Malaria and typhoid fever co-infection: disease severity and immune response

• Published in: Journal of the National Medical Association Vol. 116; no. 4; p. 449
• Main Authors: TCHOUTANG, Ange Maxime, Eric, MacDonald BIN, Kamdem, Severin Donald, NKUNO, Marie Chrisitne, NGUM, NGUM Lesly, Tepa, Arnauld, NETONGO, Palmer MASUMBE
• Format: Journal Article
• Language: English
• Published: Washington Elsevier Inc 01.08.2024; Elsevier Limited
• Subjects: Fever; Hematology; Hormones; Immune response; Malaria; Tropical diseases; Typhoid
• ISSN: 0027-9684; 1943-4693
• DOI: 10.1016/j.jnma.2024.07.086

Malaria and Typhoid fever are significant diseases in many parts of the world, especially in the tropics and fever is a common sign. Prominent markers for early diagnosis and better comprehension of this pathological association and immunity are vital to reduce mortality, drug resistance and for clinical purposes. We sought to explore the profile of severity, oxidative stress, and inflammatory markers during malaria and typhoid fever co-infection. From a cross-sectional study, 81 malaria and/or typhoid fever-positive patients from 288 fever patients were selected. Malaria was diagnosed using a Rapid diagnostic test and microscopy while typhoid fever was diagnosed using a Rapid typhoid test and Widal. Severity, stress level and inflammatory responses were evaluated by hematological analysis using full blood count, erythropoietin, cortisol, IL-10, IL-4 and IFN-γ through ELISA, superoxide dismutase and Catalase activities by spectrophotometer. Data were analysed using SPPS 26 and PRISM 9 software. Co-infected patients present significant alterations of red blood cell lines such as thrombocytopenia and anaemia. We founded also a significant increase of stress marker cortisol, IFN-γ and IFN-γ/IL-10 ratio compared to other groups, a decrease in anti-oxidant activities and an alteration of erythropoietin production. The levels of IL-10 and IL-4 were higher during mono-infections. Co-infected subjects show changes in hematological parameters. The presence of malaria and typhoid fever results in a significant increase in stress, alterations in erythropoietin production, anti-oxidants and TH1- cytokine dominance. These findings allow for better management by the clinicians of these infections in the tropics.