Enteric fever cases showing concurrent seropositivity with Dengue and malaria: A sero-diagnostic challenge

Abstract

Enteric fever, Dengue and malaria still remain diseases of public health importance in the tropics. Individuals residing in endemic areas are at risk of contracting these infections either concurrently or an acute infection superimposed on a chronic one. This study was undertaken to document patients showing co seropositivity for Enteric fever, Malaria and Dengue and to record the baseline Salmonella antibody titer in voluntary blood donors who represent general population of the area. The present study was conducted in the Department of Microbiology, J.J.M. Medical College, Davangere. Among the 824 febrile patients enrolled with positive serological test for either Typhoid, Dengue or Malaria, 189 patients were found to have co seropositivity to any two of the above diseases on subjecting their serum to Widal test, Dengue ELISA and malaria antigen detection by immunochromatography. A total of 189 patients showed co seropositivity for any of the above mentioned diseases accounting for 22.90%. Typhoid-Dengue was found in 9.83% Typhoid-Malaria in 6.67% and all the three in 0.48%. DengueMalaria co-seropositivity was recorded in 5.94%. The basal titer in healthy population was found to be <1:20. The co seropositivity rate in our study is 22.9% which poses a challenge in the diagnosis and treatment of such patients. As the gold standards culture and microscopy are time consuming and molecular diagnostic tools not a practical reality in many rural and developing primary health centers, simple, rapid and sensitive serological methods are being used as an alternative diagnostic tool in diagnosing atypical co infections which in some instance leads to overwhelming diagnosis of co infections and improper treatment.

False sero-positivity of Salmonella typhi Specific Antibody in Dengue and Corona Virus Infected Patients: An Observational Study

“…The result of our study on 80 patients which included dengue and COVID-19 positive patients and 30 healthy control subjects showed around two in four subjects serum samples antibody titre of Salmonella enteric serovar typhi O and H antigen were more than 1:20 and 1:40, which is similar to the study done by Ramya and Sunitha where they found 42% of their study population had anti O titers above 1:20 and 52% had anti H titres above 1:20 against serotype S.typhi. 1 In the present study, among the dengue IgM positive patients 20% samples antibody titre of O Ag of Salmonella enteric serovar typhi were 1:80 and antibody titre for H antigen were 1:160, and they also showed IgM positive bands on ICT test. However, their blood culture showed no growth after 5 days of incubation and clinically no signs and symptoms of typhoid fever.…”

“…Typhoid and Dengue fever are the most concurrent diseases in the tropical country for many years and along with these, coronavirus emerged as one of the most lethal disease in the world. 1 Although these diseases are caused by two separate agents, they have some similar symptoms which can easily end up with misdiagnosis. So, diagnosis of the causative agents is important in the treatment of these diseases which are directly related with population density, urbanization, endemicity, mobility as well as mortality.…”