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Nurmawati S, Alam A, Djauhari H, Merati TP, Sudarmono P, Setiawaty V, Arlinda D, Sugiyono RI, Arief M, Hadi U, Aman AT, Lokida D, Gasem MH, Tjitra E, Liang CJ, Neal A, Kosasih H, Karyana M, Lau CY, Alisjahbana B. Clinical characteristics of enteric fever and performance of TUBEX TF IgM test in Indonesian hospitals. PLoS Negl Trop Dis 2024; 18:e0011848. [PMID: 39052692 PMCID: PMC11315288 DOI: 10.1371/journal.pntd.0011848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 08/09/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Accurate diagnosis of enteric fever is challenging, particularly in low- and middle-income countries, due to the overlap of clinical and laboratory features with other pathogens. To better understand the difficulties in enteric fever diagnosis, we evaluated the characteristics of patients clinically diagnosed with enteric fever and the real-world performance of TUBEX TF, one of the most used tests in Indonesia. METHODOLOGY/PRINCIPAL FINDINGS Patients were recruited through the AFIRE (Etiology of Acute Febrile Illness Requiring Hospitalization) study at eight Indonesian hospitals. Blood culture was performed for all patients, and TUBEX TF was performed for suspected enteric cases. Salmonella PCR and ELISA tests were performed at a reference lab. Sensitivity and specificity of TUBEX TF and IgM and IgG anti-S. Typhi ELISA were determined. Of 301 patients clinically diagnosed with enteric fever, 50 (16.6%) were confirmed by blood culture and/or PCR. Confirmed cases were mostly school-aged children presenting with fever, anorexia, dizziness and/or abdominal pain with normal leukocyte count or leukopenia. TUBEX TF demonstrated a sensitivity of 97.6% to 70.7% and specificity of 38.3% to 67.2% at cutoffs of 4 and 6, respectively. Acute IgG demonstrated the best sensitivity and specificity, at 90.7% and 82.7%, respectively, and the best ROC characteristics. CONCLUSIONS/SIGNIFICANCE A substantial proportion of enteric fever was misdiagnosed at all study hospitals, likely due to the overlap of clinical characteristics and lab parameters with those of other common pathogens. The TUBEX TF rapid serological assay demonstrated suboptimal performance in our setting and tended to over-diagnose enteric fever. The role of IgG from acute specimens for identification of enteric fever cases merits additional consideration.
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Affiliation(s)
- Syndi Nurmawati
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia
| | - Anggraini Alam
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Pediatric Department, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Hofiya Djauhari
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia
| | - Tuti P. Merati
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - Pratiwi Sudarmono
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Faculty of Medicine, Universitas Indonesia, Central Jakarta, Indonesia
| | - Vivi Setiawaty
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Prof. Dr. Sulianti Saroso Infectious Disease Hospital, North Jakarta, Indonesia
| | - Dona Arlinda
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Health Policy Agency, Ministry of Heath, Central Jakarta, Indonesia
| | - Retna Indah Sugiyono
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Health Policy Agency, Ministry of Heath, Central Jakarta, Indonesia
| | - Mansyur Arief
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - Usman Hadi
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Abu Tholib Aman
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Dr. Sardjito General Hospital/Faculty of Medicine, Universitas Gadjah Mada, Sleman, Indonesia
| | - Dewi Lokida
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Tangerang General Hospital, Tangerang, Indonesia
| | - M. Hussein Gasem
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Dr. Kariadi General Hospital/Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Emiliana Tjitra
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Health Policy Agency, Ministry of Heath, Central Jakarta, Indonesia
| | - C. Jason Liang
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Aaron Neal
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Herman Kosasih
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
| | - Muhammad Karyana
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Health Policy Agency, Ministry of Heath, Central Jakarta, Indonesia
| | - Chuen-Yen Lau
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Bachti Alisjahbana
- Indonesia Research Partnership on Infectious Diseases (INA-RESPOND), Central Jakarta, Indonesia
- Research Center for Care and Control of Infectious Disease, Universitas Padjadjaran, Bandung, Indonesia
- Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
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Geteneh A, Tadesse S, Biset S, Girma L, Fissiha P. Rapid stool antigenic test for typhoid fever among suspected cases, Northeast, Ethiopia. Sci Rep 2023; 13:649. [PMID: 36635427 PMCID: PMC9837061 DOI: 10.1038/s41598-023-27909-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 01/10/2023] [Indexed: 01/14/2023] Open
Abstract
Typhoid fever continued to be the key cause of morbidity and mortality in developing countries with poor hygienic practices and limited access to safe drinking water. The Widal card agglutination test is the main diagnostic tool in Ethiopia, which is limited in differentiating the overlapping symptoms with other acute febrile illnesses such as malaria and viral enteritis. This eventually leds to unnecessary antibiotic use and eventual drug resistance. Therefore this study wants to assess the burden and associated potential risk factors of typhoid fever among suspected cases using the typhoid rapid stool antigen test in Northeast Ethiopia. A hospital-based cross-sectional study was conducted at Gaint and Meket Shediho primary hospitals from May to July 2021. A total of 255 patients clinically suspected of typhoid fever, and willing to grant informed consent were included systematically. The demographic and hygiene-related variables were collected using a pre-tested structured questionnaire. The rapid stool antigenic test and xylose-lysine-deoxycholate agar (XLD) stool culture were evaluated for the level of agreement. The present study indicated that the prevalence of typhoid fever was 15.3%. This displayed that the human-restricted infectious disease, typhoid fever remained a challenge to Ethiopians. Washing hands with soap, history of typhoid fever, having previous history of hospitalization, and chronic underlying disease was the significant potential factor for typhoid fever. The higher agreement of the rapid stool antigenic test with the stool culture can indicate the factual burden of typhoid fever in the suspected population. This could minimize empiric treatment and the possible emergence of drug resistance. Thus, resource-poor settings may need to look for a rapid and reliable stool antigenic test.
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Affiliation(s)
- Alene Geteneh
- Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia.
| | - Selamyhun Tadesse
- grid.507691.c0000 0004 6023 9806Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Sirak Biset
- grid.59547.3a0000 0000 8539 4635Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Lencho Girma
- Department of Medical Laboratory Science, Mizan Aman College of Health Sciences, Aman, Ethiopia
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Winters M, Oppenheim B, Sengeh P, Jalloh MB, Webber N, Pratt SA, Leigh B, Molsted-Alvesson H, Zeebari Z, Sundberg CJ, Jalloh MF, Nordenstedt H. Debunking highly prevalent health misinformation using audio dramas delivered by WhatsApp: evidence from a randomised controlled trial in Sierra Leone. BMJ Glob Health 2021; 6:bmjgh-2021-006954. [PMID: 34758970 PMCID: PMC8578963 DOI: 10.1136/bmjgh-2021-006954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/17/2021] [Indexed: 01/23/2023] Open
Abstract
Introduction Infectious disease misinformation is widespread and poses challenges to disease control. There is limited evidence on how to effectively counter health misinformation in a community setting, particularly in low-income regions, and unsettled scientific debate about whether misinformation should be directly discussed and debunked, or implicitly countered by providing scientifically correct information. Methods The Contagious Misinformation Trial developed and tested interventions designed to counter highly prevalent infectious disease misinformation in Sierra Leone, namely the beliefs that (1) mosquitoes cause typhoid and (2) typhoid co-occurs with malaria. The information intervention for group A (n=246) explicitly discussed misinformation and explained why it was incorrect and then provided the scientifically correct information. The intervention for group B (n=245) only focused on providing correct information, without directly discussing related misinformation. Both interventions were delivered via audio dramas on WhatsApp that incorporated local cultural understandings of typhoid. Participants were randomised 1:1:1 to the intervention groups or the control group (n=245), who received two episodes about breast feeding. Results At baseline 51% believed that typhoid is caused by mosquitoes and 59% believed that typhoid and malaria always co-occur. The endline survey was completed by 91% of participants. Results from the intention-to-treat, per-protocol and as-treated analyses show that both interventions substantially reduced belief in misinformation compared with the control group. Estimates from these analyses, as well as an exploratory dose–response analysis, suggest that direct debunking may be more effective at countering misinformation. Both interventions improved people’s knowledge and self-reported behaviour around typhoid risk reduction, and yielded self-reported increases in an important preventive method, drinking treated water. Conclusion These results from a field experiment in a community setting show that highly prevalent health misinformation can be countered, and that direct, detailed debunking may be most effective. Trial registration number NCT04112680.
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Affiliation(s)
- Maike Winters
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ben Oppenheim
- Center on International Cooperation, New York University, New York, New York, USA.,Metabiota, San Francisco, California, USA
| | | | | | | | | | - Bailah Leigh
- College of Medicine and Allied Health Sciences, Freetown, Sierra Leone
| | | | - Zangin Zeebari
- Department of Economics, Finance and Statistics, Jönköping International Business School, Jönköping, Sweden
| | - Carl Johan Sundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Mohamed F Jalloh
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Helena Nordenstedt
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Robertine LF, Payne VK, Honorine NT, Mounchili S, Saturine MM, Manjuh BR, Aboubakar NN, Roland B. Trends of potential waterborne diseases at different health facilities in Bamboutos Division, West Region, Cameroon: a retrospective appraisal of routine data from 2013 to 2017. JOURNAL OF WATER AND HEALTH 2021; 19:616-628. [PMID: 34371498 DOI: 10.2166/wh.2021.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Many Cameroonian cities lack access to potable drinking water where populations rely on alternative water sources of doubtful quality. This study aimed at describing the trends and patterns of waterborne diseases (WBDs) reported in some health facilities in Bamboutos Division between 2013 and 2017 as baseline data towards understanding the profile of WBDs in this area. A retrospective review of clinical data kept on patients who visited the main health facilities in Bamboutos Division from January 2013 to December 2017 was conducted. Overall, 39.1% (n = 8,124) of total patients were positive for at least one WBD. Categories of WBDs were dysenteries (18.6%), gastroenteritis (4.2%), viral hepatitis (0.2%) and typhoid was the most preponderant (24.4%). The most affected age groups were those above 24 years but significant differences were observed only in 2013 and 2017. Distribution of potential WBDs was locality dependent. The highest prevalence of typhoid fever was recorded in Bameboro (35.4%), dysenteries in Bamedjinda (20.4%) and gastroenteritis (17.3%) in Bamekoumbou. The study shows very high overall prevalence of WBDs in some localities which could be considered as 'hotspots' of WBDs in Bamboutos. This suggests the urgent need for setting up measures to tackle the challenges of potable drinking water supply.
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Affiliation(s)
- Lontuo-Fogang Robertine
- Research Unit of Applied Biology and Ecology (URBEA), Department of Animal Biology, Faculty of Science, University of Dschang, P.O. Box 067, Dschang, Cameroon E-mail:
| | - Vincent Khan Payne
- Research Unit of Applied Biology and Ecology (URBEA), Department of Animal Biology, Faculty of Science, University of Dschang, P.O. Box 067, Dschang, Cameroon E-mail:
| | - Ntangmo Tsafack Honorine
- Research Unit of Applied Biology and Ecology (URBEA), Department of Animal Biology, Faculty of Science, University of Dschang, P.O. Box 067, Dschang, Cameroon E-mail:
| | - Souleman Mounchili
- Malaria Research Laboratory, Organisation de Coordination pour la lutte contre les Endémies en Afrique centrale (OCEAC), BP 288 Yaoundé, Cameroon
| | - Matango Murielle Saturine
- Research Unit of Applied Biology and Ecology (URBEA), Department of Animal Biology, Faculty of Science, University of Dschang, P.O. Box 067, Dschang, Cameroon E-mail:
| | - Bup Rita Manjuh
- Research Unit of Applied Biology and Ecology (URBEA), Department of Animal Biology, Faculty of Science, University of Dschang, P.O. Box 067, Dschang, Cameroon E-mail:
| | - Ngouyamsa Nsapkain Aboubakar
- Research Unit of Applied Biology and Ecology (URBEA), Department of Animal Biology, Faculty of Science, University of Dschang, P.O. Box 067, Dschang, Cameroon E-mail:
| | - Bamou Roland
- Research Unit of Applied Biology and Ecology (URBEA), Department of Animal Biology, Faculty of Science, University of Dschang, P.O. Box 067, Dschang, Cameroon E-mail: ; Malaria Research Laboratory, Organisation de Coordination pour la lutte contre les Endémies en Afrique centrale (OCEAC), BP 288 Yaoundé, Cameroon
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Popoola O, Kehinde A, Ogunleye V, Adewusi OJ, Toy T, Mogeni OD, Aroyewun EO, Agbi S, Adekanmbi O, Adepoju A, Muyibi S, Adebiyi I, Elaturoti OO, Nwimo C, Adeoti H, Omotosho T, Akinlabi OC, Adegoke PA, Adeyanju OA, Panzner U, Baker S, Park SE, Marks F, Okeke IN. Bacteremia Among Febrile Patients Attending Selected Healthcare Facilities in Ibadan, Nigeria. Clin Infect Dis 2019; 69:S466-S473. [PMID: 31665773 PMCID: PMC6821210 DOI: 10.1093/cid/ciz516] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The relative contribution of bacterial infections to febrile disease is poorly understood in many African countries due to diagnostic limitations. This study screened pediatric and adult patients attending 4 healthcare facilities in Ibadan, Nigeria, for bacteremia and malaria parasitemia. METHODS Febrile patients underwent clinical diagnosis, malaria parasite testing, and blood culture. Bacteria from positive blood cultures were isolated and speciated using biochemical and serological methods, and Salmonella subtyping was performed by polymerase chain reaction. Antimicrobial susceptibility was tested by disk diffusion. RESULTS A total of 682 patients were recruited between 16 June and 16 October 2017; 467 (68.5%) were <18 years of age. Bacterial pathogens were cultured from the blood of 117 (17.2%) patients, with Staphylococcus aureus (69 [59.0%]) and Salmonella enterica (34 [29.1%]) being the most common species recovered. Twenty-seven (79.4%) of the Salmonella isolates were serovar Typhi and the other 7 belonged to nontyphoidal Salmonella serovarieties. Thirty-four individuals were found to be coinfected with Plasmodium falciparum and bacteria. Five (14.7%) of these coinfections were with Salmonella, all in children aged <5 years. Antimicrobial susceptibility testing revealed that most of the Salmonella and Staphylococcus isolates were multidrug resistant. CONCLUSIONS The study demonstrates that bacteria were commonly recovered from febrile patients with or without malaria in this location. Focused and extended epidemiological studies are needed for the introduction of typhoid conjugate vaccines that have the potential to prevent a major cause of severe community-acquired febrile diseases in our locality.
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Affiliation(s)
- Oluwafemi Popoola
- Department of Community Medicine, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria
- University College Hospital Ibadan, Nigeria
| | - Aderemi Kehinde
- University College Hospital Ibadan, Nigeria
- Department of Medical Microbiology and Parasitology, and, Nigeria
| | | | | | - Trevor Toy
- International Vaccine Institute, Seoul National University Research Park, Republic of Korea
| | - Ondari D Mogeni
- International Vaccine Institute, Seoul National University Research Park, Republic of Korea
| | | | - Sarah Agbi
- College of Medicine, University of Ibadan, Nigeria
| | - Olukemi Adekanmbi
- University College Hospital Ibadan, Nigeria
- Department of Medicine, University of Ibadan
| | - Akinlolu Adepoju
- University College Hospital Ibadan, Nigeria
- Department of Paediatrics, College of Medicine, University of Ibadan
| | | | | | | | | | | | | | - Olabisi C Akinlabi
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan
| | | | | | - Ursula Panzner
- International Vaccine Institute, Seoul National University Research Park, Republic of Korea
| | - Stephen Baker
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Se Eun Park
- International Vaccine Institute, Seoul National University Research Park, Republic of Korea
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Florian Marks
- International Vaccine Institute, Seoul National University Research Park, Republic of Korea
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Iruka N Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan
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Tchuandom SB, Tchouangueu TF, Antonio-Nkondjio C, Lissom A, Djang JON, Atabonkeng EP, Kechia A, Nchinda G, Kuiate JR. Seroprevalence of dengue virus among children presenting with febrile illness in some public health facilities in Cameroon. Pan Afr Med J 2018; 31:177. [PMID: 31086629 PMCID: PMC6488248 DOI: 10.11604/pamj.2018.31.177.16390] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/21/2018] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION A routine diagnosis of Dengue virus (DENV) infection is not usually conducted in hospitals. Because symptoms overlap, many potential febrile illnesses due to DENV may be confused for malaria, typhoid or paratyphoid (enteric) fever. The absence of data on DENV exposure rates among children attending health facilities could undermine management of this disease. This study aimed to investigate the seroprevalence of dengue virus infection in children presenting febrile illness in some public health facilities in Cameroon. METHODS A cross-sectional study was performed in children ≤ 15 years attending seven urban and three semi-urban public hospitals of Cameroon. From each volunteer, 2ml of whole blood was collected and tested for dengue virus IgM, malaria (Pf/Pan antigens) and enteric fever (Typhoid IgM) using rapid diagnostic tests (RDT); in order to allow the healthcare workers to quickly put the positive cases under appropriate treatment. Positive cases of dengue virus infection were confirmed by indirect ELISA. Data analysis were performed using the statistical package for social sciences software, version 22.1. RESULTS A total of 961 children were enrolled in the study and 492 (51.2%) were infected with at least one of the three pathogens. Overall, DENV IgM seroprevalence among febrile children was 14.4% (138/961). About 390 (40.6%) and 22 (2.3%) had malaria (Pf/Pan Ag) and enteric fever (Typhoid IgM) respectively. Co-infection with dengue virus was found in 51 (5.3%) participants. The dengue virus IgM seroprevalence was higher in Bankim (19.3%), Ntui (18.3%) and Douala (18.2%). CONCLUSION Dengue virus infection seroprevalence appears to be low in children presenting with febrile illness in the studied health centres in Cameroon but call for more attention and research to further characterise the circulating strains of the dengue virus.
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Affiliation(s)
- Salomon Bonsi Tchuandom
- Department of Biochemistry, University of Dschang, Cameroon
- Public School of medical Laboratory Technicians, Yaoundé, Cameroon
| | - Thibau Flaurant Tchouangueu
- Department of Biochemistry, University of Dschang, Cameroon
- Laboratory of Microbiology and Immunology, Chantal Biya International Reference Centre for Research and Prevention on HIV/AIDS Yaoundé
| | - Christophe Antonio-Nkondjio
- Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la lutte Contre les Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroun
| | - Abel Lissom
- Department of Animal Biology and Physiology, University of Yaoundé 1, Yaoundé
| | | | | | | | - Godwin Nchinda
- Laboratory of Microbiology and Immunology, Chantal Biya International Reference Centre for Research and Prevention on HIV/AIDS Yaoundé
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Barac R, Als D, Radhakrishnan A, Gaffey MF, Bhutta ZA, Barwick M. Implementation of Interventions for the Control of Typhoid Fever in Low- and Middle-Income Countries. Am J Trop Med Hyg 2018; 99:79-88. [PMID: 30047365 PMCID: PMC6128369 DOI: 10.4269/ajtmh.18-0110] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/05/2018] [Indexed: 01/12/2023] Open
Abstract
Past research has focused on typhoid fever surveillance with little attention to implementation methods or effectiveness of control interventions. This study purposefully sampled key informants working in public health in Chile, India, Pakistan, Bangladesh, Thailand, Vietnam, South Africa, and Nigeria to 1) scope typhoid-relevant interventions implemented between 1990 and 2015 and 2) explore contextual factors perceived to be associated with their implementation, based on the Consolidated Framework for Implementation Research (CFIR). We used a mixed methods design and collected quantitative data (CFIR questionnaire) and qualitative data (interviews with 34 public health experts). Interview data were analyzed using a deductive qualitative content analysis and summary descriptive statistics are provided for the CFIR data. Despite relatively few typhoid-specific interventions reportedly implemented in these countries, interventions for diarrheal disease control and regulations for food safety and food handlers were common. Most countries implemented agricultural and sewage treatment practices, yet few addressed the control of antibiotic medication. Several contextual factors were perceived to have influenced the implementation of typhoid interventions, either as enablers (e.g., economic development) or barriers (e.g., limited resources and habitual behaviors). Consolidated Framework for Implementation Research factors rated as important in the implementation of typhoid interventions were remarkably consistent across countries. The findings provide a snapshot of typhoid-relevant interventions implemented over 25 years and highlight factors associated with implementation success from the perspective of a sample of key informants. These findings can inform systematic investigations of the implementation of typhoid control interventions and contribute to a better understanding of the direct effects of implementation efforts.
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Affiliation(s)
- Raluca Barac
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
- Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - Daina Als
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | | | - Michelle F. Gaffey
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | - Zulfiqar A. Bhutta
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Melanie Barwick
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
- Research Institute, The Hospital for Sick Children, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
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Andualem G, Abebe T, Kebede N, Gebre-Selassie S, Mihret A, Alemayehu H. A comparative study of Widal test with blood culture in the diagnosis of typhoid fever in febrile patients. BMC Res Notes 2014; 7:653. [PMID: 25231649 PMCID: PMC4177418 DOI: 10.1186/1756-0500-7-653] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 09/11/2014] [Indexed: 11/15/2022] Open
Abstract
Background Typhoid fever is a major health problem in developing countries and its diagnosis on clinical ground is difficult. Diagnosis in developing countries including Ethiopia is mostly done by Widal test. However, the value of the test has been debated. Hence, evaluating the result of this test is necessary for correct interpretation of the result. The main aim of this study was to compare the result of Widal test and blood culture in the diagnosis of typhoid fever in febrile patients. Methods Blood samples were collected from 270 febrile patients with symptoms clinically similar to typhoid fever and visiting St. Paul’s General Specialized Hospitals from mid December 2010 to March 2011. Blood culture was used to isolate S.typhi and S.paratyphi. Slide agglutination test and tube agglutination tests were used for the determination of antibody titer. An antibody titer of ≥1:80 for anti TO and ≥1:160 for anti TH were taken as a cut of value to indicate recent infection of typhoid fever. Results One hundred and eighty six (68.9%) participants were females and eighty four (31.1%) were males. 7 (2.6%) cases of S. typhi and 4 (1.5%) cases of S. paratyphi were identified with the total prevalence of typhoid fever 4.1%. The total number of patients who have indicative of recent infection by either of O and H antigens Widal test is 88 (32.6%). The sensitivity, specificity, Positive predictive Value and Negative predictive Value of Widal test were 71.4%, 68.44%, 5.7% and 98.9% respectively. Conclusions Widal test has a low sensitivity, specificity and PPV, but it has good NPV which indicates that negative Widal test result have a good indication for the absence of the disease.
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Affiliation(s)
- Gizachew Andualem
- Department of Medical Laboratory Sciences, College of Medical Sciences, Haramaya University, Harar, Ethiopia.
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Parry CM, Wijedoru L, Arjyal A, Baker S. The utility of diagnostic tests for enteric fever in endemic locations. Expert Rev Anti Infect Ther 2014; 9:711-25. [DOI: 10.1586/eri.11.47] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Lunguya O, Phoba MF, Mundeke SA, Bonebe E, Mukadi P, Muyembe JJ, Verhaegen J, Jacobs J. The diagnosis of typhoid fever in the Democratic Republic of the Congo. Trans R Soc Trop Med Hyg 2012; 106:348-55. [DOI: 10.1016/j.trstmh.2012.03.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 03/16/2012] [Accepted: 03/16/2012] [Indexed: 10/28/2022] Open
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11
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Ahmed A, Ahmed B. Jaundice in typhoid patients: Differentiation from other common causes of fever and jaundice in the tropics. Ann Afr Med 2010; 9:135-40. [DOI: 10.4103/1596-3519.68361] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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12
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Comparative study of dot enzyme immunoassay (Typhidot-M) and Widal test in the diagnosis of typhoid fever. Indian Pediatr 2009; 47:331-3. [PMID: 19430063 DOI: 10.1007/s13312-010-0062-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Accepted: 12/22/2008] [Indexed: 10/19/2022]
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13
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Tam FC, Wang M, Dong B, Leung DT, Ma CH, Lim PL. New rapid test for paratyphoid a fever: usefulness, cross-detection, and solution. Diagn Microbiol Infect Dis 2008; 62:142-50. [DOI: 10.1016/j.diagmicrobio.2008.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2008] [Revised: 07/02/2008] [Accepted: 07/03/2008] [Indexed: 10/21/2022]
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Tam FCH, Ling TKW, Wong KT, Leung DTM, Chan RCY, Lim PL. The TUBEX test detects not only typhoid-specific antibodies but also soluble antigens and whole bacteria. J Med Microbiol 2008; 57:316-323. [PMID: 18287294 DOI: 10.1099/jmm.0.47365-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
TUBEX (IDL Biotech) is a 5 min semiquantitative colorimetric test for typhoid fever, a widely endemic disease. TUBEX detects anti-Salmonella O9 antibodies from a patient's serum by the ability of these antibodies to inhibit the binding between an indicator antibody-bound particle and a magnetic antigen-bound particle. Herein, we report that TUBEX could also be used to specifically detect soluble O9 lipopolysaccharide in antigen-spiked buffer by the ability of the antigen to inhibit the same binding between the particles. Sensitivity of antigen detection was improved (8-31 mug ml(-1)) by using a modified protocol in which the test sample was mixed with the indicator particles first, rather than with the magnetic particles as for antibody detection. The antigen was also detectable in spiked serum and urine samples, albeit less well (2-4-fold) than in buffer generally. However, no antigen was detected from six typhoid sera examined, all of which had anti-O9 antibodies. In addition, whole organisms of Salmonella Typhi (15 strains) and Salmonella Enteritidis (6 strains) (both O9(+) Salmonella), grown in simulated blood broths or on MacConkey agar, were also detectable by TUBEX when suspended at >9 x 10(8) organisms ml(-1). Expectedly, Salmonella Paratyphi A (7 strains), Salmonella Typhimurium (1 strain) and Escherichia coli (2 strains) were negative in the test. Thus, the same TUBEX kit may be used in several ways both serologically and microbiologically for the rapid diagnosis of typhoid fever. However, validation of the newer applications will require the systematic examination of real patient and laboratory materials.
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Affiliation(s)
- Frankie C H Tam
- Clinical Immunology Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Thomas K W Ling
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Kam Tak Wong
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Danny T M Leung
- Clinical Immunology Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Raphael C Y Chan
- Department of Microbiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Pak Leong Lim
- Clinical Immunology Unit, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
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Petti CA, Polage CR, Quinn TC, Ronald AR, Sande MA. Laboratory medicine in Africa: a barrier to effective health care. Clin Infect Dis 2005; 42:377-82. [PMID: 16392084 DOI: 10.1086/499363] [Citation(s) in RCA: 494] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2005] [Accepted: 09/16/2005] [Indexed: 11/03/2022] Open
Abstract
Providing health care in sub-Saharan Africa is a complex problem. Recent reports call for more resources to assist in the prevention and treatment of infectious diseases that affect this population, but policy makers, clinicians, and the public frequently fail to understand that diagnosis is essential to the prevention and treatment of disease. Access to reliable diagnostic testing is severely limited in this region, and misdiagnosis commonly occurs. Understandably, allocation of resources to diagnostic laboratory testing has not been a priority for resource-limited health care systems, but unreliable and inaccurate laboratory diagnostic testing leads to unnecessary expenditures in a region already plagued by resource shortages, promotes the perception that laboratory testing is unhelpful, and compromises patient care. We explore the barriers to implementing consistent testing within this region and illustrate the need for a more comprehensive approach to the diagnosis of infectious diseases, with an emphasis on making laboratory testing a higher priority.
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Affiliation(s)
- Cathy A Petti
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
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