Prevalence of Typhoid Fever among Patients in Ga West Municipality, Ghana: A Blood Culture-Based Cross-Sectional Study

Typhoid fever remains a significant public health burden in sub-Saharan Africa, yet many Ghanaian municipalities lack laboratory-confirmed epidemiological data. This study determined the prevalence of blood culture-confirmed typhoid fever and identified associated demographic and clinical factors among febrile patients in Ga West Municipality, Ghana. We conducted a cross-sectional study from October 2025 to March 2026 among 284 febrile patients attending seven health facilities. We processed blood cultures using standard microbiological procedures to isolate Salmonella Typhi. Data on sociodemographic and clinical characteristics were collected using a structured questionnaire. We used descriptive statistics, chi-square tests, and binary logistic regression for analysis, with statistical significance set at p < 0.05. The prevalence of blood culture-confirmed typhoid fever was 2.8% (95% CI: 1.2%-5.4%), with 8 positive isolates among 284 participants. Fever (85.6%), headache (56.7%), loss of appetite (49.6%), and abdominal pain (48.6%) were the most common presenting symptoms. Prevalence varied widely by age group (0.0%–10.0%), being highest among participants aged ≥60 years (10.0%) and lowest among those aged 18–29 years (0.0%). Five positive cases were male, and three were female; sex was not significantly associated with blood culture positivity. Clinical characteristics were significantly associated with blood culture positivity (χ² = 13.527, df = 6, p = 0.036) and independently predicted laboratory-confirmed typhoid fever (model χ² = 15.214, df = 3, p = 0.018), whereas sociodemographic factors were not significantly associated. The low prevalence of culture-confirmed typhoid fever (2.8%) among febrile patients underscores the importance of laboratory confirmation to avoid overdiagnosis and inappropriate antibiotic use. Strengthening blood culture capacity and implementing evidence-based clinical algorithms are essential for improving typhoid diagnosis, antimicrobial stewardship, and public health interventions in Ga West Municipality and similar settings in Ghana.