High Occurrence of Typhoid Fever and Malaria Co-Infection Among Patients Clinically Diagnosed of Malaria and or Typhoid Infection in CALABAR, NIGERIA

ABSTRACT
Background: The occurrence of typhoid fever and malaria co-infection among patients clinically diagnosed of malaria/ and or typhoid fever was investigated in Calabar, Nigeria. Both disorders present with febrile illness. Materials and Methods: Venous blood collected from the study subjects were examined for the presence of Salmonella antibodies using the Slide Widal test (screening test) and the Tube Widal test (confirmatory test) whereas the diagnosis of malaria was based on the examination of a thin and thick blood films stained with 2% Giemsa. Results: The prevalence of malaria and typhoid was 26.7% and 43.3% whereas the prevalence of co-infection of typhoid and malaria was 14.6%. There was no statistically significant difference in the prevalence of malaria by age of patients (P˃0.05, X2=2.934). Males 21(30.9%) were more infected with malaria than females 19(23.2%), although there was no statistically significant difference in the prevalence of infection by gender (P˃0.05, X2=0.651). There was no statistically significant difference in the prevalence of typhoid by age of subjects (P˃0.05, X2 =7.3). More females 38(46.3%) were infected with typhoid fever than males 27(39.7%) although there was no statistically significant difference in the prevalence of typhoid by gender (P˃0.05, X2= 0.269). Age (P˃0.05, X2 =14.66) and gender (P˃0.05, X2 =7.62) did not significantly affect the prevalence of co-infection of malaria and typhoid. Subjects aged 46-60 years had the highest co-infection rate of 5(20.0%) while those aged 1-15 years had the least infection 1(5.0%). The occurrence of co-infection among males and females were 9(13.2%) and 12(14.6%) respectively. Conclusions: This study confirmed a high prevalence of malaria (26.7%), typhoid fever (43.3%) and co-infection of malaria and typhoid fever (14.0%) among subjects clinically diagnosed of malaria and / or typhoid fever. This study has confirmed that relying solely on the diagnosis of typhoid fever on results of slide widal test leads to over diagnosis of the infection and unwarranted administration of antibiotics.