The Lower Manya Krobo Municipal Health Directorate in the Eastern Region has recorded a total of 5,876 cases of typhoid fever from January to November 2025.

This has sparked renewed concerns over sanitation practices, food vendor screening, and weak collaboration among key institutions responsible for public health.

Health data compiled by the Directorate from facilities in the municipality showed a steady rise in reported cases over the 11 months.

The facilities were Atua Government Hospital, Akuse Government Hospital, St. Martin de Porres Catholic Hospital, among other public and private health centres.

The figures for 2025 indicated that 432 cases were recorded in January, 402 in February, 469 in March, 505 in April, 538 in May, and 641 in June.

In July, the Directorate recorded 423 cases, 696 in August, 655 in September, 642 in October, and 473 in November.

The spike, particularly between June and October, had raised alarm among health authorities, attributing the trend to poor sanitation and lack of safe water.

Speaking to the Ghana News Agency (GNA) in an interview, Dr. James Atampiiga Avoka, the Municipal Director of Health, Lower Manya Krobo, attributed the growing number of cases partly to the lack of coordination between the Environmental Health Department and the Ghana Health Service (GHS).

He explained that, "although food vendor screening was a critical preventive measure for typhoid fever, the process was not conducted by the Health Directorate but by the Environmental Health Department."

He said, “We do not know who conducts the screening, when it is done, or how it is carried out but when cases get out of hand, we are then asked to intervene, which shouldn’t be the case."

He said effective disease prevention required the Health Directorate’s involvement from the beginning of the food vendor screening process to the end, to enable them monitor procedures, track infected individuals, and identify the
sources of infection.

“For my work, policies related to health must be effectively implemented, and we must go round to monitor how these policies are enforced for the benefit of the people. If screening is done without our involvement, how do we monitor or control what happens on the field?” he quizzed.

Dr. Avoka blamed weak enforcement of sanitation bylaws and alleged that some food vendors who tested positive for typhoid were advised to seek treatment but were not prevented from operating their business.

“You could see someone selling and preparing food near a gutter, and during screening, the person tests positive for typhoid. Instead of enforcing the law on the person, the person is told to visit the Hospital."

He said enforcing sanitation bylaws and ensuring compliance rested with the Environmental Health Department, adding that the absence of strict enforcement allowed unsafe practices to persist.

He noted that the Health Directorate did not know who certified the screening results, claiming that private individuals were sometimes engaged to conduct the screening without proper oversight.

Dr. Avoka said he had raised the issue of rising typhoid cases on several occasions at Municipal Assembly meetings, yet the situation continued to worsen.

The Municipal Health Director called on stakeholders, including the Environmental Health Department, Ghana Health Service, Ghana Water Company Limited, and the Assembly, to collaborate to address the sanitation challenges contributing to the outbreak.

He said reducing the risk of typhoid fever required access to clean and safe water, proper food handling, good personal hygiene, and strict sanitation enforcement.

Investigations by the GNA revealed that some pipelines of the Ghana Water Company Limited in parts of the municipality run through open gutters.
Due to the plastic nature of the pipes, burst sections could easily lead to water contamination, increasing the risk of waterborne diseases such as typhoid fever.