Understanding public knowledge, attitudes, and practices on typhoid fever and its prevention in the Hohoe Municipality, Ghana: a cross-sectional study

Typhoid fever remains a significant public health challenge in low- and middle-income countries, including Ghana, where it spreads mainly through contaminated food and water amid poor sanitation and inadequate safe water supply. Despite available antibiotics and vaccines, it causes considerable morbidity and mortality, especially among vulnerable groups. The study was designed to determine the level of knowledge, attitudes, and preventive practices towards typhoid. A community-based descriptive cross-sectional study was conducted among 478 adult residents of Hohoe Municipality, Ghana. Data were collected using a structured questionnaire assessing knowledge, attitudes, and preventive practices related to typhoid fever. Analysis involved descriptive statistics (frequencies and percentages), Chi-square tests, and binary logistic regression. Statistical significance was set at p < 0.05. Most participants demonstrated good knowledge of typhoid fever (52.9%), positive attitudes toward its prevention and control (64.4%), and good preventive practices (51.7%), with “good/positive” defined as composite domain scores ≤ the 50th percentile (median). Adjusted multivariate logistic regression showed that participants with good knowledge were four times more likely to exhibit good preventive practices than those with poor knowledge [aOR = 4.0 (95% CI: 2.54–6.44); p < 0.001]. Compared with borehole users, those relying on pipe-borne water [aOR = 0.4 (95% CI: 0.18–0.86); p = 0.019] or sachet water [aOR = 0.2 (95% CI: 0.10–0.52); p < 0.001] had significantly lower odds of good preventive practices. Participants with no monthly income showed markedly higher odds of good preventive practices [aOR = 16.2 (95% CI: 1.87–139.86); p = 0.011], although this estimate should be interpreted cautiously due to the wide confidence interval. Typhoid fever remains preventable in Hohoe Municipality, yet a persistent knowledge–practice gap continues to drive transmission. Findings highlight the need for accelerated typhoid conjugate vaccine introduction, improved WASH infrastructure, and targeted hygiene promotion. Collaboration among the Ghana Health Service, Hohoe Municipal Assembly, CHPS, Ministry of Health, Gavi, WHO, UNICEF, and the Coalition against Typhoid would strengthen these efforts and support Ghana’s progress toward Sustainable Development Goals 3 (good health and well-being) and 6 (clean water and sanitation).