.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e54(65.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePost-Secondary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6(35.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11(64.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDuration in Business\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7(29.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17(70.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.668\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1-5years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19(38.0%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31(62.0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;5years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10(30.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23(69.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study evaluated the impact of health education interventions on knowledge and management of typhoid fever among patent medicine vendors, assessed baseline knowledge and management practices, instituted health education interventions, and appraised the impact of health education.\u003c/p\u003e\u003cp\u003ePrior to this interventional training, 91.9% and 86.3% of the experimental and control groups, respectively, had not had any training on typhoid fever as shown in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003c/p\u003e\u003cp\u003eThe results show that most experimental and control group study participants are less than 40 years old and have been in business for 1\u0026ndash;5 years. These findings are similar to those of a previous study carried out in Enugu among PMVs, where similar age groups and durations of business were reported\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. However, age and educational level were not significantly associated with knowledge and management, as reported in this study in table 1and 2\u003c/p\u003e\u003cp\u003eApproximately 76% of the experimental participants and 70.6% of the control participants had attended at least secondary education. These findings are in accordance with the Pharmaceutical Council of Nigeria (PCN) convention that the minimum educational attainment of PMVs in Nigeria should be primary education, and other similar studies attributed poor knowledge to the level of education and the need for continual training\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe prevalence of typhoid fever was relatively high, at 99.1% and 100%, respectively, among the two groups reported in this study. Most experimental and control groups received information about typhoid fever from healthcare professionals and did not have any previous training as reported in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e These findings follow those of two previous studies performed in Enugu, where PMVs were reported to have obtained significant health information about tuberculosis through healthcare professionals \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThis is possible because the practice among the PMVs is that new members who want to learn the trade must learn the apprenticeship from their senior colleagues to gain the appropriate experience and to be inducted into the business within specific regions. These findings are similar to those of other studies carried out in Enugu and Lagos, where the participants\u0026rsquo; primary sources of information on typhoid and TB were healthcare workers \u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. Typhoid fever knowledge includes the ability to recognize and understand the etiology, causes, signs, and symptoms; identify transmission routes; and prevent and manage the disease \u003csup\u003e\u003cb\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/b\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003ePreintervention, the experimental group reported poor knowledge of typhoid fever, with a mean score of 6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49, and poor management practices, with a mean score of 4.12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58 as shown in Tables \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. This high level of poor knowledge can explain why most respondents need training to improve their knowledge.\u003c/p\u003e\u003cp\u003eThis poor knowledge corroborates the findings of a study assessing the impact of knowledge and management practices of tuberculosis among patent medicine vendors in Enugu, Nigeria, which reported that most respondents had poor knowledge at baseline \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThis similarity may be explained by the fact that appropriate authorities or regulatory bodies are not paying critical attention to these unskilled healthcare professionals to train them for better practices; this study has closed the gap by providing educational intervention training.\u003c/p\u003e\u003cp\u003eSimilarly, these findings corroborate the BMC publication in Lagos, Nigeria, that PMVs are more accessible to rural communities. Because of this, they are more likely to misdiagnose their patients and administer unprofessional treatment \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003ePoor knowledge leads to inappropriate administration of antibiotics, contributing to the high prevalence and incidence of antimicrobial and antibiotic resistance in Nigeria. This justified the study published by the Nigerian Journal of Infectious Diseases and other studies on the molecular characterization of multidrug-resistant \u003cem\u003eSalmonella enterica\u003c/em\u003e serovar Typhi \u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eA previous study carried out in Gombe metropolis on the epidemiology of typhoid fever in Nigeria reported the same results \u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e. This poor knowledge and management practices of typhoid fever, as seen in the results at baseline, agree with the relevant studies cited here and the need to close the gap with an effective health education intervention.\u003c/p\u003e\u003cp\u003eIn general, the statistical test revealed that both groups were similar at baseline except for a few questions, such as correct knowledge of what typhoid fever is and whether typhoid fever is preventable, where the control group answered those questions more correctly.\u003c/p\u003e\u003cp\u003eThe results of the 3-month postintervention assessment revealed that the educational intervention positively increased the respondents' knowledge and management practices regarding typhoid fever as shown in Tables \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e and \u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e. This implies that the education intervention increased the knowledge of the experimental group from a baseline of 4.5% (6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49) to 52.3% (10.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.05, P\u0026thinsp;=\u0026thinsp;0.000), as reported in tables 7and 8. A significant difference were also observed in the overall mean score between the experimental group at baseline and control groups; the experimental group had a higher overall mean score than the control group as reported in Table \u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e. This further revealed that the experimental group participants were able to retain their knowledge after 3 months.\u003c/p\u003e\u003cp\u003eAfter intervention, a significant increase was noted in the mean knowledge score and the proportion of participants with overall good knowledge of typhoid fever (52.3%) but not in the control group. This finding is consistent with previous studies carried out in Ebonyi, Enugu and Kano, which reported a significant increase in knowledge after educational intervention on typhoid fever, malaria, and other health-related conditions among PMVs and other healthcare workers in Ebonyi \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe results also revealed a significant increase in the mean score and proportion of the participants on management or treatment practices after 3 months compared with the baseline score of 4.12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.68 (46.8%), which is considered poor, to 5.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58 (94.4%) good management practices.\u003c/p\u003e\u003cp\u003eThis finding shows that at 3 months post intervention, the PMVs were able to ask their patients for corrections and refer them to the laboratory to confirm signs and symptoms before administering drugs following laboratory recommendations. The improvement in management practices among the experimental group at baseline compared with that at post intervention was statistically significant at p\u0026thinsp;=\u0026thinsp;0.000.\u003c/p\u003e\u003cp\u003eWhile there was no difference among the experimental and control groups at baseline, a slight increase in the mean score and proportion was observed among the control group after 3 months. However, this increase was not significant at p\u0026thinsp;=\u0026thinsp;0.786 and 4.24\u0026thinsp;\u0026plusmn;\u0026thinsp;1.37/4.31\u0026thinsp;\u0026plusmn;\u0026thinsp;1.41.\u003c/p\u003e\u003cp\u003eAccording to the findings of this study, compared with those of the control group, the knowledge and management practices of PMVs related to typhoid fever increased or improved following their adherence to the educational training content.\u003c/p\u003e\u003cp\u003eThe present study shows that a well-organized model-based educational intervention can improve knowledge, management practices, prevention, and control of typhoid fever and other related diseases in Ebonyi State. Thus, this study validates the beneficial effects of health education interventions among patent medicine vendors. These findings are compatible with previous studies carried out by Oyo/Bayelsa, Enugu and Ebonyi, who reported improvements in knowledge and treatment practices among PMVs and other healthcare workers in Nigeria \u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eHowever, this study also validates the findings of previous studies performed in Lagos state, Nigeria, which reported that PMV's unprofessional practices and knowledge were associated with the high prevalence, incidence, and mortality of typhoid fever in Nigeria \u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e,\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e.. Thus, the convincing effects of this intervention may not be expected in this short period of 3 months but will fully reduce the prevalence, incidence, and mortality of typhoid fever in Ebonyi.\u003c/p\u003e\u003cp\u003eAdditionally, this study revealed unskilled or inadequate use of antibiotics among both groups at baseline, which is a significant risk factor for multidrug resistance or antimicrobial resistance. This finding is similar to those of previous studies carried out in Lagos, Nigeria, that reported the characteristics and risk of multidrug resistance \u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e,\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. Three months postintervention, this attitude improved because of the educational intervention in the experimental group. However, this was not further compared because it is not part of this study's objectives. However, this suggests that further implementing all inclusive, cost-effective health educational interventions will effectively improve the skills and knowledge of the PMVs in their line of business.\u003c/p\u003e\u003cp\u003eIn summary, the results of this study, the previous studies cited and the references show that the health education intervention improved the knowledge of the patent medicine vendors in Ebonyi State central LGA 3 months post intervention. Therefore, the null hypothesis that there is no statistically significant difference between health education intervention and knowledge improvement was rejected because knowledge of PMVs improved after 3 months post intervention; therefore, an alternate hypothesis was accepted in this study.\u003c/p\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eStrengths and limitation\u003c/h2\u003e\u003cp\u003eThe strengths of this study were the use of an interventional experimental design, sampling technique, and an adapted questionnaire to evaluate the effectiveness of a health education intervention delivered in a group setting. The sample size was calculated using the standard formula increasingly adopted by health experts to evaluate population health intervention. The findings of these studies are also consistent with those of previous studies\u003c/p\u003e\u003cp\u003eAdditionally, the intervention was theoretically and practically based and visually delivered.\u003c/p\u003e\u003cp\u003eHowever, the study has several limitations but one major limitation is the cost of funding because this study was self-funded\u003c/p\u003e\u003c/div\u003e"},{"header":"CONCLUSION AND RECOMMENDATIONS","content":"\n\u003ch3\u003eConclusions\u003c/h3\u003e\n\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eThe health education intervention conducted among patent medicine vendors in Ebonyi state improved their knowledge and management practices of typhoid fever.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eThe positive outcomes observed within three months post intervention indicate the potential for sustainable and behavioral change among this group.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eTherefore, further studies are needed to continue training patent medicine vendors and address other gaps in their knowledge and practices related to other diseases, such as malaria, tuberculosis, hepatitis, and HIV/AIDS.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eCollaboration with regulatory bodies, government agencies, and other key partners is essential to ensure the continued success of health education interventions among patent medicine vendors.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\u003ch2\u003eRecommendation:\u003c/h2\u003e\u003cp\u003eOn the basis of the findings reported in this study, I recommend the following:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eFurther training sessions are needed to sustain the gains of this study and to continuously improve the knowledge and skills of patent medicine vendors in Ebonyi State.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eIn addition, I recommend training PMVs on the appropriate use of antibiotics and the risk of multidrug resistance. This is vital in addressing other related disease conditions they might be managing.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eThe need for the PCN to step up monitoring to regularly supervise the activities of the PMVs and abnormalities observed can be corrected immediately.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eAdvocate for the inclusion of standardized health education programs for patent medicine vendors in ongoing public health initiatives in Nigeria.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSimon C.Udeh,\u0026nbsp;\u003c/strong\u003eProposal design, Curation, discussion\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Babatunde I. Omotowo, design of the study, data curation, mentoring\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Chukwuemerie D. Okoye, Community entry assisted, training of participants and data collection. Blessing N. Eneh,data cleaning and entry and analysis\u003c/p\u003e\n\u003cp\u003eSusan C.Udeh\u003csup\u003e,\u0026nbsp;\u003c/sup\u003eData analysis and curation\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSimon C. Udeh\u003csup\u003e1\u003c/sup\u003e, Babatunde I. Omotowo\u003csup\u003e1\u003c/sup\u003e, Chukwuemerie D. Okoye\u003csup\u003e2\u003c/sup\u003e, Blessing N. Eneh\u003csup\u003e2\u003c/sup\u003e,\u003c/p\u003e\n\u003cp\u003eSusan C.Udeh\u003csup\u003e2\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Epidemiology and Medical Statistics, Institute of Public Health, University of Nigeria, Enugu State, Nigeria\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Epidemiology and Medical Statistics, Institute of Public Health, University of Nigeria, Enugu State, Nigeria\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eEbonyi State College of Nursing Sciences, Uburu , Ebonyi State, Nigeria\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eEnugu State College of Nursing, Awgu, Enugu State, Nigeria\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eDepartment of Epidemiology and Medical Statistics, Institute of Public Health, University of Nigeria, Enugu, Nigeria\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eQuestionnaire\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe questionnaire used was adapted and modified to suit the specific objective of this study. Adjustments were made to tailor the questionnaire to the context and preferences of the research participants\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval from the Research Ethics Committee of the University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria with reference number\u0026nbsp;UNTH/NHREC/2023/09/792.\u003c/p\u003e\n\u003cp\u003eAdditional permission were obtained from the associations of patent medicine vendors in Ebonyi State. The study adhered to the principles of the Declaration of Helsinki.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eParticipants were informed of their right to withdraw at any time without consequences. All data were anonymised, stored securely, and accessible only to the research team.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eConsent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all individual participants included in the study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and /or analysed during the current study are available from the corresponding author on reasonable request\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declared that they have no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe extend our gratitude to all the study participants for their valuable contributions to this study\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSimon C.Udeh,\u0026nbsp;\u003c/strong\u003eConceptualized\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003edesigned the study, developed the questionnaire, instituted the health education, participated in data collection and interpretation and drafted the initial manuscript. \u003cstrong\u003eBabatunde I. Omotowo\u003c/strong\u003e, Contributed in designing of the study, reviewed the literature, reviewed the collected data and mentoring. \u003cstrong\u003eChukwuemerie D.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Okoye,\u003c/strong\u003e Contributed in community entry, Instituted the health education training and data collection. \u003cstrong\u003eBlessing N. Eneh,\u003c/strong\u003e Contributed in data cleaning, entry analysis and data analysis. \u003cstrong\u003eSusan C.Udeh\u003csup\u003e,\u003c/sup\u003e-\u003c/strong\u003e Conducted Data analysis, critically reviewed the manuscript for intellectual content and all authors approved the final version for submission.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. Typhoid fever Nigeria. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/csr/don/21-November-2018-typhoid-nigeria/en/\u003c/span\u003e\u003cspan address=\"https://www.who.int/csr/don/21-November-2018-typhoid-nigeria/en/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. [Accessed May 8, 2023.].\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization (WHO).Typhoid Fever. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps//.www.who.int/new-room/factsheet details/typhoid\u003c/span\u003e\u003cspan address=\"https://.www.who.int/new-room/factsheet details/typhoid\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. [Accessed May, 29 2023].\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eA.Adewale O, Ojo A, Samule. A Systematic Review and meta-analysis of the prevalence of typhoid fever in Africa, 2000\u0026ndash;2020.Front public Health. 2021; 9: 56703610.3389 fpubh.2021.567036\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIbrahim MM, Tafida AU, Abubakar U. Epidemiology of typhoid fever in Nigeria: A systematic review and meta-analysis of the incidence, prevalence and risk factors. J Infect Public Health. 2018;11(6):749\u0026ndash;58. 10.101016/jiph.2018.05.005.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOgbodo OP, Onwe OE. Typhoid Fever. A Review of the clinical epidemiological, and public health aspects in Nigeria. 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Prevalence of typhoid fever and antimicrobial susceptibility patterns of Salmonella typhi from patients attending a tertiary hospital in Lagos, Nigeria. Infect Drug Resist. 2015;8:231. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2147/IDR.S89102\u003c/span\u003e\u003cspan address=\"10.2147/IDR.S89102\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCrump JA. Progress in typhoid fever epidemiology. Clin Infect Dis. 2019;68(Suppl 1):S4\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Typhoid fever, PMVs, Health education Intervention, Ebonyi, Nigeria","lastPublishedDoi":"10.21203/rs.3.rs-7819784/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7819784/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBACKGROUND\u003c/h2\u003e\u003cp\u003eTyphoid fever is a disease of public health concern in Nigeria. The incidence rate of typhoid fever in Ebonyi was 309 cases per 100,000 populations in 2018. The patent medicine vendor (PMVs) is a person who sells medicines in Nigeria without formal pharmaceutical education and dispensing training. However, they are licenced to sell only over-the-counter drugs. This study was carried out to evaluate the impact of health education interventions on knowledge and management practices related to typhoid fever on PMVs.\u003c/p\u003e\u003ch2\u003eMETHODS\u003c/h2\u003e\u003cp\u003eA quasi-experimental study designed with experimental and control groups was carried out to evaluate the impact of a health education intervention on typhoid fever among PMVs. A multistage sampling technique was used to select the participants. A self-administered questionnaire written in English was used to obtain information from the respondents. The data were analysed via the Statistical Package for Social Sciences version 26, and descriptive statistics were used to calculate frequencies, means, standard deviations, and proportions.\u003c/p\u003e\u003ch2\u003eRESULTS\u003c/h2\u003e\u003cp\u003eA total of 162 samples were analysed. The results revealed that 95.5% (6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.49) of the participants in the experimental group had poor knowledge of typhoid fever at baseline, and 46.8% (4.12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58) had poor knowledge of management practices. The results also revealed that the control group recorded poor knowledge and management practices at baseline. The 3-month post intervention evaluation results revealed that knowledge of the experimental group improved to 56%, with mean/SD score of 10.2\u0026thinsp;\u0026plusmn;\u0026thinsp;2.05, whereas good management practices improved to 94.4%, with mean/SD score 5.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.58. The results also revealed poor knowledge of antibiotic and antimicrobial resistance and generally poor knowledge of the correct use of antibiotics to treat typhoid fever and the duration of treatment among the study experimental group.\u003c/p\u003e\u003ch2\u003eCONCLUSION\u003c/h2\u003e\u003cp\u003eThe overall increase in knowledge after 3 months of intervention was 4.12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.58, indicating that health education remains the key to improving knowledge. However, further studies must focus on the correct use of antibiotics for treatment to reduce burden of antibiotic resistance in the study area.\u003c/p\u003e","manuscriptTitle":"Evaluation of Impact of Health Education Intervention on Knowledge and Management of Typhoid Fever among Patent Medicine Vendors in Ebonyi, Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-14 01:42:05","doi":"10.21203/rs.3.rs-7819784/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-12T15:56:40+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-11T16:31:38+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-07T23:17:22+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-07T19:32:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"166488604689718757474673437827837551230","date":"2025-12-05T16:11:38+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"6028665645130883407677228403695703691","date":"2025-12-02T12:54:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"206104086176866845039076033495611218716","date":"2025-11-30T17:15:21+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-03T10:02:54+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-10-28T11:37:10+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-10-14T22:54:26+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Public Health","date":"2025-10-14T22:50:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Public Health](https://link.springer.com/journal/12982)","snPcode":"12982","submissionUrl":"https://submission.springernature.com/new-submission/12982/3","title":"Discover Public Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"245938f4-9f61-4685-8db1-125fb7b3dd2f","owner":[],"postedDate":"November 14th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-03T13:23:53+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-14 01:42:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7819784","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7819784","identity":"rs-7819784","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}