Typhoid Fever in Sub-Saharan Africa: Challenges of Diagnosis and Management of Infections

Typhoid fever; caused by Salmonella enterica serovar Typhi (S. Typhi); is a disease transmitted by the faecal-oral route. It continues to be a public health problem in many developing countries in sub-Saharan Africa. School-age children; especially those from resource-poor settings with inadequate water and sanitation systems; are dispropor- tionately affected. It is estimated that a total of 400;000 cases occur annually in Africa; an incidence of 50 per 100;000 persons per year. Lack of effective diagnosis often leads to inappropriate treatment and management of these infections. Additionally; the emergence and spread of S. Typhi strains having multiple resistance to nearly all commonly available drugs in most developing countries has been a major challenge to health care systems; reducing the effective treatment options for the disease; increasing treatment costs and increasing the risk of complications and death. Although not much data from sub-Saharan Africa has been published; it seems clear that typhoid is common in Nigeria; Mali; Ethiopia and Kenya. Given the importance of information on disease incidence for targeting control measures; including improved sanitation and water supply; vaccination and assessing impact; priority should be given to strengthening surveillance systems for typhoid fever

Antibacterial Activity of Thonningia sanguinea against some Multi-Drug Resistant Strains of Salmonella enterica

Background : The emergence of strains of S.enterica with multiple drug resistance (MDR) is of great concern worldwide.The extracts of flowers of Thonningia sanguinea are used in traditional medicine in Ivory Coast to treat diarrhoeal diseases including salmonellosis. Previous studies had shown inhibition of the MDR strain Salmonella Enteritidis lysotype 6. Objectives: The present study focused to investigate the effect of the extract of the flowers of Thonningia sanguinea on some clinical MDR strains of Salmonella namely S.Tyhpi; S. Typhimurium; S. Hadar and a sensitive strain (S.Enteritidis). Methods : The antimicrobial parameters were determined by double dilution with agar slant method. This method led us to determine MIC; IC 50 and MBC. Results: The MDR strain of S.Typhimurium presented the highest MIC (2.5 mg/ml) whereas the other two MDR strains (S.Hadar; S.Typhi) and the sensitive one (S.Enteritidis) had the same MIC (1.25 mg/ml). The four strains presented the same MBC (2.5 mg/ml). The MDR strain of S.Typhi is the most susceptible strain to the aqueous extract of the flowers of Thonningia sanguinea according to The IC 50 values. Conclusions: The aqueous extract of Thonningia sanguinea can provide an alternative therapy for the treatment of salmonellosis; mainly for typhoid fever caused by MDR strains of S Typhi. The extract also inhibits S.Hadar a MDR emerging strain in Ivory Coast