Incidence Of Concurrent Malaria And Typhoid Fever Infections In Febrile Patients In Jos, Plateau State Nigeria.

Abstract

Malaria and typhoid fever are major aetiological considerations in both acute and prolonged fever of unknown origin (PUO) in the tropics. Because of the high prevalence of malaria and typhoid fever in Nigeria, co-infections are common. This study investigated the incidence of Salmonella enterica serovar typhi and Plasmodium species in febrile patients in Jos, Nigeria. A total of 300 each of blood and stool samples were collected from patients presenting febrile conditions suggestive of malaria and typhoid fever and analyzed using parasitological, agglutination (Widal) and stool culture techniques. All isolates were identified as Salmonella enteric serovar typhi using standard microbiological techniques. The results revealed that 162(54%} patients were positive for malaria parasites out of which 68(42%} had typhoid fever by Widal test and 9(5.6%} by stool culture test. A correlation analysis showed a strong relationship between malaria parasite and Salmonella typhi both by Widal test (r=0.98) and by stool culture (r=0.91) tests. The result showed that malaria is more likely to cause fever than typhoid infection. It is therefore pertinent to suggest that every treatment of fever should be preceded by appropriate laboratory diagnosis that can establish the actual aetiology. The use of widal test alone in the diagnosis of typhoid fever is unreliable, misleading and should be discouraged. Culture technique still remains the gold standard in the diagnosis of typhoid fever and should be embraced. In the absence of culture facilities, widal test can be used provided judicious interpretation of the test result is made against a background of pertinent information. Also where culture facilities are lacking and patients show positive for malaria and widal test, malaria should be treated first. Only when malaria has been ruled out should such patients be treated for typhoid fever.