Typhoid Infection Research Articles

Highly efficient electrocatalysts of NiMoO4 doped CdO nanostructure interconnected with modified glassy carbon electrode for the detection of chloramphenicol

In this study, we developed an excellent electrocatalyst of NiMoO4 doped with CdO and then coated electrochemical detection of chloramphenicol (CAP) via a glassy carbon electrode (NiMoO4@CdO/GCE). In particular, this drug treats typhoid, fever, and salmonellosis infections. CAP detection and measurements have become progressively important in ensuring human safety. The NiMoO4@CdO nanocomposite was prepared using the one-step hydrothermal method and characterized for its structural and optical properties. The electrochemical determination of CAP was investigated using cyclic voltammetry (CV), differential pulse voltammetry (DPV), and electrochemical impedance spectroscopy (EIS) techniques. We observed that the glassy carbon electrode modified with NiMoO4@CdO efficiently reduced the CAP at a very low potential. While CAP interacts with this system, metal oxide nanocomposites can combine with CAP reduction to produce phenylhydroxylamine. According to the DPV analysis, the bare electrode provides a linear response in the 10–100 µM range and a substantial reduction in CAP over a low detection limit of 0.083 µM when compared to (NiMoO4@CdO/GCE). Other co-existing molecules challenge the utility of this sensor. Additionally, this sensor exhibited high selectivity, stability, and reproducibility. Further, we evaluated the sensor for real-sample analysis, and the results were satisfactory.

Specific anti-toxic immunotherapy: use in medical practice and perspectives

The results of use of approaches and means of antitoxic immunotherapy in medical practice are summarized: passive transfer of various variants of antibodies specific to toxic compounds, vaccination – specific active immunization with vaccines carrying determinants of the immunochemical specificity of target toxic compounds. The practical effectiveness of the known approaches of passive transfer and vaccination is associated with the ability of specific antibodies, by binding target bioactive compounds with pronounced toxicity, to change the availability of corresponding structures in the body-targets and, in the presence of a sufficient number of specific antibodies with high binding ability to the target compounds, neutralize their toxicity. In medical practice, polyspecific heterologous antisera or the gamma globulin fraction of antisera (extremely rare monoclonal antibodies of narrow specificity) are widely used for passive transfer as antidotes in the treatment of victims in order to prevent deaths and extensive necrosis of soft tissues at the site of the bite of poisonous snakes and insects. Active immunization – vaccination with appropriate antigenic drugs should create in immunized individuals a state of humoral immunity with the corresponding characteristics of antibody formation specific to the target compound. When a target toxic compound enters an immunized organism, it is also possible to neutralize its toxicity. The most successful experience in using the principles of active immunization as a technology for specific antitoxic therapy is associated with the practice of using toxoids for toxinemic infections. Specific practical techniques used to achieve the effectiveness of possible approaches to specific antitoxic immunotherapy in the form of passive transfer of specific antibodies or their fragments are considered: to combat lethal infections in the pathogenesis of which the toxic effects of bacterial exotoxins are significant; when treating victims of snake and insect bites, exposure to poisons of marine organisms, algae and plant toxins; in the treatment of severe intoxication with certain low molecular weight toxic substances: digoxin, colchicine, tricyclic antidepressants. The most successful experiences of using the principles of active immunization as a technology for specific antitoxic therapy, based on the use of toxoids with specificity for diphtheria, tetanus, botulism, cholera, typhoid fever, dysentery, gas gangrene and other toxinemic infections, are also considered. The fairly high immunogenicity of toxoids with the possibility of activating both constitutional and adaptive immunity has become the basis for their use as macromolecular carriers of hapten analogues of narcotic substances – a promising direction in drug addiction, in the implementation of which a number of experimental molecular and combined vaccines of opiates, methamphetamine, cocaine, and nicotine. This variant of practical efforts in medicine can be regarded as a new direction of specific antitoxic immunotherapy – an option to combat drug addiction by vaccinating drug addicts.

Incidence of Typhoid Fever Infection among Febrile Patients attending FUDMA Clinic

Typhoid fever remains a public health concern in Nigeria, with its incidence poising substantial challenges to health care systems. Widal agglutination test is largely the only used diagnostic test method for the laboratory diagnosis of Typhoid infection which has been proven to be neither sensitive nor specific. This paper delves into the incidence, contributory factors as well as sensitivity and specificity of commonly used diagnostic tests of typhoid fever infection among febrile patients attending the FUDMA Clinic. A total of 55 Blood and stool samples were analyzed using standard procedures for slide agglutination test (Widal) and stool culture, before culturing, the samples were first inoculated in an enrichment medium (Selenite-F broth). After 4 hours of pre-enrichment, the samples were inoculated into Salmonella Shigella Agar and Mackonkey agar, while catalase, TSI, citrate utilization test, Indole test, and urease tests served to identify the organism biochemically. Socio-demographic data revealed that 55 Participants, 52.8% were males, 72.7% were students and 80% were singles. Slide agglutination test recorded a 90.9% incidence rate, stool culture had an incidence rate of 18.18%. Among the age groups that enrolled in this study, a 44.1% incidence rate was recorded among the age Group 20-26 years. Stool culture was to found have performed better diagnostically with a sensitivity of 60% as well as a specificity of 40%. Conclusively, A high Incidence of typhoid fever was observed in this study. This Therefore suggests that there is an urgent need for improved personal hygiene and more accessibility to potable drinking water.

Hydro-Climatic Factors and Health Problems in the Town of Ouéllé (Central-Eastern Côte d'Ivoire)

This article deals with hydro-climatic factors and their health impacts in the town of Ouéllé in a context of climate change. The aim of this study is to show the impact of hydro-climatic determinants on the spatial distribution of pathologies in the town of Ouéllé. The methodological approach used was based on data collection techniques ranging from documentary research to field surveys. Interviews were conducted with experts, while questionnaires were administered to 100 people living in the urban area of Ouéllé. In addition, photographs of the spatial units were taken using a Redmi 9A smartphone, followed by the collection of geospatial data using the UTM Geo map mobile application for data collected in KML (Keyhole Markup Language) format on the Android operating system. We also used statistical data analysis techniques to process the data. The results showed that the main hydro-climatic factors in Ouéllé are rainfall, temperature and wind. The diseases linked to these hydro-climatic factors are malaria, which is the main health risk, accounting for 63% of consultations in 2023, followed by typhoid fever (8%) and acute respiratory infections (ARI) (3%).

Genetic and in-silico approaches for investigating the mechanisms of ciprofloxacin resistance in Salmonella typhi: Mutations, extrusion, and antimicrobial resistance

Salmonella enterica serovar Typhi spreads typhoid infection in humans through the consumption of contaminated food and water. Poor sanitation plays a pivotal role in its dissemination. Over time, the bacterium has acquired resistance to many promising antibiotics, posing a growing global health concern and hindering the achievement of sustainable development goals. This study aims to elucidate the molecular complexity of fluoroquinolone resistance, a first-line treatment for typhoid infection. To achieve this aim, 80 clinical isolates were collected from various diagnostic laboratories. These isolates were confirmed based on morphological characteristics and biochemical tests. Multidrug-resistant (MDR) and extensively drug-resistant (XDR) isolates were identified using the Kirby-Bauer disc diffusion method. The mechanism of ciprofloxacin resistance was investigated by sequencing the quinolone resistance-determining region (QRDR) genes and identifying the presence of the qnrS1 gene. As a result of this study, 60 % of isolates showed resistance to ciprofloxacin. At the same time, the qnrS1 gene was present in all the selected strains while mutation analysis identified significant mutation in QRDR of DNA gyrase subunit A (gyrA) and Topoisomerase IV (parC) gene. The combinatorial effect was further investigated by downloading 286 draft genomes. The Mutation analysis reveals significant mutations at gyrA S83F, gyrA D87N, gyrA S83Y, gyrB S464F, parC S80I, and parE L416F. Additionally, docking analysis indicates reduced binding affinity and altered solvent accessibility, which show the structural changes at mutation sites. This study provides crucial insights that mutation reduces the binding affinity while qnrS1 acts as a transport channel to extrude the ciprofloxacin. In the future, further validation through experimental mutagenesis is recommended, for targeted therapeutic interventions against the mounting threat of antibiotic-resistant S. Typhi.

Exploring the Antimicrobial Resistance Profile of Salmonella typhi and Its Clinical Burden.

Background: Typhoid fever caused by Salmonella enterica serovar Typhi (S. typhi) continues to pose a significant risk to public health in developing countries, including Pakistan. This study investigated the epidemiological factors linked to suspected and confirmed S. typhi infections in Peshawar's hospital population. Methodology: A total of 5735 blood samples of patients with suspected enteric fever were collected from September 2022 to November 2023. S. typhi infection was confirmed using microbiological culture of blood samples, biochemical-based tests, and DNA-sequencing methods. Drug sensitivity testing on cultures was conducted as per the CLSI guidelines. Chi-square tests were used to analyze the clinical and epidemiologic characteristics of 5735 samples stratified by S. typhi infection status, and risk factors were assessed by applying logistic regression models to estimate odds ratios (ORs). Results: The number of confirmed typhoid fever cases in this hospital-based study population was 691 (/5735, 12.0%), more prevalent in males (447/3235 13.8%) and children (0-11 years) (429/2747, 15.6%). Compared to children, the risk of S. typhi infection was lower in adolescence (adjusted OR = 0.52; 95% CI: 0.42-0.66), adulthood (19-59 years; aOR = 0.30; 95% CI: 0.25-0.38), and older adulthood (aOR = 0.08; 95% CI: 0.04-0.18) (p < 0.001). Compared to males, the risk of S. typhi infection was lower in females (aOR = 0.67; 95% CI = 0.56-0.80; p = 0.002). Living in a rural residence (compared to urban) was associated with a higher risk of infection (aOR = 1.38; 95% CI: 1.16-1.63; p = 0.001), while access to a groundwater source (compared to municipal water supply) led to a lower risk (aOR = 0.56; 95% CI: 0.43-0.73; p = 0.002). Vaccination demonstrated a robust protective effect (aOR = 0.069; 95% CI = 0.04-0.11, p = 0.002). For those with typhoid infections, clinical biomarker analysis revealed the presence of leucopenia (65/691, 9.4%), thrombocytopenia (130/691, 18.8%), and elevated alanine aminotransferase (ALT) (402/691, 58.2%) and C-reactive protein (CRP) (690/691, 99.9%) levels. Worryingly, among the positive S. typhi isolates, there was a high prevalence of drug resistance (653/691), including multidrug-resistant (MDR 82/691, 11.9%) and extensively drug-resistant types (XDR, 571/691, 82.6%). Conclusions: This study highlights the importance of age, sex, locality, water source, and vaccination status in shaping the epidemiological landscape of S. typhi in the Peshawar district. It implies that expanding vaccination coverage to the broader population of Khyber Pakhtunkhwa province, particularly in the district of Peshawar, would be beneficial.

Salmonella Typhi genotypic diversity, cluster identification and antimicrobial resistance determinants in Mukuru settlement, Nairobi Kenya

BackgroundUnderstanding the source of typhoid infections and the genetic relatedness of Salmonella Typhi (S. Typhi) by cluster identification in endemic settings is critical for establishing coordinated public health responses for typhoid fever management. This study investigated the genotypic diversity, antibiotic resistance mechanisms, and clustering of 35 S.Typhi strains isolated from cases and carriers in the Mukuru Informal Settlement.MethodsWe studied 35 S.Typhi isolates, including 32 from cases and 3 from carriers, from study participants in the informal settlement of Mukuru, Nairobi, Kenya. Genomic DNA was extracted, and whole-genome sequencing (WGS) was performed to determine the phylogenetic relatedness of strains and detect antimicrobial resistance determinants (AMR). WGS data were analyzed using bioinformatics tools available at the Center for Genomic Epidemiology and Pathogenwatch platforms.ResultsGenotype 4.3.1.2 EA3 was found to be dominant at 46% (16/35), followed by 4.3.1.2 EA2 at 28% (10/35), and 4.3.1.1 EA1 at 27% (9/35). A comparison of the isolates with global strains from Pathogenwatch identified close clustering with strains from Uganda, Tanzania, Rwanda, and India. Three isolates (9%) distributed in each cluster were isolated from carriers. All genotype 4.3.1.2 EA3 isolates were genotypically multidrug-resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. Single mutations in the quinolone resistance-determining region were identified in the gyrA (S83Y) and gyrB (S464F) genes. All isolates associated with multidrug resistance showed the presence of the IncQ1 plasmid with the following genes: blaTEM-1B, catA1, sul1, sul2, and dfrA7.ConclusionThe close phylogenetic relatedness between antimicrobial-resistant case isolates and carriage isolates indicates that typhoid carriage is a possible source of infection in the community. Comparative analysis with global isolates revealed that the Kenyan isolates share common lineages with strains from neighboring East African countries and India, suggesting regional dissemination of specific MDR clones. AMR was a major feature of the isolates. Surveillance and testing for antimicrobial susceptibility should inform options for the management of cases.

Detection of Typhoid Fever by Immuno Chromatographic Test (ICT) and Antibiotic Susceptibility Pattern of Salmonella Typhi in Chittagong Metropoliton City

Typhoid fever caused by the Salmonella typhi is a disease of global distribution and one of the major health problems in many developing countries. In this study, clinically suspected thirty five patients were enrolled from different diagnostic centers of Chittagong city. We evaluated the reliability of Immuno Chromatographic Test (ICT) compared to different diagnostic methods like blood/serum culture and serological/Widal test for early detection of the disease. A total of 18 (51.43%) and 20 (57.14%) samples were found positive in culture method and Widal test, respectively, whereas 31 (88.57%) were found positive in ICT. Moreover, 13 culture negative and 11 Widal test negative samples were found positive in ICT. As the ICT showed satisfactory results compared to the other methods used in this survey, it can be considered as a reliable method for the early detection of typhoid infection. The study revealed several antibiotic resistant patterns by standard disc diffusion method, 12 (66.66%) out of 18 culture positives were found multi-drug resistant. The Chittagong Univ. J. B. Sci.,Vol. 10(1 &amp;2):53-70, 2020

Malaria and Typhoid Co-Infection among Children under 5 Years of Age at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Anambra State, Nigeria

This study sheds light on the prevalence of malaria and typhoid in children below the age of five in a hospital in Nigeria. This study aimed to determine the presence of malaria, typhoid and malaria-typhoid co-infection in children less than five years of age. In this community-based descriptive, quantitative and cross-sectional hospital-based survey, the blood samples of 125 children between 0 to less than 5 years (68 males and 57 females) were examined for the presence of malaria parasites and typhoid infection. Blood samples were collected using venepuncture. The malaria parasitaemia was detected using malaria microscopy on a thick blood film. Typhoid fever infection was detected using the Widal Agglutination Test. The chi-square test was used to compare the prevalence of malaria, typhoid fever and malaria/typhoid co-infections between male and female infected and uninfected participants and between children below 1 year and those 1 year and above. P-values less than 0.05 were considered significant. A prevalence of 47.2%, 32% and 16% were recorded for malaria, typhoid and malaria/typhoid co-infection respectively. A mean malaria parasite intensity of 56.8475 (±3.30177) was recorded. There was no significant difference between the prevalence of malaria, typhoid and malaria/typhoid co-infection between the genders and age groups. Also, there was no significant difference between the mean PCV of the infected (33.1610 (±0.80748) and uninfected (34.6667 (0.48441) (P&gt; 0.05). These results underscore the importance of continued efforts to combat these diseases and improve the health and well-being of children in the region.

Chloramphenicol alleviates 5-fluorouracil-induced cellular senescence through activation of autophagy.

5-Fluorouracil (5-FU) is a first-line treatment for colorectal cancer, but side effects such as severe diarrhea are common in clinical use and have been linked to its induction of normal cell senescence. Chloramphenicol (CAP) is an antibiotic commonly used to treat typhoid or anaerobic infections, but its senescence-related aspects have not been thoroughly investigated. Here, we used 5-FU to induce senescence in human umbilical vein endothelial cells (HUVECs) and investigated the relationship between CAP and cellular senescence at the cellular level. In a model of cellular senescence induced by 5-FU treatment, we discovered that CAP treatment reversed the rise in the percentage of senescence-associated galactosidase (SA-β-gal)-positive cells and decreased the expression of senescence-associated proteins (p16), senescence-associated genes (p21), and senescence-associated secretory phenotypes (SASPs: IL-6, TNF-α). In addition, CAP subsequently restored the autophagic process inhibited by 5-FU and upregulated the levels of autophagy-related proteins. Mechanistically, we found that CAP restored autophagic flux by inhibiting the mTOR pathway, which in turn alleviated FU-induced cellular senescence. Our findings suggest that CAP may help prevent cellular senescence and restore autophagy, opening up new possibilities and approaches for the clinical management of colorectal cancer.

Typhoid fever in children in Goroka, Papua New Guinea.

Typhoid is endemic in many low-income countries, including in Papua New Guinea. This study aimed to describe the burden and clinical features of typhoid in children in a provincial hospital, to describe environmental conditions that lead to typhoid, and to document the antibiotic sensitivity of Salmonella spp. in the Eastern Highlands Province. A combined retrospective and prospective study of children admitted to with clinical features of typhoid to the Goroka Hospital throughout 2022. The study included 98 children, of which 54% were female. The median age was 8 (IQR 5-10.6) years. Over 60% of the patients were from Goroka District, the peri-urban area encompassing the town and surrounds. Ninety-four percent (92) of the patients used a pit latrine as a toilet and only 28% had access to treated water. Neuropsychiatric symptoms were common (60%), as was leukopenia (48%), thrombocytopenia (52%) and anaemia (42%). Thirty-seven patients had positive blood cultures for Salmonella typhi; all isolates were sensitive to third-generation cephalosporins, pefloxacin, ampicillin, trimethoprim and sulfamethoxazole, and only 54% sensitive to chloramphenicol. The median duration of hospitalisation was 6 days (IQR). There were no deaths. Prompt public health actions are needed to reduce the burden of typhoid infection in the Papua New Guinea. The conjugate typhoid vaccine should be considered in the highlands region, where typhoid is most endemic.

A Reaction-diffusion System Modeling the Transmission of Typhoid Fever in a Periodic Environment

Typhoid fever is a life-threatening infection caused by the bacterium Salmonella Typhi, and it is still an important issue in developing countries. There are two infection routes of Typhoid fever, namely, the human-to-human transmission and the environment-to-human transmission. It is evident that people living near rivers may have a higher rate of typhoid infection, and temperature changes also have significant impacts on Typhoid transmission dynamics. In the model, the population of human will be divided into susceptible individuals, infected individuals, carrier individuals, individuals under treatment, and recovered individuals. Then a periodic dispersion-reaction system is used to describe the transport and the interactions between human and bacteria in the environment. The solution maps of the proposed periodic dispersion-reaction system lack the compactness since the population under treatment has no diffusion term, which makes analysis more difficult. After the feasible domain is chosen carefully, the eventually boundedness of the solutions can be established, and the loss of compactness is overcome if the initial data is chosen from the feasible domain. In order to introduce the reproduction number &amp;lt;I&amp;gt;R&amp;lt;sub&amp;gt;0&amp;lt;/sub&amp;gt;&amp;lt;/I&amp;gt;, the linearized system around the disease-free state is constructed, and the basic reproduction number is defined as the spectral radius of the next generation operator. Then the comparison principle and persistence theory can be utilized to establish that the index &amp;lt;I&amp;gt;R&amp;lt;sub&amp;gt;0&amp;lt;/sub&amp;gt;&amp;lt;/I&amp;gt; completely determines the threshold behavior of the typhoid spread. Brief mathematical and biological interpretations are also presented.

A TonB dependent transporter YncD of Salmonella entericaSerovar Typhi possesses vaccine potential.

Multiple TonB dependent transporters (TBDTs) contribute to bacterial virulence due to the importance roles that their substrates play in bacterial growth, and possess vaccine potential. A putative TBDT, YncD, had been identified as one of in vivo induced antigens during human infection of typhoid fever, and is required for the pathogenicity of Salmonella enterica Serovar Typhi. The present study was aimed to determine the function and immunogenicity of YncD. Homologous recombination method was used to construct an yncD-deletion mutant and cirA-iroN-fepA-deletion mutant from the wild-type S. Typhi Ty2. The growth of mutants and the wild-type strain were assessed in iron-deficient medium, as well as in human macrophage cells. Recombinant YncD protein was expressed and purified using Ni-NTA affinity chromatography and anion exchange. A mouse model was then used to evaluate the immunogenicity and protection efficacy of the recombinant YncD. Antibody levels, serum bactericidal efficiency, passive immune protection, opsonophagocysis were assayed to analyse the immunoprotection mechanism of the recombinant YncD. Our results showed that YncD is associated with the iron-uptake of S. Typhi. The yncD-deletion mutant displayed impaired growth in iron-deficient medium, comparable to that the cirA-iroN-fepA-deletion mutant did. The mutation of yncD markedly decreased bacterial growth within human macrophage cells. Moreover, subcutaneous immunization of mice with recombinant YncD elicited high levels of specific anti-YncD IgG, IgG1 and IgG2a, which protected the immunized mice against the intraperitoneal challenge of S. Typhi, and decreased bacterial burdens in the livers and spleens of the infected mice. Passive immunization using the immunized sera also efficiently protected the mice from the challenge of S. Typhi. Moreover, the immunized sera enhanced in vitro bactericidal activity of complement, and opsonophagocytosis. Our results showed that YncD displays a role in the iron-uptake of S. Typhi and possesses immunogenicity.

A Retrospective Study of the Relationship Between Typhoid and Vestibular Disorders- A Case Series

Background: Typhoid fever is caused by Salmonella enterica serovar Typhi (Salmonella Typhi). faecal-oral is the main route of transmission by contaminated water or food. Over the last few years, the classic presentation of typhoid fever has varied, and the cases with atypical presentation are increasing. In this study we are presenting a retrospective evaluation of patients presenting with giddiness post history of typhoid, to correlate a link between vestibular disorders and typhoid. Aims and Objectives: To retrospectively study the relationship between typhoid and vestibular disorders. Materials and Methods: This is a retrospective hospital-based case series conducted in vertigo clinic in The Department of ENT at SGT Medical College Hospital and Research Institute, Budhera, Gurugram. Five patients who gave positive history of typhoid, their case files were retrospectively evaluated. All the patients were made to undergo routine ENT, vertigo, and audiological evaluation. Results: Total of 5 patients presented to vertigo clinic at SGT hospital with complains of giddiness, all of them gave a history of typhoid in the past few weeks. Majority of patients presented with giddiness within four weeks after history of typhoid infection. Patients developed symptoms of giddiness, nausea, and vomiting. Out of 5 patients,4 were females and one male. Two patients were in the age group of 30-40 years. Two patients were in paediatric age group. On examination, Dix Hallpike test was positive in 3 patients. Patients were treated with vestibular sedatives and corrective manoeuvre like Epley’s. Pure tone audiometry, MRI brain and lab parameters were all normal in all the five patients. Conclusion: Endotoxins of the typhoid bacillus are capable of producing cochleovestibular lesions but only a few isolated reports suggest the same. Since very few literatures has been discussed on the possible correlation between vestibular disorders and typhoid, clinicians should be aware of atypical presentations of typhoid is to avoid any delay in diagnosis and prompt treatment. Therefore, there is a strong need to analyse and study the corelation between typhoid fever and vestibular disorders.

New Approaches to Tackling Intractable Issues in Infectious Disease.

Despite major progress in the last several decades in reducing the public and animal health burden of infectious disease a number of issues remain to be resolved and which have thus far been regarded as intractable. These include (i) the persistent carrier state in individuals convalescent from typhoid and typhoid-like infections, (ii) the increasing prevalence of multi-antibiotic resistance in enteric pathogens, much of which is mediated by self-transmissible plasmids, and (iii) parasite infections which are difficult to control by vaccination and where resistance to chemotherapeutics is also increasing. The author describes very recent work carried out by his group to look at resolving these problems in new and imaginative ways.

Exploring Travel Medicine Perspectives among Primary Care Physicians in Kurnool District: A Comprehensive Study of Knowledge, Attitudes, and Practices

Background and Aim: The study’s purpose is to improve the quality of care for both local residents and travelers in the Kurnool district by identifying and addressing gaps and barriers. The main objective of the research was to assess the knowledge, attitudes, and practical implementation of travel medicine among primary health-care physicians working in the Kurnool district. Materials and Methods: The research utilized a descriptive cross-sectional study design. A total of 397 primary care doctors in the Kurnool area participated. Data were collected through a self-administered questionnaire, which covered sociodemographic factors, travel medicine knowledge, attitudes, and practices. Results: The study revealed that a significant portion (around 79.5%) of the participants reported providing travel health advice at some point. The primary source of information on travel medicine for most participants (66%) was the Ministry of Health’s travel guides. However, the study identified a knowledge gap, as 11.4% of individuals were unaware of the origin of typhoid infection. The most common health issues reported during posttrip consultations were diarrhea and respiratory infections. Conclusion: The study’s findings suggested that the general practitioners in the Kurnool district had insufficient knowledge, attitudes, and practices concerning travel medicine. This underscores the need for additional education and training in travel medicine to improve traveler health care and reduce the risk of preventable diseases.

Prevalence of typhoid fever and its associated factors among febrile patients visiting Arerti Primary Hospital, Amhara Region, north east Ethiopia.

Typhoid fever is one of the major public health concerns in developing countries, including Ethiopia. Understanding the burden and factors contributing to the transmission and development of the disease is crucial to applying appropriate preventive and therapeutic interventions. To assess the prevalence of typhoid fever and its associated factors among febrile patients visiting Arerti Primary Hospital from 1 March to 30 May 2022. A facility-based cross-sectional study was employed among 326 febrile patients visiting Arerti Primary Hospital for health services. The data were collected using laboratory procedures (widal test) and a structured interviewer-administered questionnaire. The data were entered using Epi Data version 3.1 and analyzed by SPSS version 25. Logistic regression was used to determine associations between variables. P-value < 0.05 and adjusted odds ratio with 95% confidence interval were used to measure the presence and strength of associations. In this study, of the total 317 cases that participated, the majority (64.4%) of them were males with age ranges from 13 to 63 years. The overall prevalence of positive antigen tests for typhoid infection was 30.0% (95% CI: 25.0%-35.3%). About 66.9% of the study participants had good knowledge, 75.7% had favorable perception, and 42.3% had good infection prevention practice. Being unemployed [AOR = 7.57, 95% CI (1.98, 28.93)], being a farmer [AOR = 2.73, 95% CI (1.01, 7.41)], and having a body mass index (BMI) below 18.5 kg/m2 [AOR = 5.12, 95%CI (2.45, 10.68)] were significantly associated with typhoid fever infection. The prevalence of typhoid fever among febrile patients was high. Typhoid fever infection was significantly associated with occupational status (being unemployed and being a farmer) and lower BMI. The level of knowledge, perception, and practice of typhoid fever infection prevention were found inadequate. Therefore, behavioral change interventions are needed at the community level.

Genetic Disposition: Susceptibility of Human Blood Groups and Abo Analysis to Malaria and Typhoid Infections

Genetic Disposition: Susceptibility of Human Blood Groups and Abo Analysis to Malaria and Typhoid Infections

Liver Enzymes and Blood Lactate Profile of Patients Diagnosed with Typhoid Fever in Abuja, Nigeria

Salmonella enterica serotype Typhi antibiotics resistance is on the increase and this frustrates efforts at treatment. Persistence of drug-resistant typhoid fever leads to higher mortality rate because treatment is evasive. Lactate is a marker of the severity of stress response in illnesses and liver function enzymes are indicative of the health of the liver. This study intended to identify the effect of drug resistant typhoid fever infection on liver enzymes and blood lactate levels of patients diagnosed with typhoid fever. Fifty subjects were recruited, forty-five were positive for Widal test and further subjected to stool culture examination for the identification of Salmonella Typhi. All patient’s blood were analysed for lactate, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP). Salmonella Typhi were identified in eight out of forty-five Widal positive test patients. The eight positive Salmonella Typhi isolates showed resistance to the Amoxicillin (30 mcg), Tetracycline(30 mcg), Cotrimoxazole (25 mcg), Ceftriazone (30 mcg), Levofloxacin (5 mcg), Gentamicin (30 mcg) and Netillin (30 mcg) but showed susceptibility to ofloxacin (5 mcg). ALP (158.1±8.32 IU/L), AST(55.1±6.78 U/L), ALT (65.2 ±4.96U/L) and blood lactate (10.5±2.4 mmol/L), were elevated in all drug resistant patients when compared to reference standard ALT (7-56 U/L), AST (10-40 U/L), ALP (20-120IU/L), lactate (0.8-2.2 mmol/L). ALT, AST and ALP enzyme levels increased with increasing number of resistances to antibiotics. Untreated typhoid fever infection exerts metabolic toll on liver functions.

Whole-genome sequencing of extensively drug-resistant Salmonella enterica serovar Typhi clinical isolates from the Peshawar region of Pakistan

BackgroundTyphoid fever, caused by Salmonella enterica serovar Typhi, is a significant public health concern due to the escalating of antimicrobial resistance (AMR), with limited treatment options for extensively drug-resistant (XDR) S. Typhi strains pose a serious threat to disease management and control. This study aimed to investigate the genomic characteristics, epidemiology and AMR genes of XDR S. Typhi strains from typhoid fever patients in Pakistan. MethodologyWe assessed 200 patients with enteric fever symptoms, confirming 65 S. Typhi cases through culturing and biochemical tests. Subsequent antimicrobial susceptibility testing revealed 40 cases of extensively drug-resistant (XDR) and 25 cases of multi-drug resistance (MDR). Thirteen XDR strains were selected for whole-genome sequencing, to analyze their sequence type, phylogenetics, resistance genes, pathogenicity islands, and plasmid sequences using variety of data analysis resources. Pangenome analysis was conducted for 140 XDR strains, including thirteen in-house and 127 strains reported from other regions of Pakistan, to assess their genetic diversity and functional annotation. ResultsMLST analysis classified all isolates as sequence type 1 (ST-1) with 4.3.1.1. P1 genotype characterization. Prophage and Salmonella Pathogenicity Island (SPI) analysis identified intact prophages and eight SPIs involved in Salmonella's invasion and replication within host cells. Genome data analysis revealed numerous AMR genes including dfrA7, sul1, qnrS1, TEM-1, Cat1, and CTX-M-15, and SNPs associated with antibiotics resistance. IncY, IncQ1, pMAC, and pAbTS2 plasmids, conferring antimicrobial resistance, were detected in a few XDR S. Typhi strains. Phylogenetic analysis inferred a close epidemiological linkage among XDR strains from different regions of Pakistan. Pangenome was noted closed among these strains and functional annotation highlighted genes related to metabolism and pathogenesis. ConclusionThis study revealed a uniform genotypic background among XDR S. Typhi strains in Pakistan, signifying a persistence transmission of a single, highly antibiotic-resistant clone. The closed pan-genome observed underscores limited genetic diversity and highlights the importance of genomic surveillance for combating drug-resistant typhoid infections.