Investigating The Relationship Between Malaria Parasitaemia And Widal Positivity

Ezeagwuna D A; Emele F E; Agbakoba NR; Ogbuagu C N; Ekejindu I M; Orji N M

摘要

Malaria and typhoid fever are life threatening illnesses of tropical and subtropical regions of the world with almost similar clinical manifestations. An investigation on the relationship between malaria parasitaemia and widal positivity was carried out among 100 patients who consulted doctors at the general out patients department of the Nnamdi Azikiwe Teaching Hospital, Nnewi . Blood samples were collected from patients who manifested clinical symptoms of malaria/typhoid fever . Thick blood films were made and stained with Giemsa staining technique for malaria parasite while tube agglutination test was carried out for widal positivity. Blood , urine and stool samples of patients with high widal titre were cultured in appropriate media. 41.02% of the patients were malaria parasite and widal test positive (somatic antigen) while 27.27% were positive for flagellar antigen. There were occurrence of mixed reaction in widal test among the patients tested. There was no significant relationship between malaria parasitaemia and reactivity of serum with typhoid fever (p<.05). No Salmonella species was isolated from the body fluids cultured. The poor performance of widal test in some laboratories, instant conclusion and poor interpretation of results by prescribers should be checked and base line titre of each location determined. Introduction Malaria is a parasitic infection transmitted from person to person by infected Anopheles mosquito while typhoid fever is a bacteria infection caused by Salmonella species . Both are widely spread in the tropics and subtropics. They are life threatening illnesses with similar clinical manifestations. Malaria is a singular cause of morbidity and mortality in Nigeria where a child dies of malaria attack every 30secs (WHO,1998). There has been a rise in the number of complex emergencies of malaria cases affecting large civilian population with war or civil strife, food shortages and population displacement resulting in excess mortality and morbidity (Eneanya,1998). Approximately 300-500 million cases of malaria and 3 million death occur annually worldwide, mainly in tropical developing countries (Olliaro et al, 1996). It represents 15-30% of the hospitalization cases and 15-20% of the registered death in the paediatric services(Ouledi,1995) while traveling internationally (Finlay and Falkow,1998). It affects 12.5 million persons each year in the developing world (Rao et al,1986). The organism causing it ,Salmonella typhi lives only in humans , and a small number of persons called carriers, recover from the disease but continue to carry the bacteria (John et al 1984).Both ill persons and carriers shed S.typhi in their faeces. Typhoid fever affects 17 million people worldwide every year with approximately 600,000 deaths (WHO,1996). Between the year 1607 and 1624, 6000 settlers died in Virginia, USA due to an outbreak of typhoid fever. In 1906, 53 people got infected while 5 died due to food contamination with Salmonella species by a carrier Mary Mallon in Oyster Bay, New York (WHO,1975). In the year 2001, 3 million children died of dehydration caused by diarrhea. 80% of them, in the first 2 years of their life, 57000 a week, 8000 a day 6 a minute and one every second (Serengbe et al ,2002). The main causes of diarrhea are poor personal and food hygiene and lack of clean drinking water. Organisms are transmitted by hands and formites, poor sanitation and improper separation of sewage from drinking water. Typhoid fever as reported by some experts have caused a lot of mishap in both children and adults alike. In Nigeria, Onuigbo (1990) reported a case of typhoid at the UNTH, Enugu. Ikeme and Anan,(1996) observed that of all the 214 positive cases of S.typhi, males ranking high with 117 cases and 97 females and the age distribution of the disease range from 20-30 years age group. Nsutebu, et al (2002) reported an increase in occurrence of typhoid fever in Cameroun. The reasons explored include an over diag

机译：疟疾和伤寒是世界上热带和亚热带地区威胁生命的疾病，其临床表现几乎相似。在Nnewi的Nnamdi Azikiwe教学医院的普通门诊患者中，对100名患者的疟疾寄生虫血症和维达阳性之间的关系进行了调查。从表现出疟疾/伤寒症状的患者采集血样。制作厚厚的血膜，并用吉姆萨（Giemsa）染色技术对疟原虫进行染色，同时进行管凝集试验以检测维德氏阳性。高维塔氏滴度的患者的血液，尿液和粪便样品在适当的培养基中培养。 41.02％的患者疟疾寄生虫和维德试验阳性（体抗原），而鞭毛抗原阳性的占27.27％。测试的患者中，维德勒试验中出现混合反应。疟疾寄生虫血症与血清与伤寒的反应性之间无显着相关性（p <.05）。从培养的体液中未分离出沙门氏菌。在某些实验室中，widal测试的性能不佳，处方的即时结论和对结果的不良解释应予以检查，并确定每个位置的基线滴定度。引言疟疾是被感染的按蚊传播的一种寄生虫感染，而伤寒是一种由沙门氏菌引起的细菌感染。两者都在热带和亚热带广泛分布。它们是具有相似临床表现的威胁生命的疾病。在尼日利亚，疟疾是发病率和死亡率的唯一原因，那里的儿童每30秒死于疟疾发作一次（世界卫生组织，1998年）。影响患有战争或内乱，粮食短缺和人口流离失所的大量平民的疟疾复杂紧急情况的数量有所增加，导致死亡率和发病率过高（Eneanya，1998）。全世界每年大约发生300-500百万例疟疾和300万人死亡，主要发生在热带发展中国家（Olliaro等，1996）。在国际旅行中，它代表了儿科服务的住院病例的15-30％，登记死亡的15-20％（Ouledi，1995）（Finlay和Falkow，1998）。在发展中国家，它每年影响1,250万人（Rao等，1986）。引起鼠伤寒沙门氏菌的生物仅生活在人类中，少数被称为携带者的人从疾病中恢复过来，但继续携带细菌（John等人，1984）。患病者和携带者均在其粪便中感染了鼠伤寒沙门氏菌。。伤寒每年影响全世界1700万人，约60万人死亡（WHO，1996）。在1607年和1624年之间，由于伤寒的爆发，有6000名定居者在美国弗吉尼亚州死亡。 1906年，在纽约牡蛎湾的承运人玛丽·马伦（Mary Mallon）感染了沙门氏菌，导致53人感染沙门氏菌，其中5人死亡（世卫组织，1975年）。在2001年，有300万儿童死于腹泻引起的脱水。他们中的80％在出生后的头2年内，每周57000，每天6分钟每分钟8000，每秒一次（Serengbe等，2002）。腹泻的主要原因是个人和食品卫生不良以及缺乏清洁的饮用水。生物是通过手和猛禽传播的，卫生条件差，污水与饮用水的分离不当。据一些专家报道，伤寒导致了儿童和成人的许多不幸。在尼日利亚，奥努伊格博（Onuigbo，1990）在埃努古（Enugu）的南斯拉夫联盟共和国（THTH）报告了伤寒病例。 Ikeme and Anan，（1996）观察到，在所有214例伤寒沙门氏菌阳性病例中，男性排名最高，为117例，女性为97例，该病的年龄分布范围为20-30岁。 Nsutebu等人（2002年）报道了喀麦隆伤寒的发生增加。探索的原因包括过度诊断

Investigating The Relationship Between Malaria Parasitaemia And Widal Positivity

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