Comparative Study of the Widal Test against Stool Culture in the Diagnosis of Suspected Cases of Typhoid Fever in Some Low Income Communities in the Adamawa Region of Cameroon

Introduction: Infectious diseases constitute a major concern of public health in developing countries. Facilities and well trained staff have been shown to be one of the major obstacles in the rapid and quality diagnosis of these diseases. As such, we carried out an analysis to compare the Widal test and stool culture to identify febrile patients with Salmonella infection. Method: A cross sectional study was conducted to diagnose salmonella infection with out-patients who demonstrated signs of salmonella infection. Serum was harvested from blood collected from 368 (Vina = 234, Mayo Banyo 65, and Djerem = 69) patients accompanied by stool, Widal test was conducted on the spot and stool was taken to a reference laboratory for culture using standard microbiological methods, sociological set up was calculated in percentages, prevalence was calculated using excel while statistical difference was calculated using SPSS. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to compare the Widal test against stool culture. Results: A total of 368 (50.8% females and 49.2% males) participants took part in the survey. Salmonella prevalence (66.24%) in stool culture in the Vina division was significantly different (p 0.05). The sensitivity,specificity, PPV, and NPV of slide agglutination test against stool culture varied from different areas (Vina: 51.6%, 73.62%, 79.21% and 43.61%;Mayo Banyo: 60.53%, 77.78%, 79.31% and 58.33%;Djerem: 53.18%, 83.73% 73.91% and 67.39%) respectively. Slide agglutination test has a fair agreement with the stool culture (kappa, Vina = 0.202;Mayo Banyo = 0.37 and Djerem = 0.38). Conclusion: Generally, in the three areas of study, the Widal test had a fair correlation with the stool culture;This means the Widal test should not be used alone but in combination with stool culture in the detection of salmonella infections.

Asymptomatic Carriage of Salmonella and Intestinal Parasites in Pupils in Yaounde

Background: Feco-oral transmitted diseases (FOTD) remain a public health issue, particularly in developing countries. Data concerning the carriage of Salmonella and intestinal parasites in children are available worldwide but are lacking in Cameroon. This study aimed to determine the asymptomatic carriage of Salmonella and intestinal parasites in children of two primary schools in Yaoundé. Methods: A cross-sectional descriptive study was conducted from October 2017 to May 2018 in two primary schools (from rural and urban areas) in the 7th precinct of Yaoundé. Sociodemographic, clinical and paraclinical (rectal swab, direct examination of fresh stool and bacteriological culture on Hektoen medium) data were collected. Results: We included 368 (192 boys) pupils from both schools (184 in each school) with a mean age of 8.99 ± 2.21 years. None of the children was infected by Salmonella spp. Intestinal parasite prevalence was 9.80% (6.52% of children from the urban school vs 13.04% from the rural ones). The intestinal parasite prevalence tended to be higher in girls than in boys (11.98% vs. 7.39%). Among intestinal parasites, protozoa were the most widely found. Entamoeba histolytica and Giardia intestinalis were the most prevalent pathogenic intestinal protozoa (11.11% vs. 25% of all positive stool exams). The helminths, less frequent, were represented by Ascaris lumbicoides and Enterobius vermicularis. The factors associated with intestinal parasite carriage were mainly rural school location and age between 11 - 13 years. Conclusion: Among children in primary school, Salmonella infection was absent, while intestinal parasites are frequent, represented mostly by protozoa. This parasitism is in our cohort associated with the rural school location and the 11 - 13 years age group. This suggests that there is additional room for the implementation of prevention measures for intestinal parasite infections in our setting.

一例罕见的感染性结肠炎

Methicillin-resistant Staphylococcus aureus(MRSA)is responsible for numerous infectious processes.Gastrointestinal tract involvement is rather rare and only a handful of cases of MRSA colitis have been reported in North America.We present a case of MRSA colitis in an adult without apparent risk factors.Abdominal computed tomography(CT)showed thickening of the sigmoid colon,indicative of colitis,and empiric therapy with ciprofloxacin and metronidazole was started.Initial work-up for infection-including blood and stool cultures,and stool Clostridium difficile toxin assay-was negative.The patient’s clinical status improved but his diarrhea did not abate.Repetition of stool culture demonstrated luxuriant growth of MRSA sensitive to vancomycin.Oral vancomycin was administered and the patient’s symptoms promptly ceased.