Please enter verification code
Use of Stool Culture as a Determinant Parameter of Enteric Fever in Adults Attending Bingham University Teaching Hospital Jos, Nigeria
Clinical Medicine Research
Volume 3, Issue 2, March 2014, Pages: 31-35
Received: Jan. 31, 2014; Published: Mar. 20, 2014
Views 3168      Downloads 215
Ramyil, Mamzhi-crown Seljul, Department of Medical Microbiology and Parasitology, College of Health Sciences Bingham University Teaching Hospital, Jos, Nigeria
Ogundeko, Timothy Olugbenga, Department of Pharmacology and Therapeutics, College of Health Sciences Bingham University Teaching Hospital, Jos, Nigeria
Idyu, Iorkyase Isaiah, Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmaceutical Sciences, University of Jos, Nigeria
Ameh, Joshua Momoh, Department of Laboratory Services and Histopathology, Bingham University Teaching Hospital, Jos, Nigeria
Article Tools
Follow on us
Background: Enteric fever caused by salmonella typhi is an endemic disease in the tropics and sub-tropics; and has become a major public health problem in developing countries of the world. Presently, cultures of Stool and blood are the most diagnostic means of confirming salmonellosis in humans. However, the stool and serum sample of an infected patient against the somatic (O) and flagella (H) antigens of the bacteria requires thorough laboratory analysis. This study was biased on the use of stool culture as a confirmatory analysis of typhoid fever indices in the region of research particularly among adolescents (18 yrs and above). Methods: 60 adults attending Bingham University Teaching Hospital with symptoms clinically suspected to be enteric fever were randomly selected. Informed consent of volunteers was obtained in 48 patients and stool specimens collected and were cultured. Stool specimens were processed using isolation method and biochemical characteristics of susceptibility testing of typhoid fever from the individual patient. A significant mean difference of male and female that were affected by enteric fever was determined. Results: Results obtained from a total number of 48 patients (32 male and 16 female) indicated 12 positive stool cultures among which 10 were males and 2 were females (31.25% and 12.5%) respectively. Salmonella was found to be susceptible to Offloxacin, Ciprofloxacin, Ceffraxole and Cefuroxime respectively; thus constituting the choice drugs in the treatment of enteric fever. Conclusion: Result showed that a significant mean difference between the number of affected patients and those not affected (P.v = 0.0521) authenticates stool culture as confirmatory test for enteric fever as against clinical diagnosis. Salmonella enterica showed more resistance to some commonly used drugs. Therefore, sensitivity testing based on prescription is recommended to prevent continuous drug resistance development. Results further showed that men were more affected than women; however, a suggested area to explore in the study of enteric fever infections.
Enteric Fever, Stool Culture, Salmonellosis, Nigeria
To cite this article
Ramyil, Mamzhi-crown Seljul, Ogundeko, Timothy Olugbenga, Idyu, Iorkyase Isaiah, Ameh, Joshua Momoh, Use of Stool Culture as a Determinant Parameter of Enteric Fever in Adults Attending Bingham University Teaching Hospital Jos, Nigeria, Clinical Medicine Research. Vol. 3, No. 2, 2014, pp. 31-35. doi: 10.11648/j.cmr.20140302.15
Whitaker JA, Franco-Paredes C, Del Rio C, Edupuganti S. Rethinking typhoid fever vaccines: implications for travelers and people living in highly endemic areas; 16:46–52, J Travel Med 2009.
Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever; 82:346–53. Bull World Health Organ 2004.
John A. Crump and Eric D. Mintz; Global Trends in Typhoid and Paratyphoid Fever: Clinical Infectious Diseases 2009/2010; 50:241–6 1058-4838/2010/5002-0013 DOI: 10.1086/649541
World Health Organization; Prepared for World Water Day 2001. Reviewed by staff and experts from the cluster on Communicable Diseases (CDS) and the Water, Sanitation and Health unit (WSH), World Health Organization (WHO) 2008.
Ibekwe, A.C., Okonko, I.O., Onunkwo,A.U., Donbraye, E., Babalola, E.T. and OnojaB.A.; Baseline Salmonella agglutinin titres in apparently healthy freshmen in Awka, South Eastern, Nigeria. Science Research Essay 3(9): 225-230, 2008.
Baver, H., Growing problems of salmonellosis in modern society. Medicine, 52: 32-36; 1995.
Archibald LK, Reller LB. Clinical microbiology in developing countries.7:302–5; Emerg Infect Dis 2001.
Crump JA, Ram PK, Gupta SK, Miller MA, Mintz ED. Part 1. Analysis of data gaps pertaining to Salmonella enterica serotype Typhi infections in low and medium human development index countries, 1984–2005. Epidemiol Infect 136:436–48; 2008.
Oboegbulam, S.I; J.U. Oguike and M. Gugnanai; Microbiological studies on cases diagnosed as typhoid/enteric fever in southeast Nigeria. J. on Communicable Diseases, 27:97 – 100; 1995.
Tanyigna, K.B; J.A Ayeni; E.N Okeke; J.A Onal and C.S Bello; Antibody levels to salmonella typhi and paratyphi in Nigeria. East Africa Medical J. 76 (11): 623 – 625; 1990.
Zailani S.B; A.O Aboderin and A.O Onipede; Effect of socio-economic status, age and sex on antibody titre profile to salmonella typhi/paratyphi in Ile-Ife, Nigeria. Nigeria Medical J. 13 (4): 383-387; 2004.
Akinyemi K.O; A.O Coker; D.K Olukoya; A.O Oyefolu; E.P Amorighoye and E.O Omonigbehin; Prevalence of multi-drug resistant salmonella typhi among clinically diagnosed typhoid fever patients in Lagos, Nigeria Zoology and Nature for Schools, 55: 489-493; 2008.
Effa E.E and H Bukirwa; Azithromycin for treating uncomplicated typhoid and paratyphoid fever (enteric fever). Cochrane Database system review 2008.
Ekenze S.O; P.E Okoro; C.C Amah; H.A Ezike and A.N Ikefuna; Typhoid ideal perforation analysis of morbidity and mortality in 89 children. Nigeria J. Clin. Pract. 11 (1): 58-62; 2008.
Nasir A.A; J.O Adeniran; L.O Abdur-Rahman; T.O Odi and J.A Omotayo; Typhoid intestinal disease: 32 perforations in 1 patient. Nigeria Postgraduate Medical J. 15: 55-57; 2008.
Shaw AV, Reddy EA, Crump JA. Etiology of community-acquired bloodstream infections in Africa [abstract L-620]. In: Program and absracts of the 46th Annual Meeting of the Infectious Diseases Society of America. Washington, DC: Infectious Diseases Society of America, 2008.
Mweu E, English M. Typhoid fever in children in Africa. Trop Med Int Health:13:1–9; 2008.
Muyembe-Tamfum JJ, Veyi J, Kaswa M, Lunguya O, Verhaegen J and Boelaert M. An outbreak of peritonitis caused by multidrug-resistant Salmonella Typhi in Kinshasa, Democratic Republic of Congo. Travel Med Infect Dis; 7:40–3 2009.
Ochiai RL, Acosta CJ, Danovaro-Holliday MC: A study of typhoid fever in five Asian countries: disease burden and implications for control. Bull World Health Organ; 86:260–8 2008.
Cleary TG. Salmonella Species. In: Long S, Pickering L and Prober C: Principles and practice of pediatric infectious diseases. 2nd ed. Philadelphia. Churchill Living stone; P. 830-5 2003;.
American Academy of Pediatrics. Salmonella infections. In: Pickering LK, ed. Red Book: Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL: American Academy of Pediatrics: 541-7 2003.
Snow M. Protecting travelers from typhoid fever. Nursing. 36(3): 73 – 73 2006. [PubMed:16523113 ].
Huckstep RL. Bacteriology: The Salmonellae. 25 - 34. In: Wright FJ. Typhoid Fever and other Salmonella infections. S. Livingston LTD, Edinburgh and London 1962.
Ngwu BA, Agbo JA. Typhoid fever: clinical diagnosis versus laboratory confirmation. Niger J Med. 12(4): 187 – 192, 2003. [PubMed: 14768191].
Edelman R, Levine MM. Summary of an international workshop on typhoid fever. Rev Infect Dis. 8:329–49; 1986.
Crump JA, Kretsinger K, Gay K. Clinical response and outcome of infection with Salmonella enterica serotype Typhi with decreased susceptibility to fluoroquinolones: a United States FoodNet multicenter retrospective cohort study. Antimicrob Agents Chemother;52: 1278–84 2008.
Pandit A, Arjyal A, Day JN. An open randomised comparison of gatifloxacin versus cefixime for the treatment of uncomplicated enteric fever. PLoS ONE; 2:e524, 2007.
Shrivastava Bhanu, Shrivastava Vandana, Shrivastava Archana; Comparative study of the diagnostic procedures in salmonella infection, causative agent. An overview study. International research journal of Pharmacy, pp 2230-8407 2011.
Pang B.: Prevalence of salmonella typhi and intestinal parasites among food handlers in Bahir Dar Town, Northwest Ethiopia. Ethiopian Journal of Health Development, 24 (1):46-50; 2008.
Beyene G, Asrat D, Mengistu Y, Aseffa A, Wian J; Typhoid fever in Ethiopia. Infect Developing Countries: 2(6):448-453 2008
Charles AM, Adam MH, Gad, El Rab MO, Morshed MG and Shakoor Z; Detection of salmonella typhi agglutinatinins in sera of patients with other febrile illnesses and healthy individuals. Journal of African Medicine, 10(1); 41-44 2012.
FAO (Food and Agricultural Organization) 2012; Available at Accessed 03-02-2013
Butler T, Islam A, Kabir and Jones PK; Pattern of morbidity and mortality in typhoid fever dependent on age and gender. Review of 552 hospitalized patients with diarrheoa. Journal of Infectious Diseases. 13:85-90; 1991
World Health Organization; Typhoid vaccines: WHO position paper Weekly Epidemiological Record (WER); 83(6):49-60, 2006
Muhammad SS, Khurshid Ak, and Javed A; Correlation of serum free thyroxine with components of metabolic syndrome in euthyroid South Asian men and women. International Journal of Medicine and International Health:8(6):575-578 2012.
World Health Organization; Typhoid immunization, vaccine and biological progrmmes and project. Weekly Epidemiological Record. Pp 84-87, 2000
Muhammad SS, Khurshid Ak, and Javed A; Correlation of serum free thyroxine with components of metabolic syndrome in euthyroid South Asian men and women. International Journal of Medicine and International Health: 8(6):575-57, 2012.
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
Tel: (001)347-983-5186