CLINICAL AND ENVIRONMENTAL DISTRIBUTION OF SALMONELLA ENTERICA VAR TYPHI PARATYPHI WITH CONCOMITANT ENDEMIC MALARIA IN ENUGU URBAN AND PERI-URBAN AREAS OF NIGERIA.
Evaluation of distribution rates of Salmonella enterica typhi/paratyphi in subjects at acute and convalescent stages of typhoid fever was carried out using Widal test, stool and blood cultures. Incidences of the concurrent enteric and malaria fever illnesses were determined. Environmental distributions of the salmonella organisms in domestic water sources were also investigated. Two hundred and sixty nine (48.3%) symptomatic and 23g (11.1%) asymptomatic subjects were positive for enteric fever bacilli by Widal test (titre ≥1/160) and blood culture methods. The specificity rate of Widal test, stool and blood cultures techniques were 72.4%, 70.8% and 96.0% while sensitivity rates were 88.4%, 75.1% and 57.5%, respectively. There was no significant difference (P=0.103.) in total incidence rate of typhoid fever in male (32.8%) and female (42.8%) subjects in the whole population. The age range with the greatest risk of enteric fever infection was 21 – 30 years, with mean age was of 32.8 years. The rate of infection was not significantly high in peri-urban area (P = 0.464). There was 11.4% rate of typhoid/malaria co-existent in the population. The rate of typhoid infection was highest among students (40.0%) while malaria was more prevalent among petty traders/artisans (51.4%). The rate of carriers in male and female subject was 49.0% and 44.7%, respectively (P> 0.05). The total rate of salmonella isolates from water samples was 12.6%, while the rate from pipe-borne water was 8.5%. High rate of the isolates (95.7%) were susceptible to ciprofloxacin (5mcg). The sensitivity rate to other antibiotics were as follows: oflaxacin (5mcg) 92.0%, pefloxacin (5mcg) 75.3%, gentamicin (10mcg) 47.8%, chloramphenicol (30mcg) 40.7%, ceftriazone (10mcg) 36.0% amoxicillin (30mcg) 30.0% and cefuroxime (10mcg) 30.0%. Ampicilin (10mcg) and nalidixic acid (30mcg) showed no sensitivity zones.