Typhoid fever in sub-Saharan Africa: Challenges of diagnosis and management of infections

Abstract Background Coronavirus disease (COVID-19) is a severe acute respiratory infection which has afflicted virtually almost all nations of the earth. It is highly transmissible and represents one of the most serious pandemics in recent times, with the capacity to overwhelm any healthcare system and cause morbidity and fatality. Main content The diagnosis of this disease is daunting and challenging as it is dependent on emerging clinical symptomatology that continues to increase and change very rapidly. The definitive test is the very expensive and scarce polymerase chain reaction (PCR) viral identification technique. The management has remained largely supportive and empirical, as there are no officially approved therapeutic agents, vaccines or antiviral medications for the management of the disease. Severe cases often require intensive care facilities and personnel. Yet there is paucity of facilities including the personnel required for diagnosis and treatment of COVID-19 in sub-Saharan Africa (SSA). It is against this backdrop that a review of key published reports on the pandemic in SSA and globally is made, as understanding the natural history of a disease and the documented responses to diagnosis and management is usually a key public health strategy for designing and improving as appropriate, relevant interventions. Lead findings were that responses by most nations of SSA were adhoc, paucity of public health awareness strategies and absence of legislations that would help enforce preventive measures, as well as limited facilities (including personal protective equipment) and institutional capacities to deliver needed interventions. Conclusion COVID-19 is real and has overwhelmed global health care system especially low-income countries of the sub-Sahara such as Nigeria. Suggestions for improvement of healthcare policies and programs to contain the current pandemic and to respond more optimally in case of future pandemics are made herein.

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Phytochemical investigation of the antisalmonellal effect of Cyperus sphacelatus Rottb. (Cyperaceae)

Current Chinese Science ◽

10.2174/2210298101666210302105522 ◽

2021 ◽

Vol 01 ◽

Author(s):

Napoleon A. Mfonku ◽

Gabriel T. Kamsu ◽

Norbert Kodjio ◽

Jie Ren ◽

James A. Mbah ◽

...

Keyword(s):

Typhoid Fever ◽

Antimicrobial Agents ◽

Methylene Chloride ◽

2D Nmr ◽

Sub Saharan Africa ◽

Resistant Isolate ◽

Bacterial Strains ◽

Phytochemical Investigation ◽

Methylene Chloride Extract ◽

Sub Saharan

Background: Typhoid fever is a major health burden in Sub-Saharan Africa. Conventional anti-typhoid drugs are becoming more and more unavailable to most patients in Africa due to the increased costs and emerging drug resistance. Therefore, there is a need for discovery of new antimicrobial agents to combat typhoid fever. Objective: This work aimed to investigate the bioactive components in Cyperus sphacelatus Rottb. (Cyperaceae) and test the antisalmonellal activity of the isolated compounds. Methods: Compound purification was done through column chromatography. Structure elucidation was accomplished based on the 1D and 2D NMR, IR and mass spectra. The biological assay was done using five bacterial strains, including Salmonella enterica subsp. enterica sérovars Typhi ATCC 6539 (STS), S. enterica subsp. enterica sérovars Typhi (ST), S. enteritidis (STE), S. enterica subsp. enterica sérovars Typhimurim (STM), and a resistant isolate of S. enterica subsp. enterica sérovars Typhi (ST566). Results: Three natural products were isolated from the methylene chloride extract of the rhizomes of C. sphacelatus, including a new furanoquinone, scabequinon-6(14)-ene (1) and two known compounds, cyperotundone (2) and vanillin (3). Compound 1 showed moderate antisalmonellal activity, with a minimal inhibitory concentration (MIC) of 32 µg/mL against STM and STS. The best inhibitory result was obtained with compound 2 on STM with a MIC of 8 µg/mL. Compound 2 also gave the best minimum bactericidal concentration (MBC) of 32 µg/mL on the STM strain. Conclusion: Discovery of the three antisalmonellal compounds from C. sphacelatus supports the addition of this plant to typhoid fever preparations.

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Diagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives

The Lancet Infectious Diseases ◽

10.1016/s1473-3099(09)70321-4 ◽

2010 ◽

Vol 10 (1) ◽

pp. 60-65 ◽

Cited By ~ 44

Author(s):

Anthony D Harries ◽

Rony Zachariah ◽

Joep J van Oosterhout ◽

Steven D Reid ◽

Mina C Hosseinipour ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Sub Saharan Africa ◽

Therapy Failure ◽

Resource Limited Settings ◽

Diagnosis And Management ◽

Resource Limited ◽

Sub Saharan

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The Severe Typhoid Fever in Africa Program: Study Design and Methodology to Assess Disease Severity, Host Immunity, and Carriage Associated With Invasive Salmonellosis

Clinical Infectious Diseases ◽

10.1093/cid/ciz715 ◽

2019 ◽

Vol 69 (Supplement_6) ◽

pp. S422-S434 ◽

Cited By ~ 3

Author(s):

Se Eun Park ◽

Trevor Toy ◽

Ligia Maria Cruz Espinoza ◽

Ursula Panzner ◽

Ondari D Mogeni ◽

...

Keyword(s):

Typhoid Fever ◽

Democratic Republic Of Congo ◽

Natural Infection ◽

Healthcare Facility ◽

Sub Saharan Africa ◽

Host Immune Responses ◽

Salmonella Infections ◽

Control And Prevention ◽

Sub Saharan ◽

Study Sites

Abstract Background Invasive salmonellosis is a common community-acquired bacteremia in persons residing in sub-Saharan Africa. However, there is a paucity of data on severe typhoid fever and its associated acute and chronic host immune response and carriage. The Severe Typhoid Fever in Africa (SETA) program, a multicountry surveillance study, aimed to address these research gaps and contribute to the control and prevention of invasive salmonellosis. Methods A prospective healthcare facility–based surveillance with active screening of enteric fever and clinically suspected severe typhoid fever with complications was performed using a standardized protocol across the study sites in Burkina Faso, the Democratic Republic of Congo (DRC), Ethiopia, Ghana, Madagascar, and Nigeria. Defined inclusion criteria were used for screening of eligible patients for enrollment into the study. Enrolled patients with confirmed invasive salmonellosis by blood culture or patients with clinically suspected severe typhoid fever with perforation were eligible for clinical follow-up. Asymptomatic neighborhood controls and immediate household contacts of each case were enrolled as a comparison group to assess the level of Salmonella-specific antibodies and shedding patterns. Healthcare utilization surveys were performed to permit adjustment of incidence estimations. Postmortem questionnaires were conducted in medically underserved areas to assess death attributed to invasive Salmonella infections in selected sites. Results Research data generated through SETA aimed to address scientific knowledge gaps concerning the severe typhoid fever and mortality, long-term host immune responses, and bacterial shedding and carriage associated with natural infection by invasive salmonellae. Conclusions SETA supports public health policy on typhoid immunization strategy in Africa.

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