KIU Publications

Typhoid fever remains a major public health challenge in Uganda, driven largely by fecal contamination of drinking water and beverages in settings with constrained water, sanitation, and hygiene (WASH) services. Climate change is amplifying key environmental and social conditions that favor waterborne transmission: heavier rainfall events and flooding, longer and hotter dry spells that intensify water scarcity, and increased reliance on unsafe water sources and informal food/water vending. Uganda’s experience with large water-linked outbreaks—such as the major Kampala outbreak in early 2015—illustrates how breakdowns in safe water access and urban WASH infrastructure can rapidly produce widespread exposure. This narrative review synthesizes evidence on (i) climatesensitive mechanisms linking extreme weather and drought to typhoid transmission, (ii) the Uganda-specific outbreak and climate context, (iii) the role of rapid urbanization and informal settlements in mediating risk, and (iv) priority interventions and research needs, including climate-informed surveillance, resilient water systems, outbreak-ready WASH, and targeted typhoid vaccination strategies.