Prevalence of malaria, typhoid, toxoplasmosis and rubella among febrile children in Cameroon

Abstract

BackgroundThe current roll-out of rapid diagnostic tests (RDTs) in many endemic countries has resulted in the reporting of fewer cases of malaria-attributed illnesses. However, lack of knowledge of the prevalence of other febrile illnesses and affordable diagnostic tests means that febrile patients are not managed optimally. This study assessed the prevalence of commonly treatable or preventable febrile illnesses in children between 6 months and 15 years using rapid diagnostic tests at the point-of-care.MethodsFebrile children were enrolled between February-April 2014 at a health facility after obtaining informed consent from parent. Eligible participants were aged 6 months-15 years with a history of fever in the last 24 h or axillary temperature ≥38 °C at consultation. All participants were tested using RDTs for malaria, typhoid, toxoplasmosis and rubella. Malaria parasites were further identified by microscopy and PCR. Clinical and household characteristics were recorded and association with pathogens determined.ResultsOf the 315 children enrolled, the mean age was 5.8 ± 3.8 years. Stomach pain (41.2 %) was the most reported symptom. Prior to attending the health facility, 70.8 % had taken antipyretics, 27.9 % antimalarials, 11.4 % antibiotics and 13.3 % antifungal drugs. Among 315 children with fever, based on RDTs, 56.8 % were infected with malaria, 4.4 % with typhoid, 3.2 % with acute toxoplasmosis, and 1.3 % with rubella (all positive for rubella were in the same family and not vaccinated). All non-malarial infections were co-infections and approximately 30 % of the fever cases went un-diagnosed. Malaria prevalence by microscopy and PCR was 43.4 and 70.2 % respectively. The sensitivity and specificity of RDTs for the diagnosis of malaria were 75.98 and 100 % respectively, with 0.73 measurement agreement between RDTs and microscopy while that of RDT and PCR were 81 and 100 % respectively with a K value of 0.72. The use of Insecticide Treated Bednets was 44 %. There was a significant association between ITN non-usage and malaria (p = 0. 029) as well as drinking water and presence of typhoid (p = 0.047). No association was observed between type of housing and malaria, or toxoplasmosis and raising cats.ConclusionThough malaria still remains the major cause of fever in children, using RDTs for other treatable febrile illnesses like typhoid and toxoplasmosis could facilitate the optimal management of febrile illnesses in children especially when these occur as co-infections with malariaElectronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1996-y) contains supplementary material, which is available to authorized users.

Detection and serotyping of dengue viruses in febrile patients consulting at the New-Bell District Hospital in Douala, Cameroon

“…The malaria incidence of 20.2% (23/114) in Douala during March-April was relatively low when compared to 56.8% (179/315) recorded from children in Yaoundé (from February to April 2014), the capital city of Cameroon [ 30 ]. This low incidence could be explained by the sustained control efforts such as the use of insecticide treated bed nets and/or by the fact that malaria is more prevalent in children under five years of age, while in our study, all age groups were represented.…”

Seroprevalence of Toxoplasmosis and associated risk factors in pregnant women at the Protestant Hospital, Mbouo-Bandjoun, Cameroon

“…In immunocompetent adults and children, this infection is usually asymptomatic or causes symptoms such as fever or malaise that spontaneously resolve (1,2). Sometimes, it can induce foetal complications in pregnant women (2) and also cervical lymphadenopathy and/ or ocular disease in immunocompromised patients infected with the human immunodeficiency virus (HIV) (3).…”

Prevalence of malaria, typhoid and co-infection in District DIR (lower), Pakistan

“…Although, malaria and typhoid is caused by two different organisms in which one is protozoan and other is gram negative bacilli, which transmit by two different mechanisms and both disease share similar symptomology, because both typhoid and malaria share social circumstances which are important for their transmission (RAO; SOWMYA, 2015). The People living in the area which are endemic for both typhoid and malaria are at risk of getting disease either concurrently or acute infection superimpose the chronic one (ACHONDUH-ATIJEGBE et al, 2016). So the mimicking and same symptomology of typhoid and malaria often present a diagnostic problem which lead to diagnostic confusion.…”