Community-based prevalence of typhoid fever, typhus, brucellosis and malaria among symptomatic individuals in Afar Region, Ethiopia

Abstract

BackgroundIn sub-Saharan Africa, where there is the scarcity of proper diagnostic tools, febrile illness related symptoms are often misdiagnosed as malaria. Information on causative agents of febrile illness related symptoms among pastoral communities in Ethiopia have rarely been described.MethodsIn this a community based cross-sectional survey, we assessed the prevalence of typhoid fever, typhus, brucellosis and malaria among individuals with a set of given symptoms in Amibara district, Afar Region, Ethiopia. Blood samples were collected from 650 study participants, and examined by Widal and Weilfelix direct card agglutination test (DCAT) as well as test tube based titration test for Salmonella enterica serotype Typhi (S. Typhi) and Rickettsia infections. Rose Bengal Plate Test (RBPT) and Complement Fixation Test (CFT) were used to screen Brucella infection. Thin and thick blood smears were used to diagnosis malaria.ResultsOut of 630 sera screened by DCAT, 83 (13.2%) were reactive to H and/or O antigens for S. Typhi infection. Among these, 46 (55.4%) were reactive by the titration test at the cut off value ≥ 1:80. The combined sero-prevalence for S. Typhi by the two tests was 7.3% (46/630). The seroprevalence for Rickettsia infection was 26.2% (165/630) by DCAT and 53.3% (88/165) by the titration test at the cut off value ≥ 1:80. The combined sero-prevalence for Rickettsia infection by the two tests was 14.0% (88/630). The sero-prevalence for Brucella infection was 12.7% (80/630) by RBPT, of which 28/80 (35%) were positive by CFT. The combined sero-prevalence for Brucella infection by the two tests was 4.4% (28/630). Out 650 suspected individuals for malaria, 16 (2.5%) were found positive for P. falciparum infection.ConclusionIn this study, typhoid fever, typhus, brucellosis and malaria were observed among symptomatic individuals. The study also highlighted that brucellosis cases can be misdiagnosed as malaria or other disease based solely on clinical diagnosis. Therefore, efforts are needed to improve disease awareness and laboratory services for the diagnosis of brucellosis and other zoonotic diseases to identify other causes of febrile illness in this pastoral setting.

Prevalence of Schistosoma mansoni–Salmonella coinfection among patients in southern Ethiopia

“…By extrapolation, the overall prevalence of Salmonella infection was 7.70%. These data are more or less similar to the previous findings of two independent studies from Ethiopia and Nigeria [ 29 , 30 ] but is much lower than the extent of prevalence described by some other authors in Ethiopia [ 32 , 33 ]. Nevertheless, the rate of Salmonella infection currently observed was relatively lower than S. mansoni infection, and almost all Salmonella -infected patients were positive for S. mansoni , considering both health institutions.…”

“…Male patients ( n = 38) outnumbered female patients; this is in agreement with the findings of previous studies conducted in another region of Ethiopia [ 28 ] and also Sudan [ 27 ]. It was also found that a majority (n = 31) of positive cases occur in children aged 5 to 15; this finding is by and large consistent with the data in the existing literature [ 29 , 30 ]. A possible reason for the higher prevalence rate of S. mansoni in children might be attributed to their frequent recreational activities in muddy, contaminated and stagnant water bodies, which are laden with snails infected with S. mansoni .…”

Sero-prevalence of brucellosis, Q-fever and Rift Valley Fever in humans and livestock in Somali region, Ethiopia

“…Camel seropositivity for brucellosis in Ethiopia ranged from 0.7 to 12% for the Rose Bengal Plate Test (RBPT) and 0.5 −10% for Complement Fixation Test (CFT) in different agro-ecologies [14]. Studies on human brucellosis in Ethiopia are sparse with less information about risk factors for human infection [13, 17].…”

Sero-prevalence and risk factors of human brucellosis among febrile patients visited health institutes at Awra and Gulina district, Afar Region, Ethiopia

“…A health institution based cross-sectional study design was used to determine sero-prevalence and risk factors of brucellosis among febrile patients visiting health institutes of Awra and Gulina district of Afar region, Ethiopia from February to May 2019. The nding of previous community based sero-prevalence of brucellosis (4.4%) in other pastoral area of the community of the region was used to estimate the sample size [17]. Based on this information, the calculated sample size, at 95% con dence level, 5% degree of accuracy and with 10% compensation for refusal, was 444 respondents.…”

“…Some studies have showed that animal brucellosis is highly distributed and the livelihood of the population is very close to animals that create potential risk factors to acquire brucellosis [13][14][15]. Nevertheless, human brucellosis has been rarely surveyed either as misdiagnosed or abandoned at all due to similarity of signs and symptoms presumably with malaria or unfamiliarity of health care workers with the disease and its epidemiology in this area [16,17]. The aim of this study was to determine the sero-prevalence and risk factors of human brucellosis among febrile patients visiting health institutes in Awra and Gulina District of Afar region, Ethiopia…”