, Volume 13, Issue 4, pp 633–651 | Cite as

Health at the Sub-catchment Scale: Typhoid and Its Environmental Determinants in Central Division, Fiji

  • Aaron Peter Jenkins
  • Stacy Jupiter
  • Ute Mueller
  • Adam Jenney
  • Gandercillar Vosaki
  • Varanisese Rosa
  • Alanieta Naucukidi
  • Kim Mulholland
  • Richard Strugnell
  • Mike Kama
  • Pierre Horwitz
Original Contribution


The impact of environmental change on transmission patterns of waterborne enteric diseases is a major public health concern. This study concerns the burden and spatial nature of enteric fever, attributable to Salmonella Typhi infection in the Central Division, Republic of Fiji at a sub-catchment scale over 30-months (2013–2015). Quantitative spatial analysis suggested relationships between environmental conditions of sub-catchments and incidence and recurrence of typhoid fever. Average incidence per inhabited sub-catchment for the Central Division was high at 205.9/100,000, with cases recurring in each calendar year in 26% of sub-catchments. Although the numbers of cases were highest within dense, urban coastal sub-catchments, the incidence was highest in low-density mountainous rural areas. Significant environmental determinants at this scale suggest increased risk of exposure where sediment yields increase following runoff. The study suggests that populations living on large systems that broaden into meandering mid-reaches and floodplains with alluvial deposition are at a greater risk compared to small populations living near small, erosional, high-energy headwaters and small streams unconnected to large hydrological networks. This study suggests that anthropogenic alteration of land cover and hydrology (particularly via fragmentation of riparian forest and connectivity between road and river networks) facilitates increased transmission of typhoid fever and that environmental transmission of typhoid fever is important in Fiji.


typhoid incidence recurrence environmental determinants catchment 

Supplementary material

10393_2016_1152_MOESM1_ESM.docx (115 kb)
Supplementary material 1 (DOCX 115 kb)


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Copyright information

© International Association for Ecology and Health 2016

Authors and Affiliations

  • Aaron Peter Jenkins
    • 1
  • Stacy Jupiter
    • 2
  • Ute Mueller
    • 1
  • Adam Jenney
    • 3
    • 4
  • Gandercillar Vosaki
    • 2
  • Varanisese Rosa
    • 4
  • Alanieta Naucukidi
    • 4
  • Kim Mulholland
    • 4
    • 6
  • Richard Strugnell
    • 7
  • Mike Kama
    • 5
  • Pierre Horwitz
    • 1
  1. 1.Edith Cowan UniversityJoondalupAustralia
  2. 2.Wildlife Conservation SocietySuvaFiji
  3. 3.Fiji National UniversitySuvaFiji
  4. 4.Murdoch Childrens Research InstituteParkvilleAustralia
  5. 5.Fiji Ministry of Health and Medical ServicesSuvaFiji
  6. 6.London School of Hygiene and Tropical MedicineLondonEngland
  7. 7.University of MelbourneMelbourneAustralia

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