RESUMO
Aims: This study was aimed at generating updated baseline data on co-infection of malaria and typhoid fever and finding out the implications of these co-infections in disease severity. Study Design: The study was cross-sectional. Place and Duration of Study: The study was carried out in Kumba, Southwest Cameroon from May to July, 2010. Methodology: Venous blood was collected from 206 febrile patients of both sexes aged 4-80 years old at the Kumba District Hospital. Malaria parasite density and speciation were determined using Giemsa-stained thick and thin blood films respectively. Typhoid fever was diagnosed by isolation and characterisation of the aetiologic agent from stool samples in 178/206 patients. Antimicrobial susceptibility of recovered isolates was determined by the disc diffusion method. Anaemia status, Alanine aminotransferase (ALT) and Aspatate aminotransferase (AST) values were determined. Results: Overall malaria prevalence was 90.3% (186/206) while geometric mean parasite density (GMPD) was 866 (range: 40 – 64880) parasites/μL of blood. Plasmodium falciparum was the most prevalent Plasmodium species. Overall prevalence of typhoid fever was 7.9% (14/178) while malaria/typhoid fever co-infection rate was 6.74% (12). Of the 14 typhoidal Salmonella isolates recovered, 6 were identified as Salmonella typhi and 8 as S. paratyphi. The Salmonella isolates were all susceptible to ciprofloxacin and gentamycin. Patients co-infected with malaria/typhoid fever had a significantly higher (P = .007) GMPD (1203, range: 100-64880 parasites/μL) when compared to patients with mono-infections of malaria (774, range: 40-18660 parasites/μL). Abnormal ALT and anorexia prevalence values were significantly higher (P=.01 and P =.045 respectively) in patients with only typhoid fever than their counterparts. The values of anaemia and AST were comparable in all groups of patients. Conclusion: This study confirms that co-infections of malaria and typhoid fever are common and may exacerbate malaria intensity.
RESUMO
Aim: The aim of this study was to determine the prevalence and density of malaria parasites in asymptomatic school children in Mutengene and evaluate the performance characteristics of the ‘CareStartTM Malaria HRP2 pf (CAT NO: G0141, ACCESSBIO)’ rapid diagnostic test (RDT) using light microscopy as a gold standard. Study Design: The study was a cross-sectional survey. Place and Duration of Study: The study was carried out in Mutengene, from February to March, 2013. Methodology: A total of 406 pupils were studied. Demographic data was taken for each child and capillary blood was collected. Blood films were prepared for the assessment of parasite density and speciation. A drop of blood was used on the RDT to determine the malaria status. Results: The mean age at 95% confidence interval (CI) was 8 ± 2 years (range = 4 -15 years) and the overall prevalence of malaria was 39.9% (162) by microscopy. The geometric mean parasite density (GMPD) was 2332.7 parasites/µL (range: 218 - 16000). Only 386 pupils were examined by both methods. More pupils were positive by microscopy (40.9%, CI = 36.1 - 45.9) than by RDT (27.9%, CI = 23.7 - 32.7) and the difference was statistically significant (χ2 = 16.1, P <0.0001). The majority of those detected had high infection (≥ 5000 parasite/µL). Less than 50% of those with low (25.0%, CI = 12.0 - 44.9), moderate (40.7%, CI = 32.24-49.70) and high parasitaemia (75%, CI = 5.00-89.82) were positive by RDT and the difference was significant (χ2 = 10.09, P = 0.006). The RDT showed a low sensitivity of 48.5% (CI = 40.3 – 56.9%) and specificity of 84.0% (CI = 80.0- 88.2%). Conclusion: More research needs to be done on the RDT to improve on its performance characteristics before it could be used in mass surveillance programmes.
RESUMO
Aim: This work was aimed to assess the influence of socio-demographic and environmental factors on the incidence of asymptomatic malaria and anaemia among pupils in Fako Division, southwest Cameroon. Experimental Design: The study was a cross-sectional survey. Place and Duration of Study: The study was carried out in Fako Division, southwest Cameroon -Bolifamba, Dibanda and Mutengene from February to March, 2013. Methodology: A total of 316 pupils aged 4–15 years were studied. Data on sociodemographic and environmental factors was obtained from a semi-structured questionnaire. Blood samples were collected. Malaria parasite incidence and densitywere determined from Giemsa-stained thin and thick blood smears respectively. Haemoglobin (Hb) levels were determined using a haemoglobinometer. Results: The overall incidence of asymptomatic malaria was 43.4% (CI=38-48.9). Malaria incidence was significantly highest (χ2=7,P=0.03) in pupils of 6-10 years age group (49.0%, CI=42.1-59.9) when compared with their counterparts. Although not significant, malaria parasite incidence was higher in males, pupils with fever, highest in pupils of Bolifamba and poor social status than their respective counterparts. Geometric mean parasite density (GMPD) was significantly highest (Kruskal Wallis test, *χ2=6.4, P=0.04) in Dibandathan other sites. Anaemia incidence was higher among inhabitants of Dibanda (56.7%) than other sites. Anaemia incidence was statistically higher (χ2=5.6, P=0.02) in malaria positive pupils, highest in Dibanda (χ2=27.244, P<0.001) and the middle class when compared with their respective counterparts. Mean HB was significantly higher in malaria negative (t=1-8, P=0.02), highest in the poor class (χ2=13.4, P=0.001) and Mutengene (F=21.2, P=0.0001) when compared with their respective counterparts. Conclusion: Sensitization on effective malaria control strategies needs to be emphasized so that a reduction in malaria burden can be achieved.