Malaria and typhoid as joined disease

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More often than not, we are inundated with typhoid and malaria disease! Sometimes, one wonders if this is a new or emerging disease.

When patients have some symptoms such as fever, headache, generalised body pain and body weakness etc, they approach any nearby laboratory, where investigations for typhoid and malaria are conducted for them at the same time.

From this lab, they are told they have typhoid and malaria and need to be treated for them. Thus, some of them present with the result from these labs and ask for treatment from a doctor!

For the avoidance of doubts, there is no disease like typhoid and malaria. These diseases hardly occur together and the modes of contracting them are different.

While malaria is a disease caused by a parasite known as plasmodium, typhoid is caused by bacteria known as salmonella typhi. Malaria parasite is carried by mosquitoes and injected into humans while the mosquitoes feed on human blood through the skin.

However, typhoid is contracted through drinking contaminated water or eating contaminated food. This contamination usually comes from human excreta. 

Granted that they sometimes manifest with similar symptoms, this is not an excuse to either lump them together or diagnose both of them every time patients present with suggestive symptoms.

Patients should present to hospitals for proper diagnosis to be made and appropriate treatment offered.

The common investigation done for malaria is aimed at identifying the parasite in the blood of the affected persons while the common investigation done for typhoid (Widal test) is to identify the antibody which the body produces against the bacteria.

While the test conducted for malaria is somehow specific, that of typhoid is less specific. 

For Widal test, which is the test conducted to diagnose typhoid, to be conclusively positive, the titre has to be rising. Patients are required to be tested three consecutive times, at least one week interval.

If there is consistently rising titre, treatment may commence after the second test, otherwise, the result of the third test may be needed for proper diagnosis. This antibody testing is done because culture for the organism is not readily available in many laboratories. 

It is however, disheartening that, usually, single test is done to make diagnosis in many laboratories.  What these laboratories do not take into consideration is the fact that, for people who live in endemic areas, they are likely to have been exposed to these bacteria at one time or the other.

During such exposure, the body would have produced some antibodies against the organism, which are still in the blood of the exposed person. However, when there is a new infection, antibody production speeds up, which makes the level to rise rapidly.

To appreciate this, it is necessary to retest an individual suspected of suffering from typhoid a week after the first test and another one a week later. With this, the diagnosis is easy if there is a rising titre value.

It must be stated, however, that this article does not attempt to downplay the fact that both diseases can coexist together. It is a possibility that this can occur. However, each of the diseases should be diagnosed properly and treated as such.

Routine diagnosis of these diseases without following due process has led to abuse of their treatments and development of resistance to the drugs of choice.

This knowledge is necessary so that patients can be wary of laboratories whose aim is profit-making rather than help patient in reaching appropriate diagnosis towards appropriate treatment.   

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