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Comparative evaluation of various tests for diagnosis of concurrent malaria and typhoid Fever in a tertiary care hospital of northern India.
[typhoid]
Malaria
and
Typhoid
are
two
major
infectious
diseases
,
still
prevalent
in
most
of
the
tropical
countries
including
India
.
Millions
of
individuals
residing
in
these
endemic
cases
contact
these
diseases
either
concurrently
or
as
acute
infection
superimposed
on
a
chronic
one
.
Diagnosis
and
comparative
evaluation
of
various
tests
for
diagnosis
of
Typhoid
-
Malaria
co
-infection
in
patients
suffering
from
febrile
illness
.
Around
800
patients
of
both
Out
Patient
Department
(
OPD
)
and
In
Patient
Department
(
IPD
)
were
referred
to
microbiology
lab
for
Widal
test
/
Typhi
dot
IgG
/
IgM
and
Malaria
card
test
between
July
2012
-
September
2012
.
Patients
found
to
be
suffering
from
co
-infection
were
further
confirmed
for
typhoid
by
blood
culture
.
Those
patients
who
were
found
sterile
on
blood
culture
were
further
confirmed
by
stool
culture
.
Patients
positive
by
Malaria
card
test
(
either
antibody
or
antigen
or
both
)
were
confirmed
by
peripheral
blood
smear
examination
for
malaria
parasite
by
both
thick
and
thin
smear
examination
.
68
(
8
.
5
%
)
patients
were
found
to
be
suffering
from
co
-
infection
by
the
above
tests
.
Blood
culture
revealed
15
(
22
%
)
bacterial
pathogens
in
the
widal
positive
patients
out
of
which
6
(
8
.
8
%
)
were
Salmonella
Typhi
and
3
(
4
.
41
%
)
were
Salmonella
Paratyphi
A
.
Stool
culture
revealed
8
(
11
.
7
%
)
S
.
Typhi
and
5
(
7
.
35
%
)
S
.
Paratyphi
A
cases
.
Out
of
68
patients
positive
by
Malaria
card
test
,
only
36
(
52
.
94
%
)
showed
Malaria
parasite
in
peripheral
blood
smear
also
.
Thus
the
no
.
of
confirmed
cases
of
co
-infection
was
found
to
be
only
1
.
6
%
.
The
interpretation
of
Widal
test
and
Malaria
card
test
,
when
diagnosing
concurrent
malaria
and
typhoid
fever
,
must
therefore
be
done
with
a
lot
of
caution
.
Negative
or
positive
Widal
agglutination
test
is
neither
definitive
nor
completely
informative
.
Similarly
erroneous
interpretation
of
Malaria
card
test
(
especially
Antibody
detection
card
test
)
result
may
lead
to
prolonged
treatment
and
economic
burden
on
patient
.
Diseases
Validation
Diseases presenting
"positive patients"
symptom
allergic bronchopulmonary aspergillosis
cadasil
cholangiocarcinoma
cowden syndrome
esophageal squamous cell carcinoma
heparin-induced thrombocytopenia
hodgkin lymphoma, classical
kabuki syndrome
kallmann syndrome
primary effusion lymphoma
sneddon syndrome
typhoid
waldenström macroglobulinemia
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