Short communication: Prevalence of typhoid fever in febrile patients with symptoms clinically compatible with typhoid fever in Cameroon

Abstract

Summary Typhoid fever is difficult to differentiate from other causes of infection such as malaria because their signs and symptoms often overlap. There has been an unprecedented increase in the number of typhoid fever cases diagnosed in Cameroon. Febrile patients are often treated for malaria and typhoid fever simultaneously. This cross‐sectional study was carried out to determine the prevalence of typhoid fever in 200 consecutive patients with fever and symptoms clinically compatible with typhoid fever to verify recent estimates of a high prevalence of typhoid fever in Cameroon. Patients were enrolled in three of the 10 provinces of Cameroon. Blood culture, thick and thin blood smears and Widal tests using acute sera were performed in all cases; stool culture for 120 patients. Typhoid fever was confirmed in only 2.5% as evidenced either by culture (four cases) or high salmonella antibody titres (one case); malaria was diagnosed in 94 (47%) patients. Typhoid fever is not as endemic in Cameroon as recently feared.

Clinical profile of enteric fever: a prospective study of fifty enteric fever patients

“…There was no significant difference between antimicrobial susceptibility patterns of S. typhi and S. paratyphi A. 4,5,6 In this study cases admitted were throughout the year showing the endemecity of the disease. Maximum numbers of cases were admitted during May-September (56%) ( Table 7).…”

A comparative study of Widal test with blood culture in the diagnosis of typhoid fever in febrile patients

“…These false positive results may be associated with cross reacting antibodies from serum of febrile patient other than typhoid fever. In a study conducted in Cameroon to study the prevalence of typhoid fever of febrile patients with clinically compatible symptom of typhoid fever, 45% of the patients the true diagnosis of malaria but only 2.5% of the patients had culture proven typhoid fever [4]. …”

“…Options for the diagnosis of typhoid fever are clinical signs and symptoms, serological markers, bacterial culture, antigen detection and DNA amplification [4, 5]. Blood, bone marrow and stool culture are the most reliable diagnostic methods but they are expensive techniques and some bacterial culture facilities are often unavailable [6–8].…”

Current concepts in the diagnosis and treatment of typhoid fever

“…In areas where malaria is endemic and where schistosomiasis is common the presentation of typhoid may be atypical 13 14. Multidrug resistant typhoid and paratyphoid infections are more severe with higher rates of toxicity, complications, and mortality than infections with sensitive strains 12.…”