Concurrent Infections and Louse-Flea Borne Typhus Fever in Acute Febrile Patients Diagnosed Serologically In International Clinical Laboratories, Addis Ababa, Ethiopia

Background: Typhus fever, which is one of acute febrile illnesses, remains known enemy of human populations globally, particularly considerable in tropical and subtropical developing countries. Besides, concurrent infections have been reported from many regions of Africa where febrile illnesses are predominantly endemic. Of these, co-infection of typhoid fever and typhus fever is commonly observed in different parts of Ethiopia. But, limited study were conducted previously to measure serological and bacteriological estimations of co-infection of these febrile illnesses. Therefore, this study was designed to determine serological estimates of concurrent infections and Typhus fever from acute febrile patients diagnosed in ICL. Methods: A retrospective study was conducted with electronic data of acute febrile patients who made serological testing from January 2007 to 2011 in the International Clinical Laboratories. Data collection was performed from Dec 29, 2011 to Feb 10; 2012. Data were electronically stored into EpiData 3.1 and exported to SPSS 20 and STATA 11 for statistical analysis. Continuous measures were summarized by mean calculation and standard deviation at 95 % CI. For most variables, frequency analysis was performed to descriptively observe them. The relationship of exposure and outcome variables was assessed by Spearson calculation. Ethical clearance was given from Institutional Review Board of ALIBP and additionally approved by Research Committee of ICL. Result: Over five years, a total of 5, 029 patients with acute febrile illness were serologically diagnosed for typhoid fever and typhus fever at same time in ICL, Addis Ababa, Ethiopia. The age of patients distributed from less than a year to eight seven years old and mean age was located at 33.3914.72 years [95 % Conf. Interval]. Of those patients, smaller numbers (43 %) were females with 22 % Weil Felix positive and greater numbers (57 %) were male with 15 % Weil Felix positive. Around 6 % of febrile patients were co-infected with typhoid fever and Typhus fever or 42 % of Weil Felix positive. Approximately 18 % of patients had significant titer equal to or greater than 1in 80l that considered national cut value to exclude presence of multiple infections. Conclusion: Multiple infections are commonly known to result in severe disability and death. At early onset, serological diagnosis can exclude absence of Typhoid fever or typhus fever as IgM seroconversion takes time.