Magnitude of Malaria-Typhoid Fever Coinfection in Febrile Patients at Arba Minch General Hospital in Southern Ethiopia

BACKGROUND

Coinfection with malaria and typhoid fever is a major public health issue in developing countries. In endemic areas, including Ethiopia, people are at risk of acquiring both malaria and typhoid fever at the same time. Therefore, this study aimed to determine the magnitude of malaria-typhoid fever coinfection in febrile patients attending hospital at Southern Ethiopia.

METHODS

A hospital-based cross-sectional study was carried out on 416 febrile patients attending Arba Minch General Hospital from 1st October to 30th December 2021. The data was collected using a pretested structured questionnaire. Capillary and Venus blood samples were collected for assessing malaria and typhoid fever, respectively. Blood smear, culture, and biochemical tests were performed based on standard parasitological and microbiological methods. The P-value ≤ 0.05 was considered statistically significant.

RESULTS

The magnitude of malaria, typhoid fever, and their coinfections was 26.2% (109/416), 6.5% (27/416), and 3.1% (13/416), respectively. Among the confirmed malaria cases, about 66% of infections were Plasmodium falciparum. The malaria-typhoid fever coinfection showed a statistically significant association with a clinical presentation of a continuous pattern of fever (AOR = 5.84; 95% CI: 1.44-23.71, P = 0.014) and chills (AOR = 3.94; 95% CI: 1.04-14.89, P = 0.044). About 29.6% of Salmonella isolates were multidrug-resistant (MDR).

CONCLUSION

The total rate of coinfection with malaria and typhoid fever was comparable to that of previous studies. With the consideration of higher prevalence of drug resistance of Salmonella spp. and higher prevalence of malaria-typhoid fever coinfection, proper diagnostic procedure should be implemented for proper use of drugs.

Co-infection With Dengue Virus and Extensively Drug-Resistant Salmonella typhi

In South Asia, infectious diseases are associated with significant morbidity and mortality. Malaria, typhoid, and dengue are the most common infectious diseases, and patients may be co-infected with these diseases, resulting in diagnostic and treatment dilemmas.

Dengue is caused by the Arboviridae family of viruses and is transmitted by Aedes aegypti. Dengue virus has four serotypes and the symptoms of dengue fever mimic those of other infectious diseases such as malaria, chikungunya, Zika virus disease, influenza A, enteric fever, and coronavirus disease 2019, which are also prevalent in areas of frequent dengue fever outbreak. Dengue fever is characterized by fever, severe myalgia, retro-orbital pain, skin rashes, and bone pain, which is why dengue fever is also referred to as breakbone fever. Patients with secondary dengue virus infection more commonly present with abdominal pain when compared with those with primary dengue virus infection.

Salmonella typhi causes enteric fever, which is a human infection with no animal reservoir, but the symptoms of enteric fever closely resemble those of dengue fever. Concurrent infections with multiple organisms are especially difficult to diagnose.

In this report, we present the case of a 15-year-old boy from Peshawar, Pakistan, who was co-infected with the dengue virus and extensively drug-resistant Salmonella typhi. To the best of our knowledge, this is the first reported case of co-infection with dengue virus and extensively drug-resistant Salmonella typhi. 

Dengue virus non-structural Protein-1 expression and associated risk factors among febrile Patients attending University of Abuja Teaching Hospital, Nigeria

BACKGROUND

Dengue is a mosquito-borne and neglected tropical viral disease that has been reported to be hyper-endemic in Nigeria. However, this is the first dengue study in Abuja.

OBJECTIVE

This hospital-based cross-sectional study investigated the prevalence of Dengue virus (DENV) non-structural protein-1 (NS1) antigenaemia, anti-Dengue virus IgG and their associated risk factors among febrile patients attending the University of Abuja Teaching Hospital (UATH), Nigeria.

MATERIALS AND METHODS

From May to August 2016, blood samples were individually collected from 171 consented participants. These samples were analyzed using DENV NS1 and anti-DENV IgG Enzyme Linked Immunosorbent Assay (ELISA) kits. Well-structured questionnaires was used to collect sociodemographic variables of participants.

RESULTS

Out of the 171 participants, the prevalence of Dengue virus NS1 antigenaemia and IgG seropositivity were 8.8% and 43.3%, respectively. Three (1.8%) of the patients were NS1 (+) IgG (-), 12 (7.0%) had NS1 (+) IgG (+), 62 (36.3%) were NS1 (-) IgG (+), while 97 (56.7%) of the remaining patients were NS1 (-) IgG (-). There was statistical association between DENV NS1 antigenaemia with age of patients (p=0.034), residence in proximity to waste dumpsites (p<0.0001) but not with occupation of patients (p=0.166), use of indoor insecticide sprays (p=0.4910) and presence of household artificial water containers (p=0.3650). There was statistical association between the prevalence of anti-Dengue virus IgG with occupation (p=0.0034) and education level of patients (p<0.001). However, there was no statistical association between the prevalence of anti-Dengue virus IgG with gender (p=0.4060) and residential area of patients (p=0.3896).

CONCLUSION

Findings from this study revealed that DENV infection is one of the etiological agents of acute febrile illnesses in Abuja. It's recommended that Dengue testing be considered during differential diagnosis of febrile patients.