International Journal of Science and Research (IJSR) ISSN (Online): 2319-7064 Impact Factor (2012): 3.358 Volume 3 Issue 10, October 2014 www.ijsr.net Licensed Under Creative Commons Attribution CC BY Seroprevalence of Typhoid Fever among Subjects with Acute Febrile Manifestations at Tertiary Care Center, Addis Ababa, Ethiopia Jelkeba Bali Weyesa Department of Biomedical Sciences, College of Health Sciences, Mizan-Tepi University, Ethiopia Abstract: Background: Typhoid fever is a life-threatening systemic disease characterized by stepwise rise of fever (38-41ºC) and frequent abdominal manifestations. It continued to be a major endemic disease in developing countries where there are unsanitary practices. The reports of global burden of typhoid fever suggested that up to 16 to 22 million cases and 200 000 to 600, 000 deaths occur each year. Over past decades varying trend observed in developing countries, which reported of having an average incidence of 540 per 100, 000 populations. In Ethiopia, the definite diagnosis of typhoid fever by isolating the organisms is not normally done because of lack of bacteriological facilities and longer time required. However, the sensitive rapid slide agglutination tests alone, mostly without tube dilution method, routinely performed to detect presence of antibody production against typhoid fever. Here, we determined the seroprevalence of Salmonella Typhi from patients suspected of typhoid fever at the International Clinical Laboratories, Addis Ababa, Ethiopia. Result: Over five years, a total of 5, 029 patients with suspicion of typhoid fever were serologically diagnosed in the International Clinical Laboratories, Addis Ababa, Ethiopia. Of those patients, smaller numbers (43%) were females with 17% Widal positive and greater numbers (57%) were male with 12 %Widal positive. The age of patients distributed from less than a year to eight seven years and mean age was located at 33.39±14.72 years [95% CI]. Approximately 22% of patients had significant titer equal to 1 in 20 or more for H and/or O agglutinins corresponding antibody presence in serum. Of widal tests, 8.26% had significantly reactive antibody against H and O antigens whereas 6.7% and 5% were significantly reactive for only H and O antigens, respectively. The significant titer level indicative of typhoid diagnosis was equal to 1 in 80μl or more in both H and O agglutinins. Conclusion: Widal slide test is non-specific test that need additional confirmatory tube tests and bacteriological isolation of Salmonella Typhi. Hence, seroprevalence report may overstate or understate estimate of typhoid fever. Keywords: Seroprevalence, Typhoid fever, Salmonella typhi, febrile illness, Widal test, Bacteriological methods, cut values 1. Introduction Typhoid fever continued to be global public health problem in developing countries from thousands of years back. It is estimated that upto16-22 million cases of typhoid fever and 200, 000-600, 000 deaths reported globally each year. 1, 2 In industrialized countries like the United States and UK, typhoid incidence is equal or lower than 1 in 100, 000 populations (≈300 clinical cases per year) and traveler-related cases comprise significant proportion of report. 3, 4 Unlike developing countries, the disease burden is still significant and typhoid fever remains one of the main concerns in developing countries. 5, 6 According to health information report of 1994, approximately estimates of 2, 655, 000 typhoid cases and 130, 000 deaths with incidence rate of 500 cases per million populations were occurred in Africa whereas estimates of 13, 310, 000 typhoid cases and 440, 000 deaths with certain peak incidence of 1000 cases per million populations were occurred in Asia. In same year, estimates of 595, 000 typhoid cases and 10, 000 deaths with incidence of 150 cases per million populations were occurred in Latin America. In that report, the incidence estimates of typhoid fever in developing countries varied from 150 cases per million populations per year in Latin America to 1000 cases per million populations per year in some Asian countries. In 2000, an average incidence of Typhoid fever was 540 in 100, 000 populations in developing countries. 7 The disease affects all age group with varying severity and incidence rate. However, the estimates of illness burden are highest among infant, children, and adolescent age categories in south central and Southeastern Asia. 8 In global context, children easily develop typhoid fever infection compared to other age group, although the clinical course is generally milder in children than in adults. Typhoid fever has no race predilection but attacks males more than females. In certain literature, the Salmonella typhi case fatality rate vary in range of 10- 30% but effective thepeutic measures can reduce to <4%. 9 2. Methods and Materials 2.1. Study Design and Area A retrospective data analysis was carried out to determine seroprevalence of typhoid fever at the International Clinical Laboratories. Electronic data of patients with suspicion of typhoid fever over the five years were retrieved from ICL databases in Polytech technology software and collected using standard format. The Headquarter of the International Clinical Laboratories, in which this study was carried out, is geographically located in Addis Ababa that provides more than 200 laboratory tests for across country clients, mainly from Addis Ababa and surroundings (Figure 1). The ICL is a private higher Laboratory facility established in 2004, now it has expanded its facilities to four regional towns of Ethiopia. It is running its full 24 hours services per day with about 90 employees working in three shifts. So far, it has Paper ID: SEP14697 147