Knowledge, Attitudes, and Practices Regarding Typhoid Fever Among University Students in Bangladesh: A...

Typhoid fever remains a significant public health concern in Bangladesh due to overcrowding, insufficient sanitation, unsafe food and contaminated water exposure, and antimicrobial resistance. The aim of this research is to gather evidence-based information to guide future public health programs and educational initiatives specifically targeting university students.

From August 2024 to July 2025, a cross-sectional survey was conducted among 470 students from three universities in Dhaka city. A structured questionnaire was developed following standard guidelines, and data were collected through convenient sampling. Comparative analyses, Pearson's correlation, multivariable linear regression models, and structural equation modeling (SEM) were used to statistically evaluate the linkage between outcome measures across various sociodemographic and academic variables.

Among 470 valid responses, 127 participants were male (27.02%), and 343 were female (72.98%). Mean ± SD scores were 80.05 ± 16.34 for knowledge, 73.99 ± 24.60 for attitude, and 60.93 ± 16.01 for practice. Knowledge showed weak but significant positive correlations with attitude (r = 0.343, 95% CI: 0.261-0.420; p < 0.001) and practice (r = 0.139, 95% CI: 0.049-0.227; p = 0.002), while attitude was positively correlated with practice (r = 0.143, 95% CI: 0.053-0.231; p = 0.002). In the practice model, knowledge and attitude were not significant predictors after adjustment. Instead, male students demonstrated poorer preventive practices (β = -0.448; 95% CI: -0.667 to -0.230; p < 0.001), while master's-level students reported better practices than 1st-year students (β = 0.748; 95% CI: 0.335 to 1.161; p < 0.001).

Overall participants in the study had relatively good knowledge and favorable attitudes toward typhoid fever. However, some important gaps remained in preventive practices and vaccination. Behavior-focused health education, improved access to the typhoid conjugate vaccine, and strengthened campus-based WASH strategies may help in improving typhoid prevention among university students.