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      Magnitude of Malaria-Typhoid Fever Coinfection in Febrile Patients at Arba Minch General Hospital in Southern Ethiopia

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          Abstract

          Background

          Coinfection with malaria and typhoid fever is a major public health issue in developing countries. In endemic areas, including Ethiopia, people are at risk of acquiring both malaria and typhoid fever at the same time. Therefore, this study aimed to determine the magnitude of malaria-typhoid fever coinfection in febrile patients attending hospital at Southern Ethiopia.

          Methods

          A hospital-based cross-sectional study was carried out on 416 febrile patients attending Arba Minch General Hospital from 1 st October to 30 th December 2021. The data was collected using a pretested structured questionnaire. Capillary and Venus blood samples were collected for assessing malaria and typhoid fever, respectively. Blood smear, culture, and biochemical tests were performed based on standard parasitological and microbiological methods. The P-value ≤ 0.05 was considered statistically significant.

          Results

          The magnitude of malaria, typhoid fever, and their coinfections was 26.2% (109/416), 6.5% (27/416), and 3.1% (13/416), respectively. Among the confirmed malaria cases, about 66% of infections were Plasmodium falciparum. The malaria-typhoid fever coinfection showed a statistically significant association with a clinical presentation of a continuous pattern of fever (AOR = 5.84; 95% CI: 1.44–23.71, P = 0.014) and chills (AOR = 3.94; 95% CI: 1.04–14.89, P = 0.044). About 29.6% of Salmonella isolates were multidrug-resistant (MDR).

          Conclusion

          The total rate of coinfection with malaria and typhoid fever was comparable to that of previous studies. With the consideration of higher prevalence of drug resistance of Salmonella spp. and higher prevalence of malaria‐typhoid fever coinfection, proper diagnostic procedure should be implemented for proper use of drugs.

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          Most cited references42

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          Fever, fever patterns and diseases called 'fever'--a review.

          Fever is a prominent feature of disease since antiquity. The febrile response is orchestrated by the central nervous system through endocrine, neurological, immunological and behavioural mechanisms. Other than a regulated rise in body temperature, fever is often accompanied by various sickness behaviours, changes in metabolic and physiological characteristics of body systems and alterations in immune responses. Fever and the febrile response, therefore, remain significant contributors to the pathogenesis, clinical presentation and outcome of many illnesses and diseases. This review highlights the pathophysiology of the febrile response and describes the fever types and patterns, including their clinical significance. The various medical illnesses called "fever" are also listed and the origins of their appellations discussed. Copyright © 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.
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            Prevalence of malaria infection in Butajira area, south-central Ethiopia

            Background In 2005, the Ethiopian government launched a massive expansion of the malaria prevention and control programme. The programme was aimed mainly at the reduction of malaria in populations living below 2,000 m above sea level. Global warming has been implicated in the increase in the prevalence of malaria in the highlands. However, there is still a paucity of information on the occurrence of malaria at higher altitudes. The objective of this study was to estimate malaria prevalence in highland areas of south-central Ethiopia, designated as the Butajira area. Methods Using a multi-stage sampling technique, 750 households were selected. All consenting family members were examined for malaria parasites in thick and thin blood smears. The assessment was repeated six times for two years (October 2008 to June 2010). Results In total, 19,207 persons were examined in the six surveys. From those tested, 178 slides were positive for malaria, of which 154 (86.5%) were positive for Plasmodium vivax and 22 (12.4%) for Plasmodium falciparum; the remaining two (1.1%) showed mixed infections of Plasmodium falciparum and Plasmodium vivax. The incidence of malaria was higher after the main rainy season, both in lower lying and in highland areas. The incidence in the highlands was low and similar for all age groups, whereas in the lowlands, malaria occurred mostly in those of one to nine years of age. Conclusion This study documented a low prevalence of malaria that varied with season and altitudinal zone in a highland-fringe area of Ethiopia. Most of the malaria infections were attributable to Plasmodium vivax.
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              The Relationship Between Blood Sample Volume and Diagnostic Sensitivity of Blood Culture for Typhoid and Paratyphoid Fever: A Systematic Review and Meta-Analysis

              Abstract Background Blood culture is the standard diagnostic method for typhoid and paratyphoid (enteric) fever in surveillance studies and clinical trials, but sensitivity is widely acknowledged to be suboptimal. We conducted a systematic review and meta-analysis to examine sources of heterogeneity across studies and quantified the effect of blood volume. Methods We searched the literature to identify all studies that performed blood culture alongside bone marrow culture (a gold standard) to detect cases of enteric fever. We performed a meta-regression analysis to quantify the relationship between blood sample volume and diagnostic sensitivity. Furthermore, we evaluated the impact of patient age, antimicrobial use, and symptom duration on sensitivity. Results We estimated blood culture diagnostic sensitivity was 0.59 (95% confidence interval [CI], 0.54–0.64) with significant between-study heterogeneity (I 2 , 76% [95% CI, 68%–82%]; P < .01). Sensitivity ranged from 0.51 (95% CI, 0.44–0.57) for a 2-mL blood specimen to 0.65 (95% CI, 0.58–0.70) for a 10-mL blood specimen, indicative of a relationship between specimen volume and sensitivity. Subgroup analysis showed significant heterogeneity by patient age and a weak trend towards higher sensitivity among more recent studies. Sensitivity was 34% lower (95% CI, 4%–54%) among patients with prior antimicrobial use and 31% lower after the first week of symptoms (95% CI, 19%–41%). There was no evidence of confounding by patient age, antimicrobial use, symptom duration, or study date on the relationship between specimen volume and sensitivity. Conclusions The relationship between the blood sample volume and culture sensitivity should be accounted for in incidence and next-generation diagnostic studies.
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                Author and article information

                Contributors
                Journal
                J Trop Med
                J Trop Med
                jtm
                Journal of Tropical Medicine
                Hindawi
                1687-9686
                1687-9694
                2022
                1 August 2022
                : 2022
                : 2165980
                Affiliations
                1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
                2School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
                3Department of Pharmacy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
                Author notes

                Academic Editor: Wenping Gong

                Author information
                https://orcid.org/0000-0003-0574-6074
                https://orcid.org/0000-0002-6133-8860
                Article
                10.1155/2022/2165980
                10299876
                37383527
                a2ae9eb4-031e-42b3-bdcd-7306c11f451d
                Copyright © 2022 Sifray Batire et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 May 2022
                : 4 July 2022
                : 7 July 2022
                Funding
                Funded by: Arba Minch University College of Medicine And Health Sciences
                Categories
                Research Article

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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