Malaria and typhoid fever coinfection among patients presenting with febrile illnesses in Ga West Municipality, Ghana

Abstract

Background: Malaria and typhoid fever coinfection presents major public health problems especially in the tropics and sub-tropics where malaria and typhoid fever are co-endemic. Clinicians often treat both infections concurrently without laboratory confirmation. However, concurrent treatment has public health implications as irrational use of antibiotics or anti-malarials may lead to the emergence of drug resistance, unnecessary cost and exposure of patients to unnecessary side effects. This study determined the proportion of febrile conditions attributable to either malaria and/or typhoid fever and the susceptibility patterns of Salmonella spp. isolates to commonly used antimicrobial agents in Ghana. Methods: One hundred and fifty-seven (157) febrile patients attending the Ga West Municipal Hospital, Ghana, from February to May 2017 were sampled. Blood samples were collected for cultivation of pathogenic bacteria and the susceptibility of the Salmonella isolates to antimicrobial agents was performed using the Kirby-Bauer disk diffusion method with antibiotic discs on Müller Hinton agar plates. For each sample, conventional Widal tests for the detection of Salmonella spp were done as well as blood film preparation for detection of Plasmodium spp. Data on the socio-demographic and clinical characteristics of the study participants were collected using an android technology software kobo-collect by interview. Data were analyzed using Stata version 13 statistical Software. Logistic regression models were run to determine odds ratio (OR) and the direction of association between dependent and independent variables, setting p-value at <0.05 for statistical significance. Results: Of the total number of patients aged 2–37 years (median age = 6 years, IQR 3–11), 82 (52.2%) were females. The proportion of febrile patients with falciparum malaria were 57/157 (36.3%), while Salmonella typhi O and H antigens were detected in 23/157 (14.6%) of the samples. The detection rate of Salmonella spp in febrile patients was 10/157 (6.4%). Malaria and typhoid fever coinfection using Widal test and blood culture was 9 (5.7 % ) and 3 (1.9%), respectively. The isolates were highly susceptible to cefotaxime, ceftriaxone, ciprofloxacin, and amikacin but resistant to ampicillin, tetracycline, co-trimoxazole, gentamicin, cefuroxime, chloramphenicol, and meropenem. Conclusion: Plasmodium falciparum and Salmonella spp coinfections were only up to 1.9%, while malaria and typhoid fever, individually, were responsible for 36.3% and 6.4%, respectively. Treatment of febrile conditions must be based on laboratory findings in order not to expose patients to unnecessary side effects of antibiotics and reduce the emergence and spread of drug resistance against antibiotics.

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

“…e prevalence of culture-confirmed typhoid fever was 6.5% CI: (4.3-9.1)]. is finding is more or less similar to previous studies done in Shashemene, Ethiopia (5.0%) [22], West, Ghana (6.37%) [31], Northern, Uganda (6.8%) [20], and Kolkata, India (4.5%) [27]. e prevalence is much lower than the extent of prevalence stated in Northern Ethiopia (68.7%) (17), Nigeria (12%-40%) [32], Northern India (22%) [33], and Karnataka, India (55.4%) [34].…”

“…This finding agrees with the results reported for Ghana (1.91%) [ 38 ], India (1.6% and 1.59%) [ 33 , 36 ], and Pakistan (4%) [ 30 ]. In contrast, the current coinfection prevalence is lower than reported in KMC&H, Guntur (6.5%) [ 39 ], Cameroon (7.8%) [ 15 ], Enugu, Nigeria (15.6%) [ 31 ], Calabar, Nigeria (28%) [ 21 ], Southeastern Nigeria (36.2%) [ 28 ], and Akure, Nigeria (51.5%) [ 40 ]. The low prevalence of malaria-typhoid fever coinfection in our study might be due to the test methods employed for the diagnosis of malaria and typhoid fever.…”

Utilization of 18s ribosomal RNA LAMP for detecting Plasmodium falciparum in microscopy and rapid diagnostic test negative patients

“…The reason that could be ascribed to this observation was probably due to the differences in the prevalence of malaria in these study sites. The prevalence of malaria in the Ga West Municipality, a contiguous district to the study site for the Aninagyei (2020) study, was reported to be 36.3% [ 33 ], which was significantly higher than the prevalence of malaria in Kwahu-South (11.9%) [ 34 ], a contiguous district to the New Juaben South Municipality, the study district for this study. Secondly, the study site for the previous study was peri-urban while that of this study was urban.…”

Typhoid Fever, Malaria and their Co-infection: A Review

“…Typhoid fever and malaria share many similar signs and symptoms. As a result, the feverish patient may receive incorrect diagnosis and treatment due to the similar clinical features of the two illnesses (Birhanie et al, 2014;Tanko Rufai et al, 2022). The intertwined challenges of malaria and typhoid fever underscore the importance of accurate diagnosis and appropriate management to mitigate the burden of these diseases in endemic regions.…”