Analysis of typhoid serodiagnostic data and patient socio-demographic and clinical characteristics at Uganda Martyrs' Hospital, Lubaga
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Date
2023Author
Aguma, Nicholus
Moparti, Sri Venkata Satya Sai Eswar
Noumechi, Tietche Rochel
Wejjo, Yonasan
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INTRODUCTION
Typhoid fever remains a major public health concern. According to World Health Organization (WHO), there were an estimated 10.9 million cases of typhoid fever worldwide in 2019 with 110,000 deaths. Typhoid fever (also known as enteric fever) is a systemic infection transmitted through ingestion of food and water contaminated with human feces and caused by the Gram-negative bacteria Salmonella enterica serotypes Typhi or Paratyphi A, B and C (Background document: the diagnosis, treatment and prevention of typhoid fever. Geneva, Switzerland: 2003, Andrews JR, Ryan ET, 2015). It is characterized by numerous nonspecific symptoms, including high fever, headache, malaise, joint pain, abdominal pain, and gastrointestinal symptoms such as nausea, vomiting, constipation, and diarrhea.
In Uganda, there was an outbreak of typhoid fever in the Kasese District from 2008 till 2011 causing a high rate of intestinal perforation (MS Walters et al 2009). According to Health Management Information System (HMIS), in Kampala over the period of two years from January 2021 to December 2022, the number of typhoid cases reported was 86,622, however, they might not represent the actual positivity rate of typhoid in Kampala because it is likely that most of them were diagnosed solely based on clinical characteristics or a few serological diagnoses. It is therefore not certain whether the figures in the HMIS reflect the true picture of typhoid in Kampala. Estimating the prevalence of positive S.Typhi serology over the same period and the associated demographic and clinical characteristics in a busy health care center shall contribute to clarifying the burden of typhoid in Kampala.
METHODOLOGY
The research employed a descriptive cross-sectional study design, utilizing laboratory records and conducting statistical analysis to identify significant trends and patterns. The data for this study was collected using tools capturing relevant socio demographic characteristics and typhoid serology test results from the records at Lubaga Hospital Laboratory. The results of the analysis were presented in the form of tables and charts.
Results: Findings revealed only 13 cases (0.36%) positives at Lubaga Hospital for typhoid compared to 86,622 positives throughout Kampala according to the HMIS data extract.
Conclusion: The prevalence of typhoid-positive tests among suspected cases at Lubaga Hospital was 0.36% which is very low relative to the number of reported cases in HMIS for Kampala district. It is likely that many of the cases reported in the HMIS were not accurately diagnosed.At Lubaga hospital, typhoid diagosis is majorly relient on commercial rapid tests whose performances are not well documented.