BackgroundToxoplasmosis is a widely distributed zoonotic disease, caused by the protozoan parasite Toxoplasma gondii. T. Infections can result in stillbirths, abortions or congenital defects during pregnancy, as well as toxoplasmic encephalitis in HIV/AIDS patients. This study aimed to determine the seroprevalence and risk factors for T. gondii infection in women seeking antenatal and medical care in the locality of Njinikom, North West of Cameroon.MethodsWe conducted a cross-sectional study from August to December 2014 consecutively enrolling 178 consenting women aged 15 to 49 years attending antenatal care or medical check-ups at the hospital. A questionnaire survey was administered to study participants and potential risk factors for Toxoplasma exposure sought. Venous blood was collected and serum from each participant analysed for T. gondii infection as evidenced by the presence of anti-T. gondii IgG and IgM antibodies detected using the indirect enzyme-linked immunosorbent assay (ELISA) technique. The proportion of anti-T. gondii antibody positivity calculated as the percentage of antibody seropositivity to T. gondii antigens. Predictors of T. gondii infection were analysed by univariate and multivariate regression and association with T. gondii seropositivity assessed. Epi-Info 3.5.4 was used for statistical analyses. A p < 0.05 was considered significant for all analyses.ResultsThe seroprevalence of anti-T. gondii antibodies (IgM or IgG) were 54.5 % (97/178). Among seropositive women, 88.7 % (86/97), 30.9 % (30/97), and 19.6 % (19/97) were respectively seropositive for IgG antibody, IgM antibody and both IgM and IgG antibodies. Among the risk factors evaluated, only the consumption of raw or undercooked meat (p = 0.02) was observed to be an independent risk factor of T. gondii infection. The consumption of unwashed vegetables and fruits was significant (p = 0.01) only with simple logistic regression analysis.ConclusionsOur findings suggest recent T. gondii exposure is high in our study population, and may constitute a significant risk factor for stillbirths, abortions or congenital defects during pregnancy in women attending antenatal care, or toxoplasmic encephalitis in those who are immunosuppressed such as in HIV/AIDS. Education and screening of HIV-positive individuals and pregnant women for T. gondii infection may be important primary prevention strategies in this population.

Background: Typhoid fever has several diagnostic tests. However, misdiagnosis is common since most health care facilities use only the Widal test without confirmation of results with a second test method. Objective: This study aimed at evaluating the performance of Widal test to stool culture in the Laboratory diagnosis of typhoid fever. Methods: Recruited in this study were 112 consented patients ≥1 year presenting with symptoms clinically suspected of typhoid fever visiting the Hospital in April, 2018. Blood and stool samples collected from all participants were subjected to Widal and stool culture, respectively. Serotyping was done using Salmonella O, and H antisera. Widal agglutination titre values ≥1:80 were considered as positive for the Salmonella antigen. Isolation of S. typhi from stool culture indicated an infection. Data was analysed using the Statistical Package for Social Sciences (SPSS). Sensitivity, specificity, Negative Predictive Value (NPV) and Positive Predictive Value (PPV) of Widal test were calculated. The sensitivity and specificity of the stool culture were 100% since it was the ideal to which the Widal test was compared. Results: Prevalence of typhoid fever using stool culture was 39.3%, sensitivity and specificity of Widal were 40.9% and 32.4%, respectively. NPV and PPV were 6.44% and 28.13%, respectively. Conclusion: Widal test is not reliable for diagnosis of typhoid fever. Health care personnel should develop a rapid, highly sensitive and cheap diagnostic method that is also capable of differentiating Salmonella infection from other infections.

Background. The diagnosis of typhoid fever based on the Widal slide agglutination test remains a major hurdle in developing countries due to varied perceptions of the value of the Widal test in determining clinical decision-making. We undertook a study to evaluate the diagnostic performance of the Widal test and the Typhidot immunoassay in patients suspected of having typhoid fever in the Menoua division, West Region of Cameroon. Methods. Blood and stool samples were collected from 558 consenting febrile patients on the basis of suspicion of typhoid fever. These patients attended three district health services of the Menoua division between April 2018 and September 2019. These patients had clinical symptoms suggestive of typhoid fever as determined by their consultant. Serum was used for the Widal slide agglutination test and for the Typhidot rapid immunoassay test based on manufacturer’s guidelines. A composite reference of fever plus positive coproculture for Salmonella typhi and Salmonella paratyphi was used as the reference. The sensitivity, specificity, and predictive values of the positive and negative tests were calculated as well as Cohen’s kappa for agreement between the two tests. Results. Of 558 patients, 12.90% tested positive for the reference method, 57.17% tested positive for the Widal slide agglutination test, while 15.59% were positive for Typhidot-IgM. The overall sensitivity, specificity, and predictive values of the positive and negative tests were 80.56%, 94.03%, 66.6%, and 97.03% for Typhidot-IgM and 94.44%, 48.35%, 21.32%, and 98.33% for the Widal slide agglutination test, respectively. Cohen’s kappa estimates were 0.1660 (0.121–0.211) and 0.386 (0.312–0.460) for the Widal test and Typhidot immunoassay for 53.6% and 76.16% agreements of all observations, respectively. Conclusion. The Widal test was found to have a lower predictive value for the diagnosis of typhoid fever in our setting. However, the Typhidot test, although better, was not ideal. Diagnosis of typhoid fever should therefore rely on adequate clinical suspicion and a positive Typhidot test to improve the clinical management of typhoid fever in our setting.

No abstract