Incidence of Typhoid Fever among Patients Diagnosed with Malaria in Gwagwalada, FCT
DOI:
https://doi.org/10.67601/njbls.v3i2c.76Keywords:
Infectious disease, Febrile illness, Co-infection, Widal test, Blood culture, Salmonella typhiAbstract
Malaria, typhoid and their co-infection remain the most common febrile illnesses in Nigeria, with overlapping clinical symptoms, making diagnosing almost difficult. This study was aimed at investigating the incidence of typhoid fever among patients diagnosed with malaria infection. 100 blood samples, collected from febrile patients (63 females and 37 males) between the ages of 11–60 years were screened for malaria parasites using thick and thin blood film stains. Typhoid fever was screened using the Widal-agglutination test and re-confirmed with blood culture, followed by biochemical characterization. 62 (62%) samples were positive for malaria. Of all 62 malaria positive samples, 27 (43.5%) were positive for widal test while 35 (56.4%) were negative. Blood culture confirmed 33 (53.2%) of 62 malaria-positive samples for Salmonella spp., indicating a marked discrepancy between the two diagnostic methods. Malaria-typhoid co-infection recorded 15 (24.1%). The 21–30 years of age group recorded the highest number of malaria to typhoid cases, while age 11-20 years recorded the highest number of co-infection. Females (63%) constituted a higher proportion of the study population than males (37%). The association between the number of malaria positive cases with age and positive cases for widal and culture was not statistically significant. The findings revealed that although malaria typhoid co-infection is genuinely present in the study population, the Widal test overestimates its true prevalence due to its low specificity. It is recommended that blood culture be adopted as a confirmatory diagnostic tool to improve the accuracy of typhoid fever diagnosis among malaria patients.
References
Bashir, O. A., Reigns, A., Unimke, O. P. and Mshelia, S. (2021). Population dynamics to urban spaces needs in one of africa’s largest cities: Abuja, the Federal Capital City of Nigeria. Iconic Research and Engineering Journals, 4(10): 124-130.
Buckle, C., Fischer W., Christa, L. and Black, R. E. (2012). Typhoid fever and paratyphoid fever: systematic review to estimate global morbidity and mortality for 2010. Journal of Global Health, 2(1): 010401. https://doi.org/10.7189/jogh.02.010401
Cattoir, L., Claessens, J., Cartuyvels, R., and Van den Abeele, A. (2018). How to achieve accurate blood culture volumes: the BD BACTEC FX blood volume monitoring system as a measuring instrument and educational tool. European Journal of Clinical Microbiology and Infectious Diseases, 37(9):1621–6. https://doi.org/10.1007/s10096-018-3291-x
Centre for Disease Control (CDC), 2024. www.cdc.gov
Igharo, E. A., Osazuwa, F., Ajayi, S. A., Ebueku, A. and Igbinigie, O. (2021). Dual Infection with Typhoid and Malaria in Febrile Patients in Ikare Akoko, Nigeria. International Journal of Tropical Medicine, 7(1):49-52.
Iwuafor, A. A., Egwuatu, C. C., Nnachi, A. U., Akujobi, C. N., Ita, I. O., Ogban, G. I. and Egwuatu, T. O. (2016). Malaria-related febrile illness and the use of insecticide-treated nets(INTs) for Malaria control amongst under-5year old children in Calabar, Nigeria. BMC Journal of Infectious Diseases, 16:151.
Kanjilal, S. D., Dutta, A., Mondal, R. K. and Chakravori, S. (2006). Uncomplicated falciparum malaria complicated by Salmonella septicaemia: cause not coincidence. Journal of the Indian Medical Association, 104:646-648.
Kariuki, S., Dyson, Z. A., Mbae, C., Ngetich, R., Kavai, S. M., Wairimu, C., Anyona, S., Gitau, N., Onsare, R. S., Ongandi, B., Duchene, S., Ali, M., Clemens, J. D., Holt, K. E. and Dougan, G. (2021). Multiple Introductions of Multidrug-resistant Typhoid Associated with Acute Infection and Asymptomatic Carriage, Kenya. eLife Sciences, 10:e67852. https://doi.org/10.7554/eLife.67852.
Kwiek, J. J. and Mixson-Hayden, T. (2023). Malaria paradoxes of the U.S. Civil War. American Journal of Tropical Medicine and Hygiene, 108(4), 646–650. https://doi.org/10.4269/ajtmh.22-0672.
Lee, W. C., Cheong, F. W., Amir, A., Lai, M. Y., Tan, J. H., Koh, T. T., Sabri, N. A. H. and Lau, Y. L. (2022). Plasmodium knowlesi: The game changer for malaria eradication. Malaria Journal, 21, 140. https://doi.org/10.1186/s12936-022-04131-8
National Center for Biotechnology Information (NCBI). (2023). Salmonella Typhi. In StatPearls. National Center for Biotechnology Information (NCBI Bookshelf). Typhoid fever. In StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK519002/
Ochei, J. O. and Kolhatkar, A. A. (2010). Medical Laboratory Science: theory and Practice”. New Delhi, India:Tata McGraw-Hill, 692-693.
Odikamnoro, O. O., Ikeh, I. M., Okoh, E. N., Ebirekwe, S. C., Nnsdozie, I. A., Nkwuda, J. O. and Asobie, G. C. (2017). Incidence of malaria typhoid co-infection among Adult population in Unwana Community, Afrikpo North LGA, Ebonyi State, SouthEastern Nigeria. African Journal of Infectious Disease, 15, 12(1):33-38. https://doi.org/10.21010/ajid.v12i1.6
Ohanu, M. E., Mbah, A. U., Okonkwo, P. O. and Nwagbo, F. S. (2003). Inteferance by malaria in the diagnosis of typhoid using widal test alone. West African Journal of Medicine, 22:250-252. https://doi.org/10.4314/wajm.v22i3.27961.
Ologunde, C. A., Ojomo, M. M. and Akinruli, F. T. (2026). Incidence of typhoid fever, malaria, Hepatitis B. and C, Human Immunodeficiency Virus and Urinary Tract Infections in kere Local Government Area of Ekiti State, Nigeria. South Asian Journal of Research in Microbiology, 20(5): 52-62. https://doi: 10.9734/sajrm/2026/v20i5506.
Olowolafe, T. A., Agosile, O. F., Akinpelu, A. O., Aderinto, N., Wada, O. Z. and Olawade, D. B. (2024). Malaria and typhoid fever co-infection: a retrospective analysis of University Hospital records in Nigeria. Malaria Journal, 23(1), 220. https://doi.org/10.1186/s12936-024-05052-4.
Okolo, M. L., Adeshina, K., Christopher O., Mudi, I. and Ugbane, E. (2023). Prevalence of malaria and typhoid fever co-infection among pregnant women attending antenatal clinic in Anyigba, Kogi State, Nigeria. Microbes and Infectious Diseases, 4, 671–680. https://doi.org/10.21608/MID.2022.161413.1380
Opota, O., Croxatto, A., Prod’hom, G. and Greub, G. (2015). Blood culture-based diagnosis of bacteraemia: state of the art. Journal of Clinical Microbiology and Infection. 21(4):313–22. https://doi.org/10.1016/j.cmi.2015.01.003
Rufai, T., Aninagyei, E., Akuffo, K. O., Ayin, C. T. M., Nortey, P., Quansah, R., Cudjoe, F. S., Tei-Maya, E., Duah-Junior, I. O. and Danso-Appiah, A. (2022). Malaria and typhoid fever among patients presenting with febrile illnesses in Ga West-Municipality, Ghana. Medrxiv.org. https://doi.org/10.1101/2022.04.12.22273780
Rufai, T., Aninagyei, E., Akuffo, K. O., Ayin, C. T. M., Nortey, P. and Quansah, R. (2023). Malaria and typhoid fever among patients presenting with febrile illnesses in Ga West-Municipality, Ghana. PLoS ONE 18(5): e0267528. https://doi.org/10.1371/journal.pone.0267528
Wain, J., Hendriksen, R. S., Mikoleit, M. L., Keddy, K. H. and Ochail, R. L. (2015). Typhoid Fever. Lancet. 385(9977):1136-1145.
Wenn-Chyau, L., Cheong, F. W., Amir, A., Lai, M. Y., Tan, J. H., Phang, W. K., Shahari, S. and Yee-Ling, L. (2022). Plasmodium knowlesi: The game changer for malaria eradication. Malaria Journal, 21(140).
WHO. World malaria report,2014. 2014. http://www.who.int/malaria/WMR014.
