Prevalence, Antimicrobial Resistance, and Risk Factors of Typhoid Fever Among Febrile Patients at Felege Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia

Background: Typhoid fever, caused by Salmonella typhi , is a major food- and water-borne disease in low- and middle-income countries. Poor sanitation, unsafe food consumption, and contaminated water sources increase transmission risk. The growing emergence of multi drug resistant strains further complicates treatment and control efforts, posing a significant public health challenge. Aim: To determine the prevalence, antimicrobial resistance patterns, and risk factors of typhoid fever among febrile patients in Northwest Ethiopia. Methodology: A cross-sectional study was conducted from January to August 2025 at Felege Hiwot Comprehensive Specialized Hospital among 403 systematically selected patients. Data were collected using questionnaires, stool culture, and antimicrobial susceptibility testing with the Kirby-Bauer method. Logistic regression identified significant risk factors. Results: The prevalence of typhoid fever was 4.5% (18/403). Significant predictors included eating raw vegetables and fruits [AOR=9.88, 95% CI: 1.285–75.990], eating street food [AOR=8.57, 95% CI: 1.279–57.398], and drinking raw milk [AOR=7.58, 95% CI: 1.102– 52.207]. Antimicrobial susceptibility testing showed high resistance to Ampicillin and Cotrimoxazole, while Ciprofloxacin remained highly effective. The emergence of multidrug resistance highlights the threat of limited treatment options and the need for close monitoring of drug efficacy. Conclusion: Although the overall prevalence was relatively low, typhoid fever continues to pose a public health burden in the study area. Risky food consumption habits were strong predictors of infection, while antimicrobial resistance patterns indicate narrowing therapeutic options. Strengthening preventive measures, safe food practices, and continuous surveillance of drug resistance are crucial to reduce disease transmission and improve clinical management. Promote food safety, public awareness, sanitation, safe milk consumption, antimicrobial stewardship, and laboratory surveillance to effectively reduce typhoid fever burden.