Malaria and Typhoid Fever Coinfection Among Febrile Patients Attending a Health Facility in Yaoundé, Cameroon: A Cross-Sectional Study

TL;DR

This study examines how common malaria and typhoid fever are among fever patients in Cameroon, finding high rates of both diseases and coinfections.

Contribution

The study provides new prevalence data and identifies risk factors for malaria, typhoid fever, and their coinfection in Yaoundé, Cameroon.

Findings

Malaria and typhoid fever affected 62.5% of febrile patients, with coinfection at 19.79%.

Fever and profuse sweating were significantly associated with coinfection.

Environmental factors like nearby water ponds and drinking water sources were linked to disease risk.

Abstract

Malaria and typhoid fever are significant public health challenges in tropical regions, with Cameroon serving as a notable example of their endemicity. This study is aimed at determining the prevalence of malaria, typhoid fever, and their coinfection and assessing associated risk factors among febrile patients attending a tertiary hospital.

A cross-sectional study was conducted between June and August 2023 at the Etoug-Ebe Baptist Hospital in Yaoundé, Cameroon. Two hundred and eighty-eight febrile patients aged over 2 years, suspected of having malaria and/or typhoid fever, were enrolled after obtaining informed consent from adults or a legal representative for minors. Data were collected using a structured case report form (CRF). Malaria diagnosis involved a rapid diagnostic test (RDT) for screening, followed by confirmation with thick blood smear microscopy. For typhoid fever diagnosis, a combination of serological testing (Widal and IgM/IgG rapid tests) and rapid stool antigen detection (for Salmonella O and H antigens) was used. Data analysis was conducted using SPSS Version 26 and GraphPad Prism Version 9 software.

Out of the 288 participants, 179 (62.5%) tested positive for malaria and/or typhoid fever. According to our diagnostic algorithm, the prevalence rates for malaria, typhoid fever, and coinfection were 44.79% (n = 129), 37.15% (n = 107), and 19.79% (n = 57), respectively. Coinfection was significantly associated with fever (χ2 = 7.092, p = 0.008) and profuse sweating (χ2 = 3.774, p = 0.05), while jaundice was linked to typhoid fever (χ2 = 4.777, p = 0.029). Notable risk factors for malaria and typhoid fever included the presence of ponds of water and/or clumps of grass around the house and the main source of drinking water.

Malaria and typhoid fever were prevalent among febrile patients in Yaoundé, with malaria emerging as the leading cause and notable levels of coinfection. Clinical symptoms and environmental risk factors were associated with disease occurrence, underscoring the need for strengthened control strategies.

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