{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T06:25:56Z","timestamp":1778221556357,"version":"3.51.4"},"reference-count":28,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,1,9]]},"abstract":"<jats:p><jats:italic>Salmonella enterica<\/jats:italic> serotype Typhi (<jats:italic>S.<\/jats:italic> Typhi) was estimated to cause over 200,000 deaths and more than 21 million illnesses worldwide, including over 400,000 illnesses in Africa. The current study was conducted in four villages on Pemba Island, Zanzibar, in 2010. We present data on policy makers', health administrators', and village residents' and leaders' perceptions of typhoid fever, and hypothetical and actual health care use among village residents for typhoid fever. Qualitative data provided descriptions of home-based treatment practices and use of western pharmaceuticals, and actual healthcare use for culture-confirmed typhoid fever. Survey data indicate health facility use was associated with gender, education, residency, and perceptions of severity for symptoms associated with typhoid fever. Data have implications for education of policy makers and health administrators, design and implementation of surveillance studies, and community-based interventions to prevent disease outbreaks, decrease risks of complications, and provide information about disease recognition, diagnosis, and treatment.<\/jats:p>","DOI":"10.4269\/ajtmh.2012.12-0288","type":"journal-article","created":{"date-parts":[[2012,12,4]],"date-time":"2012-12-04T15:51:11Z","timestamp":1354636271000},"page":"144-152","source":"Crossref","is-referenced-by-count":14,"title":["Utilization and Accessibility of Healthcare on Pemba Island, Tanzania: Implications for Health Outcomes and Disease Surveillance for Typhoid Fever"],"prefix":"10.4269","volume":"88","author":[{"given":"Linda M.","family":"Kaljee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred","family":"Pach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamala","family":"Thriemer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedikt","family":"Ley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Said M.","family":"Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Jiddawi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahesh","family":"Puri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenz","family":"von Seidlein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Deen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leon","family":"Ochiai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Wierzba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Clemens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Bull World Health Organ","first-page":"346","article-title":"The global burden of typhoid fever","volume":"82","author":"Crump","year":"2004"},{"key":"R2","series-title":"Vaccine","first-page":"435","article-title":"Immunogenicity, efficacy, and serological correlate of protection of Salmonella Typhi Vi capsular polysaccharide vaccine three years after immunization","volume":"14","author":"Klugman","year":"1996"},{"key":"R3","series-title":"Epidemiol Infect","first-page":"436","article-title":"Part 1: analysis of data gaps pertaining to Salmonella enterica serotype Typhi infection in low and medium human development index countries 1984\u20132005","volume":"136","author":"Crump","year":"2008"},{"key":"R4","series-title":"Lancet Infect Dis","first-page":"417","article-title":"Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis","volume":"10","author":"Reddy","year":"2010"},{"key":"R5","series-title":"Lancet","first-page":"482","article-title":"Incidence of clinically significant bacteraemia in children who present to hospital in Kenya: community-based observational study","volume":"367","author":"Brent","year":"2006"},{"key":"R6","series-title":"N Engl J Med","first-page":"39","article-title":"Bacteremia among children admitted to a rural hospital in Kenya","volume":"352","author":"Berkley","year":"2005"},{"issue":"(Suppl 1)","key":"R7","series-title":"Clin Infect Dis","first-page":"S106","article-title":"Multi-drug resistant Salmonella typhi: a worldwide epidemic","volume":"24","author":"Rowe","year":"1997"},{"key":"R8","series-title":"Med Sci (Paris)","first-page":"969","article-title":"Typhoid fever: facing the challenges of resistant strains","volume":"26","author":"Weill","year":"2010"},{"key":"R9","series-title":"Ann Afr Med","first-page":"240","article-title":"Experience with use of community health extension workers in primary care in a private rural health care institution in South South-Nigeria","volume":"9","author":"Ordinioha","year":"2010"},{"key":"R10","series-title":"Trop Doct","first-page":"91","article-title":"How are surgical theatres in rural Africa utilized? 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