Background: Typhoid fever, a significant global health problem, demonstrates a multifaceted transmission pattern. Knowledge of the factors driving its transmission is critical for developing effective control strategies and optimizing resource allocation. Objective: This review aimed to comprehensively synthesize evidence on risk factors associated with typhoid fever transmission from 1928 to 2024. Methods: We searched PubMed, Scopus, Google Scholar, and Semantic Scholar databases using keywords related to risk, contributors, determinants, and causes of typhoid fever. We followed a registered protocol to support our search and triangulated the results. Results: Overall, we retrieved 1614 articles, of which 219 were reviewed. Of these, 109 addressed multiple, non–mutually exclusive typhoid fever risk factors. Unsurprisingly, of the total articles reviewed on risk factors, approximately 70.6% (77/109) originated from the Asian continent (51/109, 46.8%) and the African continent (26/109, 23.9%). Half of the articles (55/109, 50.5%) focused on risk factors related to demographic and socioeconomic transmission, while 44% (48/109) of the articles examined foodborne transmission. Additional risk factors included water, sanitation, and hygiene practices: waterborne transmissions (45/109, 41.3%) and sanitation and hygiene practices (34/109, 31.2%), travel-related risk (19/109, 17.4%), antimicrobial use (14/109, 12.8%), climate-related factors (15/109, 13.8%), environment-related factors (9/109, 8.3%), typhoid carriers (11/109, 10.1%), and host-related risk factors (6/109, 5.5%). Conclusions: This review identifies demographic and socioeconomic factors as key drivers of typhoid transmission, underscoring the need for targeted interventions. Strengthening street food regulation in urban Asia and investing in water infrastructure in rural Africa can significantly mitigate risk. Integrating water, sanitation, and hygiene interventions with typhoid vaccines can reduce immediate exposure while enhancing long-term immunity. Prioritizing these strategies in schools and high-risk communities is essential for sustainable typhoid control. Future research should focus on longitudinal studies to assess risk factor causality and vaccine impact, guiding more effective public health interventions.

The accurate detection of SARS-CoV-2 through respiratory sampling is critical for the prevention of further transmission and timely initiation of treatment. There is a diverse range of SARS-CoV-2 detection rates in reported studies, with uncertainty regarding the optimal sampling method for COVID-19 diagnosis and monitoring. Oropharyngeal sampling (OPS) is one of the most commonly used methods of respiratory sampling in Ghana and other parts of the world for the detection of SARS-CoV-2 viral RNA. However, this sampling technique has a number of drawbacks, which include difficulty in obtaining high-quality swab samples, increased risk of infection to healthcare workers, and increased cost from a regular supply of swabs, transport media, and personal protective equipment (PPE). This study, therefore, sought to evaluate the diagnostic performance of sputum specimens in the diagnosis of COVID-19. This was a cross-sectional analytical study conducted in two health facilities in Kumasi, Ghana, between April and September 2021. Paired samples (an oropharyngeal swab and sputum) were taken from each recruited patient and run concurrently for the detection of SARS-CoV-2 genes (the N and ORF1ab genes) using RT-qPCR. Of the 317 patients recruited, 50.8% were males, and 60.4% were young adults aged 20–39 years. A significant proportion (65.9%) of the patients did not have any co-morbidity, and the majority were with symptoms; predominantly cough (36.3%), headache (31.5%), general weakness (24.0%), fever (20.2%), and sore throat (16.1%). Being symptomatic (p = 0.003), having comorbidity (p = 0.001), and the reporting facility (p = 0.010) were significantly associated with the COVID-19 status. The sputum samples yielded more COVID-positive, 120/317 (37.9%), as compared to OPS, 83/317 (26.2%). The sputum samples were 85.5% (95% CI, 76.4–91.5) sensitive, 79.1% (95% CI, 73.4–83.7) specific, and with positive and negative predictive values of 59.2% and 93.9%, respectively, when compared with OPS. The overall median of the SARS-CoV-2 viral loads for sputum (3.70 × 10³ copies/mL) were significantly higher than in OPS (1.18 × 10² copies/mL) (p = 0.003). Findings from the study suggest self-collected sputum as a useful alternative to OPS for the diagnosis of COVID-19, providing a comparable diagnostic performance and, thereby, easing the uncomfortable process and mitigating risk of aerosol transmission to healthcare workers.

The control of infectious diseases depends on effective diagnostics and interventions. In Africa, resource limitations hinder clinical surveillance. Environmental surveillance (ES), particularly wastewater surveillance, offers a cost-effective alternative. While globally expanding, its application in Africa remains limited. This review aimed to describe published studies in Africa that have utilized ES for the detection of infectious pathogens of public health importance in Africa. The study employed a rapid review approach to synthesize evidence on ES of infectious pathogens in Africa, following guidance from the Cochrane Rapid Reviews Methods. Articles from major databases, including Scopus, PubMed, Science Direct, and Cochrane, were screened using Catchii.org. Duplicates were removed, and data were extracted into Excel, and study quality was appraised using the AXIS tool and a modified Newcastle-Ottawa Scale. The search strategy identified 2,189 articles, of which 90 were found to be eligible. We identified 47 microbial species that have been reported across studies. These consisted of 46.8% bacteria ( n = 22), 36.2% viruses ( n = 17), 4.3% fungi ( n = 2), and 12.7% parasites ( n = 6). Among viruses identified, SARS-CoV-2 was the most common, followed by rotaviruses and polioviruses. Vibrio cholerae was mostly reported among bacterial pathogens. The most common sampling method was grab sampling ( n = 85, 94.4%), while two-phase separation ( n = 22, 37.3%) and filtration ( n = 11, 39.3%) were the most frequently used concentration methods for viral and bacterial detection, respectively. ES of infectious pathogens in Africa remains limited. There is a need to expand this to enhance pathogen monitoring, transmission insights, and preparedness for emerging variants.

Colonization of SARS-CoV-2 with specific bacteria may either protect or increase the risk of disease severity. This study aimed to identify microbial organisms in the lower respiratory tract and their association with SARS-CoV-2 infection. This was a cross-sectional study conducted between May 2020 and August 2021 at the Tamale Public Health Laboratory in the Northern part of Ghana. RT-PCRs for SARS-CoV-2 and bacteriological cultures were performed on sputum samples collected from suspected COVID-19 patients. Biochemical identification and antimicrobial susceptibility tests were performed on the bacterial isolates. A total of 380 participants were recruited into the study. Most participants were within the 21–30 years age group (29.6%). RT-PCR testing detected SARS-CoV-2 in 118 (31.1%) patients. Headache was found to be associated with SARS-CoV-2 (p = 0.033). Sputum cultures yielded 187 (49.2%) positive bacteria growths. Klebsiella spp. (20.5%), Moraxella catarrhalis (7.9%), and Pseudomonas spp. (6.3%) were the most commonly isolated bacteria. M. catarrhalis, Serratia spp., and Stenotrophomonas maltophilia were significantly associated with SARS-CoV-2 infection. Most of the isolates were resistant to 3rd generation cephalosporins. This study has demonstrated the association between specific bacteria and SARS-CoV-2 infection. Clinicians should investigate possible bacterial co-infections in the management of COVID-19 cases.

Background Malaria remains an important public health threat claiming many lives particularly in Sub-Saharan Africa. Light microscopy which is a blood-based test is the Gold standard for laboratory diagnosis of malaria in the clinical settings. The lack of sensitivity of Microscopy coupled with the challenges associated with blood sampling necessitates exploring alternative methods of identifying malaria cases. Aims and Objectives The aim of this study was to detect the presence of Plasmodium Lactate Dehydrogenase (pLDH) and Plasmodium falciparum Histidine-Rich Protein 2 (PfHRP2) in the saliva of suspected malaria patients and to compare the diagnostic accuracy of these saliva-borne biomarkers with the results of blood film microscopy using Nested PCR as the reference test. Methods The research was a comparative study. Matched saliva and blood samples of suspected malaria patients were collected. The blood samples were aliquoted into 2 smaller volumes and used to run blood film microscopy (thick and thin) and Nested PCR to detect DNA of the 5 Plasmodium species known to clinically infect man. Sand-wiched ELISA was separately run to qualitatively detect pLDH and PfHRP2 in the saliva samples. Accuracy indices of the saliva-based assays (saliva pLDH and PfHRP2) were compared with the conventional blood-based Microscopy. Results Of the participating 188 subjects, malaria prevalence rates of 51 (27.13%), 80(42.55%), 117 (62.23%) and 95 (50.53%) were detected by the Microscopy, saliva pLDH, saliva PfHRP2 and the PCR respectively. The sensitivity of the saliva PfHRP2 ELISA, 78.95% (95% CI, 69.38-86.64%) and saliva pLDH ELISA, 64.21% (95% CI 53.72 -73.79) were better than those obtained for the blood film Microscopy. Conclusions The saliva pLDH and the PfHRP2 ELISAs were found to be more sensitive (64.21% and 78.95% respectively) in defining malaria cases than the results obtained for the conventional blood film microscopy. Both the saliva pLDH and the PfHRP2 ELISAs showed moderate agreement with the results of the Nested PCR with Kappa co-efficient of 0.44 and 0.5 respectively.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Typhoid fever, a significant global health problem, demonstrates a multifaceted transmission pattern. Knowledge of the factors driving its transmission is critical for developing effective control strategies and optimizing resource allocation. Objective: This review aimed to comprehensively synthesize evidence on risk factors associated with typhoid fever transmission from 1928 to 2024. Methods: We searched PubMed, Scopus, Google Scholar, and Semantic Scholar databases using keywords related to risk, contributors, determinants, and causes of typhoid fever. We followed a registered protocol to support our search and triangulated the results. Results: Overall, we retrieved 1614 articles, of which 219 were reviewed. Of these, 109 addressed multiple, non–mutually exclusive typhoid fever risk factors. Unsurprisingly, of the total articles reviewed on risk factors, approximately 70.6% (77/109) originated from the Asian continent (51/109, 46.8%) and the African continent (26/109, 23.9%). Half of the articles (55/109, 50.5%) focused on risk factors related to demographic and socioeconomic transmission, while 44% (48/109) of the articles examined foodborne transmission. Additional risk factors included water, sanitation, and hygiene practices: waterborne transmissions (45/109, 41.3%) and sanitation and hygiene practices (34/109, 31.2%), travel-related risk (19/109, 17.4%), antimicrobial use (14/109, 12.8%), climate-related factors (15/109, 13.8%), environment-related factors (9/109, 8.3%), typhoid carriers (11/109, 10.1%), and host-related risk factors (6/109, 5.5%). Conclusions: This review identifies demographic and socioeconomic factors as key drivers of typhoid transmission, underscoring the need for targeted interventions. Strengthening street food regulation in urban Asia and investing in water infrastructure in rural Africa can significantly mitigate risk. Integrating water, sanitation, and hygiene interventions with typhoid vaccines can reduce immediate exposure while enhancing long-term immunity. Prioritizing these strategies in schools and high-risk communities is essential for sustainable typhoid control. Future research should focus on longitudinal studies to assess risk factor causality and vaccine impact, guiding more effective public health interventions.