E D A, E F E, A NR, O C N, E I M, O N M
malariatyphoid fever, parasitaemia, widal positivity.
E D A, E F E, A NR, O C N, E I M, O N M. Investigating The Relationship Between Malaria Parasitaemia And Widal Positivity. The Internet Journal of Tropical Medicine. 2010 Volume 7 Number 2.
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
Malaria is a parasitic infection transmitted from person to person by infected
Materials and Methods
Nnamdi Azikiwe University Teaching Hospital, Nnewi which is the study area serves as a common referral centre to all the clinics and hospitals in Anambra State and its environs. The study was conducted with patients who consulted doctors at the general out patient department. The study was carried out during the dry season and the patients were those who showed symptoms such as fever, headache, anaemia, fatigue, vomiting which were suggestive of malaria or typhoid fever as specified in the laboratory request form.
100 patients were recruited into this study and screened for typhoid antigens using tube agglutination method. Those who were non reactive to typhoid fever antigen were dropped out but those who reacted to titre (>=80) were included in the study. Patients who were malaria parasite and Salmonella negative were interviewed on the intake of drugs since last seven days. 10mls of blood were collected aseptically for malaria parasite, widal test and blood culture respectively. Urine and stool samples were also collected and analyzed. Malaria parasite test was done using thick blood film and stained with Giemsa stain , widal test was done using tube agglutination test while blood culture was done using Robertson’s cooked meat medium and subcultured appropriately. Stool culture was done using Selenite F and other appropriate media; urine culture was also done using MacConkey blood and Cystein- lactose electrolyte deficiency (CLED) agar plates. All the organisms isolated were identified using gram staining technique and biochemical tests.
Among the 100 patients examined, no Salmonella species was isolated from their blood, urine and stool samples although there were high titre of the antigen in the widal screening test. 32(41.02%) patients were positive of malaria parasite and also had high titre of the widal (somatic) antigen where 46(58.97%) were positive of malaria parasites but did not not react to the widal antigen (table 1). There was no relationship between malaria parasitaemia and typhoid fever.
Chi-square=0.498 (P< 0.05)
21(27.27%) patients were positive of malaria parasite and had high titre of widal (flagella) antigen while 56(72.72%) patients were positive of malaria but negative to widal antigens. Statistical analysis showed that there is no relationship between malaria parasitaemia and reactivity of serum with paratyphoid antigen. (table 2)