Typhoid Co-infection Research Articles

ANALYZING THE PREVALENCE AND INCIDENCE OF TYPHOID FEVER, MALARIA AND THEIR COINFECTIONS IN FEBRILE SUBJECTS OF URBAN INDIA: A CROSS-SECTIONAL STUDY

Background: Typhoid fever and malaria remain major public health threats in developing countries and tropical regions. In endemic regions, people are at a very high risk of developing both the disease at the same time with significant overlapping of associated symptoms and signs
 Aims: The present cross-sectional clinical trial was undertaken to assess the prevalence, typhoid fever, malaria, and their coinfections in urban Indian subjects with fever. 
 Materials and Methods: In 180 subjects, demographic data and clinical features of all the study subjects were recorded. For assessing typhoid fever, a slide agglutination test was done using H (flagellar) and O (somatic) antigen kits for S.typhi. The collected data were subjected to statistical evaluation for results formulation.
 Results: Total positive malaria cases were 37.22% (n=67). Among 67 positive cases, 43.28% (n=29) were seen to have P.vivax, 40.29% (n=27) had P. Falciparum and mixed infection were seen in 16.41% (n=11) subjects. Typhoid and malaria coinfection was seen in 6.66% (n=12) of study subjects. On correlating typhoid fever, malaria, and coinfections with demographic characteristics and clinical characteristics in the study subjects, it was seen that the age groups of 2 years to 10 years were associated with malaria, and the association was statistically significant with p=0.03.
 Conclusion: Within its limitations, the present study concludes that the coinfections are common owing to the high prevalence and overlapping symptoms of malaria and typhoid fever. Poor hand washing habits are associated with typhoid fever significantly. 
 Keywords: Coinfections, Malaria, P. Falciparum, S. typhi, Typhoid fever

Prevalence of Malaria and Typhoid Coinfection in Relation to Haematological Profile of University Students in Akure, Nigeria

Prevalence of Malaria and Typhoid Coinfection in Relation to Haematological Profile of University Students in Akure, Nigeria

Influenza, malaria parasitemia, and typhoid fever coinfection in children: Seroepidemiological investigation in four Health-care Centers in Lagos, Nigeria

Objectives: There are similarities in the presentation of influenza-A infection, malaria, and typhoid fever which include their overlapping clinical symptoms such as fever and myalgia. Coinfection may be easily missed and may lead to more severe associated morbidity. This study, therefore, investigated the prevalence of coinfection of influenza A, malaria, and typhoid fever in children in four locations in Lagos and determined their age, gender, and location-related prevalence. Materials and Methods: A cross-sectional hospital-based study was conducted between March and October 2018. Children less than 15 years attending four health centers in Festac, Amuwo, Ojo, and Shibiri were recruited consecutively. Demographic and epidemiological data were obtained using structured questionnaires, to ascertain children with influenza-like symptoms. Their blood samples were then tested with rapid diagnostic method for malaria and typhoid fever. The children were further screened for influenza-A-specific IgM using ELISA method. Descriptive statistics were reported while p-values were determined for comparable parameters using Chi-square. Results: There were 364 children aged <1–14 years including 207 (56.9%) males. Of the 364 children tested, 76/364 (20.9%) were seropositive for influenza-A virus out of which 47/76 (61.8%) had malaria parasitemia, 42/76 (55.3%) had typhoid fever, and 21/76 (27.6%) were coinfected with both malaria parasites and Salmonella enteric Typhi. Children coinfected with influenza-A and malaria were found with a higher frequency of chest pain and cold/chill symptom respectively compared to children having influenza alone (P = 0.0001). Seropositivity for influenza was recorded in all the months studied with the month of March recording the highest influenza-A seropositivity of 20/76 (26.3%) (P = 0.02). Conclusion: This study detected 27.6% trio coinfection seroprevalence of influenza Type-A, malaria, and typhoid fever among children population. The finding is unique being the first of such report, to the best of our knowledge. Children coinfected with influenza-A and malaria had greater morbidity.

Malaria or typhoid co-infection in a tertiary care hospital of Bareilly, Uttar Pradesh, India

Background: Malaria is a protozoal disease caused by infection with parasite of genus Plasmodium. Typhoid is common with malarial infection.Methods: A cross sectional study was done to find out co-infection of typhoid and malaria. Study was done in central pathological lab of department of pathology, RMCH, Bareilly. Blood samples were collected in EDTA vial and plain vial. Blood smear was examined for malaria parasite within RBCs. Malaria rapid test was done for detection of Plasmodium species and Widal test was done for typhoid.Results: In this study found co-infection of malaria with typhoid was 15.64%. In malarial cases 54.50% were males, while maximum cases (26.92%) were in 21-30 yrs age group. Cases of P. vivax was maximum (86.28%) and maximum cases of P. vivax (29.42 %) was in 11-20 yrs age group while that of P. falciparum (22.22%) was in 11-20, 21-30, 41-50 yrs age group and maximum number (23.60%) of mixed malarial infection was in 31-40 yrs age group, While co-infection of malaria with typhoid was maximum (24.59%) was in 11-20 yrs age group and maximum (53.28%) in females. Maximum (79.51%) cases of typhoid were of P. vivax. Conclusions: Malaria and typhoid co-infection still remain a major public health problem in many developing countries. Concurrent infection with two agents can result in an illness having overlapping symptoms creating a diagnostic dilemma for the treating physician.

Over diagnosis of typhoid and malaria co-infection by health care workers in north central Nigeria: a cross-sectional study

Introduction: Typhoid and malaria are significant causes of morbidity and mortality, especially in sub-Saharan Africa. Typhoid and malaria co-infection may occur as superinfection or even simultaneous infections. However, it appears to be rather rare. It is imperative to make an accurate diagnosis of typhoid and malaria co-infection. The study set out to determine the practice among healthcare workers in the diagnosis and treatment of typhoid and malaria co-infection.Methods: This descriptive cross-sectional study was carried out in Jos North Local Government Area in North-Central Nigeria. The sample population consisted of health care workers (HCWs) who were involved in the management of typhoid and malaria. Data were analysed using STATA version 14.0 College station, Boston, USA.Results: Seventy-five HCWs were interviewed. Typhoid and malaria were diagnosed by 67 (89%) HCWs at least once weekly, and by the other 11% at least once every month. The Widal test was used to make a diagnosis of typhoid in greater than 70% of the cases. There was no statistical difference in the rate of typhoid diagnoses between medical doctors and other HCW.Conclusion: There is a high rate of false diagnosis of malaria and typhoid co-infection. This informs the crucial need for quality training and re-training of health care workers in the diagnosis of these conditions. Keywords: False, typhoid, malaria, co-infection

Malaria and Typhoid Fever Coinfection in the Hospital University of Bobo-Dioulasso, Burkina Faso

Malaria and typhoid fever are two endemic infectious diseases in developing tropical countries including Burkina Faso. There are two distinct infectious diseases with many similar clinical signs. In each sanitary area, it is important to describe the "typhomalaria" epidemiology to elaborate adequate diagnosis algorithm and efficient treatment protocol. A cross-sectional study was carried out from July to October 2014 in the lab department of University Hospital Souro SANOU, Bobo-Dioulasso. All microscopy positive malaria during the study period was included. Serodiagnosis of Widal and Felix was performed systematically in all Plasmodium spmalaria cases. Titers of antibodies anti-agglutinin O equal or higher than 1/400 and/or 1/800 for anti-agglutinin H antibodies were considered positive for Salmonella sp. A total of 283 malaria cases were included in this study, majority falciparum malaria. In this malaria cases, 91 patients were seropositive for Salmonella sp. "Typhomalaria" co-infection prevalence was 34.3% (CI 95% (28.8%; 40.1%)). The patient with the normal hemoglobin rate had the highest prevalence of co-infection (46.7% versus 30.9; p=0.02). Malaria and typhoid fever co-infection was high (approximately 1/3 of malaria cases) in University hospital of Bobo-Dioulasso. This study revealed the need to explore typhoid fever in malaria confirmed cases, especially in persistent fevers and non-anemic situation despite adapting antimalarial treatment.

Dengue Typhoid Co-infection: a New Threat

Acute febrile illness is the most common clinical presentation among patients attending to doctor in developing countries. In Bangladesh, dengue and typhoid fever have emerged as major public health problems. Co-infection with both these diseases is rarely reported and are known to present with overlapping symptoms making the clinical diagnosis difficult. The exact incidence of dengue and typhoid co-infection is not known. Here we report a case of co-infection of dengue fever with typhoid fever.
 Anwer Khan Modern Medical College Journal Vol. 10, No. 1: Jan 2019, P 96-97

Incidence of Co-infection of Malaria and Typhoid and their Diagnostic Dilemmas

Background: This study was carried out to know the incidence of co-existence of typhoid and malaria in western part of Uttar Pradesh. Both these infections are common febrile illnesses prevalent in tropical countries including India. Materials and Methods: A total of 300 blood samples were collected from the patients presenting with fever for more than one week. Diagnosis of typhoid was carried out using Widal test and blood culture and for diagnosis of malaria blood film examination was done. Results: Out of total 300 patients, 31 (10.3%) were positive for malarial parasite and 82 (27.3%) were positive for typhoid by Widal test while 12 (4%) were positive for typhoid by blood culture. Rate of co-infection was found out to be 21 (6.7%) with Widal test and 3 (1%) with blood culture. Conclusion: As there is paucity of data on co-infection of malaria and typhoid from this part of country, this study was carried out to know their prevalence. As both these illnesses present with same clinical features, the clinicians must look for co-existence of these infections. Hence, to facilitate the diagnosis and treatment more such studies must be carried out from different parts of the country.

Malaria and typhoid fever co-infection among febrile patients in Kumbotso Local Government Area Kano, Nigeria

Malaria and typhoid fever are of tremendous public health concern in sub-Saharan Africa (Nigeria inclusive). Because of the high prevalence of malaria and typhoid fever in Nigeria, co-infection is common. This study was aimed at determining the prevalence of Malaria, Typhoid fever and their co-infection among febrile patients in Kumbotso Local Government Area Kano, Nigeria. A Total of 125 subjects of both age and sex suggestive of Malaria and/or typhoid fever were used as participants. Five milliliter (5 ml) of blood samples were collected from each of the participant for widal tests and blood film from a period of April, 2015 to October, 2015. The results revealed a malaria prevalence of 55% (69/125). The sero-prevalence of typhoid fever was 18% (22/125) while 22% (28/125) had malaria and typhoid fever co-infection and 5% (6/125) appeared to be negative for both malaria and typhoid fever. However, the result showed that malaria is more likely to cause fever than typhoid infection. Statistical analysis of the result showed that there is significant different on the incident of malaria and that of typhoid fever among febrile patients at p > 0.05. It is recommended that intervention programs aimed at reducing malaria and typhoid infections should be increased in such areas, especially in the wet seasons.Keywords: Blood film, Co-infection, Malaria, Typhoid fever, Widal test

Diagnosis of malaria and typhoid fevers using basic tools: a comparative analysis of a retrospective data with a prospective evaluation in an endemic setting

Malaria and typhoid fever are among important and endemic diseases in the tropical countries such as Nigeria. Diagnosis of most cases of malaria/typhoid co-infections are based on clinical suspicion alone or unreliable diagnostic tools leading to poor or misdiagnosis. A retrospective analysis was conducted on the positivity rate for malaria parasite and typhoid fever among patients who attended the Bayero University, Kano (BUK) Health Clinic from January to December 2013. A prospective study was also carried out on 200 febrile patients and 80 apparently healthy subjects (controls) with the view to determine the diagnostic profiles of malaria and /or typhoid fever co-infection using standard protocols (microscopy, rapid diagnostic test (RDT) for malaria parasite (MP), Widal test, stool and blood cultures for typhoid fever). Both test and control subjects were evaluated for the presence or otherwise of the malaria and /or typhoid aetiologic agents. Results obtained from the retrospective study for the period January to December 2013 indicated that, of the 2362 tests conducted, 318 (13.5%) were positive for MP using RDT and 722 (30.6%) were positive for typhoid fever using Widal test. Co-infection rate obtained was 89 (3.8%). Of the 200 subjects evaluated for the prospective study however, 42 (21%) and 34 (17%) were positive for MP using microscopic technique and RDT respectively. Microscopy was established to be more sensitive than RDT. Eighty nine (45%) were Widal positive. The culture method for typhoid fever diagnosis was negative. Co-infection rate stood at 17 (8.5%). No association however was found between the two disease conditions (p=0.6032). Significant proportion of the patients 86 (43%) were neither positive for malaria nor for typhoid fevers. Three isolates of non-typhoid salmonella specie and three other bacterial isolates were recovered from the stool and blood samples of the patients respectively. Baseline titre value for Widal test at BUK community was established as 160 and above for O antibodies to S. typhi, hence the criterion employed in the prospective evaluation. Laboratory evidence of malaria and typhoid co-infection rate at a titre of ≥160 was 8.5% using microscopy and 7% using RDT. The use of RDT is simple and easy, but has less sensitivity, thus may leave some patients with malaria un-detected. Based on the results of these findings, vis a vis the proportion of individuals negative for both malaria and typhoid fevers, clinicians should revisit causes of febrile illnesses other than malaria or typhoid and hence the need to include other tests for the detection of other causes.Keywords: Malaria diagnosis, Typhoid fever, RDT, Widal test, Co-infections, Nigeria

Co-dynamics of Pneumonia and Typhoid fever diseases with cost effective optimal control analysis

In this paper, we propose and analyze a mathematical model for Pneumonia–Typhoid co-infection to examine their characteristic relationship due to preventive and treatments strategies. Firstly, we qualitatively analyzed the model, and the basic reproduction number is determined with respect to the existence and stability of equilibria. The possibility of bifurcation is studied and also we investigated the sensitivity index of co-infection model reproduction number together with the local and global stability of the equilibra. Secondly, we extend the co-infection model by incorporating time dependent controls as intervention and we used Pontryagin’s maximum principle for derivation of necessary conditions for the optimal control and optimality system. Finally, the optimality system is numerically simulated by considering four strategies and also their cost effectiveness is analysed. We found that Pneumonia treatment with Typhoid fever prevention costs least. Therefore, for optimal cost effective control of both diseases, the policy makers must focus more on prevention strategy while treating the infected individual is not neglected.

Co-Infection of Malaria and Typhoid Fever among Pregnant Women Attending Primary Health Care Centre, Ojo Local Government, Lagos, Nigeria

Background: Co-infection of malaria and typhoid can result in serious complications and conditions in pregnant women. Objectives: This research was carried out to investigate the co-infection of malaria and typhoid fever among pregnant women attending antenatal clinic at Primary Health Care centre, Oto-Awori Local Council Development Area (LCDA) in Ojo Local Government, Lagos. Methods: 170 blood samples of pregnant women were examined for the presence of malaria parasite and typhoid fever using standard methods and compared with equal number of non-pregnant women (170). Co-infection was characterized based on age group, trimester, gravidal, education status and employment status. Women’s data were collected through questionnaires. Results: Prevalence of co-infection of malaria and typhoid in pregnant women was high in age group 26-35 years 50 (63.3%), 50 (63.3%) of women in second trimester had coinfection, high prevalence of co-infection was observed in gravidal Co-infection of malaria and typhoid were high among the pregnant women of gravidal 1, 2 and 3. Also, co-infection of malaria and typhoid was high among women with secondary 41 (51.9%) and tertiary 31 (39.2%) education, semi-skilled women 37 (46.8%) and respondents had good knowledge of malaria and typhoid. Conclusions: This study revealed the prevalence of coinfections among the pregnant women; hence more attention should be given to this group.

A Predictive Symptoms-based System using Support Vector Machines to enhanced Classification Accuracy of Malaria and Typhoid Coinfection

A Predictive Symptoms-based System using Support Vector Machines to enhanced Classification Accuracy of Malaria and Typhoid Coinfection

“Malaria And Typhoid Co-Infection In India: A Diagnostic Difficulty’’

“Malaria And Typhoid Co-Infection In India: A Diagnostic Difficulty’’

Dengue and Typhoid Fever Coinfection in A Child

Dengue and Typhoid Fever Coinfection in A Child

Prevalence of Malaria and Typhoid Co-infection amongst Residents of Uyo, Akwa Ibom State, Nigeria

Prevalence of Malaria and Typhoid Co-infection amongst Residents of Uyo, Akwa Ibom State, Nigeria

Malaria and Typhoid Co-infection: Need to Interpret Serological Results Cautiously.

To, The Editor, This is in reference to the article “Comparative evaluation of various tests for diagnosis of concurrent Malaria and Typhoid fever in a tertiary care hospital of Northern India” published by Deepika verma et al., in the Journal of Clinical and Diagnostic Research, 2014, May, Vol-8(5), in which the prevalence of malaria and typhoid co-infections have been reported to be 8.5% using serological tests and 1.6% using blood culture for enteric fever and peripheral smear for Malaria [1]. We would like to add to the existing knowledge by sharing our findings using various serological and gold standard tests for Malaria and Enteric fever. This is also to highlight the epidemiological differences in both the diseases as well as confections in different regions of Northern India. Both typhoid and malaria are diseases of epidemiological importance globally. Though caused by different organisms – one Gram negative bacilli, the other protozoa, and transmitted via different mechanisms, both present with acute febrile illness which requires workup for both. Co-infections can lead to misdiagnosis usually resulting in either under treatment or over treatment. This predisposes transmission of infection from untreated patient to new host and further irrational use of antibiotics/anti malarial results in increasing surge of drug resistance [2,3]. The present study was conducted in VMMC & Safdarjung hospital, New Delhi from July 2014 to June 2015. A total of 1464 samples collected from the patients attending the outpatient department and admitted in the wards of our hospital were tested for the diagnosis of malaria and enteric fever both. The inclusion criteria followed for the study were- Patients presenting with undifferentiated fever of minimum 5 days with clinical suspicion of typhoid or malaria. Patients of age from >2 years onwards. The patients having history of intake of anti-malarial drug, or antibiotics were excluded from the study. Blood smear examination, Rapid malaria antigen test, blood culture, and Widal test were done for the diagnosis of Malaria and typhoid respectively. Out of 1464 samples 14(1%) were positive by both Widal and rapid malaria antigen test. However, out of 14 samples positive by Widal and rapid malaria test, only 6 (5 S. typhi and 1 S. paratyphi) were confirmed by blood culture and ten were confirmed for malaria by peripheral smear. Hence co-infection cases confirmed by gold standard tests were only six (0.40%). These results are similar to the findings obtained by the authors and establish that the results obtained by Widal and Malaria rapid tests should be interpreted carefully especially while reporting Malaria and typhoid co-infections. To the best of our knowledge and as per pubmed search there is no published data on the prevalence of malaria typhoid co-infection from Delhi. Hence this study was done to determine the prevalence of malaria typhoid co-infections in our region. On comparing the data with the above mentioned authors and some other and the other reports from Uttar Pradesh, prevalence of confection cases in our study was found to be very less [1,4]. However, this may be attributed higher prevalence of typhoid and malaria in Uttar Pradesh as evident by the website of National Vector Born Disease Control Programme [5]. Hence it is important to consider endemicity of the infections, while interpreting the results of serological tests where typhoid and Malaria co-infection are suspected.

Dengue and typhoid co-infection: A case report from a tertiary care hospital in South India

Dengue and typhoid co-infection: A case report from a tertiary care hospital in South India

The prevalence of malaria and typhoid co-infection in pregnant women attending antenatal in Wuse general hospital Abuja, Nigeria

Malaria and typhoid fever are both endemic in the tropics and pregnant women constitute one of the high risk groups. The objective is to determine the rate of malaria- typhoid co-infection in pregnant women attending antenatal clinics in Wuse general hospital Abuja, Nigeria.A study of malaria infection and typhoid fever on the pregnant women attending wuse general hospital and its haematological parameters was carried out between April and May, 2015 in Abuja. Blood samples were collected and examined for malaria and typhoid using widal agglutination method and P. falciparium antigens rapid test device respectively. Of the 200 sampled, 16(8%) were infected with malaria parasite while 77 (38.5%) were infected with typhoid, 9(4.5%) had the malaria typhoid co-infection. More co-infection 7(10.6%) was recorded among primigravidae than the multigravidae 2 (2.2%) these differences were statistically significant (P < 0.05, df =1, X 2 cal= 8.5462, X 2 tab= 3.841). Highest prevalence was recorded among those in their first trimester 6 (8.9%) and lowest among those in the third trimester 0 (0%), these differences were also statistically significant (P < 0.05, df =1, X 2 cal= 4.3292, X 2 tab= 5.991). The study showed that typhoidfever was complicated by malaria in pregnancy in at least 38.5% of the cases and this has a far reaching effect on adverse pregnancy outcome. This has immense public health implication.

Prevalence of Malaria and Typhoid Fever Co-Infection: Knowledge, Attitude and Management Practices among Residents of Obuda-Aba, Abia State, Nigeria

A study of prevalence, knowledge, attitude and management practices of malaria and typhoid fever co-infection was carried out among residents of Obuda-Aba, Abia State, Nigeria, between July and September, 2014. Venepuncture technique was used for collection of the blood samples. A total of 245 persons comprising 120 males and 125 females were examined. Field stained thick and thin blood films were used to detect malaria parasites in the samples. Typhoid fever was diagnosed from each blood sample using Widal test kit. Out of the 245 persons sampled, 95(38.78%) tested positive for malaria, 105 (42.86%) tested positive for typhoid fever, 45(37.50%) were co-infected with malaria and typhoid fever among the males and 55(44.00%) were co-infected with malaria and typhoid fever among the females. Co-infection of malaria and typhoid fever was highest in the age group of 61-75 years, 4(100%) among the males and highest in the age group of 16-30 years, 15(83.33%) among the females. On the perception of the possible causes of malaria and typhoid fever, 24 respondents reported excessive fried oil as the cause while 17 respondents stated excessive intake of alcohol. On the perception of the sign and symptoms associated with malaria and typhoid fever, 77 respondents stated loss of appetite, 67 respondents stated fatigue and 70 respondents stated headache. On the practices available for protection against malaria and typhoid fever, 54 respondents reported routine treatments with drugs, 21 respondents stated good sanitary measures while 33 respondents reported access to safe food and water. There is need for massive health education campaign to educate the residents of Obuda-Aba to correct the wrong perception they have about malaria and typhoid fever for effective treatment and control of the diseases.