Malaria and Typhoid Fever Coinfection in the Hospital University of Bobo-Dioulasso, Burkina Faso

Abstract

Malaria and typhoid fever are two endemic infectious diseases in developing tropical countries including Burkina Faso. There are two distinct infectious diseases with many similar clinical signs. In each sanitary area, it is important to describe the "typhomalaria" epidemiology to elaborate adequate diagnosis algorithm and efficient treatment protocol. A cross-sectional study was carried out from July to October 2014 in the lab department of University Hospital Souro SANOU, Bobo-Dioulasso. All microscopy positive malaria during the study period was included. Serodiagnosis of Widal and Felix was performed systematically in all Plasmodium spmalaria cases. Titers of antibodies anti-agglutinin O equal or higher than 1/400 and/or 1/800 for anti-agglutinin H antibodies were considered positive for Salmonella sp. A total of 283 malaria cases were included in this study, majority falciparum malaria. In this malaria cases, 91 patients were seropositive for Salmonella sp. "Typhomalaria" co-infection prevalence was 34.3% (CI 95% (28.8%; 40.1%)). The patient with the normal hemoglobin rate had the highest prevalence of co-infection (46.7% versus 30.9; p=0.02). Malaria and typhoid fever co-infection was high (approximately 1/3 of malaria cases) in University hospital of Bobo-Dioulasso. This study revealed the need to explore typhoid fever in malaria confirmed cases, especially in persistent fevers and non-anemic situation despite adapting antimalarial treatment.

Prevalence, probability, and outcomes of typhoidal/non-typhoidal Salmonella and malaria co-infection among febrile patients: a systematic review and meta-analysis

“…In Africa, 61 studies (75.3%) were conducted; in Asia, 19 studies (23.4%); and in Europe, 1 study. The African studies were conducted in Nigeria (30/61, 49.2%) 36 – 38 , 42 , 47 , 48 , 50 , 51 , 57 , 59 , 61 , 64 , 75 , 77 , 82 – 84 , 89 – 91 , 94 – 101 , 103 , 107 , Cameroon (5/61, 8.2%) 35 , 40 , 73 , 92 , 93 , Ghana (5/61, 8.2%) 41 , 53 , 56 , 76 , 85 , Kenya (5/61, 6.2%) 28 , 29 , 60 , 72 , 80 , Tanzania (4/61, 6.56%) 20 , 39 , 44 , 46 , Malawi 17 , 27 , 30 , Burkina Faso 54 , 86 , Mozambique 79 , Sierra Leone 87 , the Democratic Republic of the Congo 49 , Ethiopia 45 , Gabon 55 , and Gambia 31 , and one study was conducted in Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania 62 . The Asian studies were conducted in India (12/19, 63.2%) 43 , 66 – 68 , 71 , 74 , 81 , 88 , 104 –…”

“…Among the 81 studies included in the analysis, 49 studies (60.5%) enrolled febrile patients 35 – 41 , 43 – 47 , 50 – 53 , 55 , 57 , 59 , 62 , 64 – 68 , 70 – 77 , 81 , 83 , 84 , 87 , 89 , 90 , 92 , 93 , 95 , 98 , 102 – 108 , 8 studies enrolled pregnant women 42 , 61 , 82 , 91 , 94 , 96 , 100 , 101 , 6 studies enrolled patients with severe malaria 30 , 54 , 63 , 79 , 80 , 85 , 9 studies enrolled malaria positive patients 28 , 48 , 56 , 58 , 60 , 69 , 78 , 86 , 88 , 5 studies enrolled typhoid/non-typhoid-positive patients 17 , 27 , 29 , 31 , 49 , and one study enrolled children with pathogenic bacteremia 20 . Co-infections with malaria and typhoidal/NTS were reported in 4,523 cases from 73,775 total patients enrolled in the 81 included studies.…”

“…Co-infections with malaria and typhoidal/NTS were reported in 4,523 cases from 73,775 total patients enrolled in the 81 included studies. Co-infections with malaria and typhoidal Salmonella spp., including S. typhi and S. paratyphi , were reported in 3813 cases from 56 studies 31 , 36 , 38 , 39 , 41 – 43 , 45 – 48 , 50 – 52 , 57 , 59 , 61 , 65 – 68 , 70 , 71 , 73 – 78 , 81 – 84 , 86 – 108 . Co-infections with malaria and NTS, such as S. typhimurium , were reported in 707 cases from 18 studies 17 , 27 – 31 , 44 , 53 , 56 , 60 , 62 , 69 , 72 , 79 , 80 , 84 , 85 , 93 .…”

“…Salmonella spp. infection was identified using blood cultures (39/81, 48.1%) 17 , 20 , 27 – 31 , 37 , 38 , 44 , 47 , 49 , 50 , 53 , 54 , 56 – 58 , 60 , 62 , 63 , 66 , 68 , 69 , 71 , 72 , 74 , 77 – 81 , 83 , 85 , 89 , 98 , 104 – 106 , 108 , Widal test (27/81, 33.3%) 36 , 40 , 41 , 43 , 45 , 46 , 48 , 51 , 52 , 59 , 61 , 67 , 70 , 75 , 86 – 88 , 90 , 94 , 96 , 97 , 99 – 103 , stool cultures (5/81, 6.17%) 82 , 84 , 92 , 93 , 107 , RDTs (4/81, 4.94%) 35 , 42 , 73 , 91 , and molecular methods (3/43, 6.98%) 39 , 55 , 64 . One study …”

“…The pooled prevalence rate of typhoidal/NTS infection among malaria patients was estimated from 57 studies 28 , 35 – 41 , 43 – 48 , 50 – 53 , 55 – 60 , 64 – 66 , 68 – 71 , 73 , 75 – 78 , 81 , 83 , 84 , 86 – 90 , 92 , 93 , 95 , 97 – 99 , 102 – 108 . The studies were divided into groups based on diagnostic tests for Salmonella spp.…”