Factors Associated with Typhoid Fever Amon Attending Kangema Sub County Hospital, County, Kenya

Ng Adults Murang’A

Serial No:

Date:

Please tick where applicable

PART 1: DEMOGRAPHIC CHARACTERISTICS

1

What is your sex?

Male

Female

2

What is your age (In years)

3

What is your religion?

4

What is your ethnicity?

5

What is your marital status?

Married

Single

Divorced

Widowed

6

Which is your highest level of education attained?

University

O-level

College

Primary

None

7

What is your occupation?

employed

Unemployed

self-employed

8

What is the reason for you seeking medical care in this facility?

Sick

go to question 9

Vaccination

Medical certificate

Go to part 2

Other reasons (Indicate)

9

How long have you been unwell?

0 - 2 days

9 - 11 days

3 - 5 days

12 - 14 days

6 - 8 days

>14 days

10

Were there any medical care sought?

Yes

No

If no go to part 2

11

Where did you seek health care?

Public

Friends

Private

Others

Pharmacy

Traditional healers