Dommages hépatiques et facteurs de risque associés chez les patients fébriles atteints de paludisme et/ou de fièvre typhoïde dans deux centres hospitaliers de Yaoundé – Cameroun

Abstract

Malaria and typhoid fever are among the main causes of mortality and morbidity in tropical and subtropical countries like Cameroon. It is very common to see patients being infected or treated simultaneously for these two diseases. Due to the stadium liver diseases from their pathogens, malaria and fever typhoid can cause liver damage if not properly managed. Thus, a cross-sectional study was carried out on 350 febrile patients came for consultation in our collection centers. The attitude of patients towards the practice of preventive measures and management of malaria and typhoid fever were collected using a structured questionnaire. Subsequently, blood samples were collected and subjected to blood tests thick drop and Widal for the respective diagnosis of malaria and typhoid fever as well as for the serum dosage of liver enzymes: Alanine aminotransferase (ALT) Aspartate aminotransferase (AST) and alkaline phosphatase (ALP). The data were analyzed using appropriate statistical tools. On the 350 patients tested, 129 (36.86%) were positive for malaria, 106 (30.29%) were positive for typhoid fever and 56 (16,00%) were co-infected. Women were the most represented (66.3%). Irregular use or non-use of mosquito nets and insecticides, the presence of pools of stagnant water, bushes were significantly associated with malaria. Likewise, the presence of garbage dumps was significantly associated with typhoid fever. The serum level of liver enzymes was abnormally higher in co-infected patients compared to mono-infected malaria and mono-infected typhoid fever patients. In addition, a parasitemia greater than 2500 parasites/µL of blood and a time before consultation greater than 7 days state significantly (p<0.05) associated with an elevation of hepatic markers. Patients co-infected were at greater risk of developing liver damage (cholestasis and cytolysis hepatic) either 51,8%. Thus, the occurrence of liver damage in patients with malaria and typhoid fever is linked to the status of the parasitémia infection and the time taken before the consultation.