Brief Introduction
Malaria is a disease caused by malaria parasites. There four known Plasmodium parasites: P. falciparum, P. vivax, P. malariae and P. ovale. Plasmodium falciparum causes the deadliest form of malaria. The parasite is transmitted by female anopheles mosquitoes. The prevalence of malaria in Nigeria is very high and the country is said to be a holoendemic zone. The reason is because malaria affects Nigerians throughout the year. There is no break in transmission and it does not follow seasonal changes.

On the other hand, typhoid fever, otherwise known as enteric fever is caused by Salmonella typhi and Salmonella paratyphi. Typhoid fever follows a faeco-oral transmission. What this means is that you can get the disease if you eat food or drink beverages handled by someone that is shedding the bacteria. Also, in Nigeria, like in other developing countries, where defecation in open places is common, transmission can also be water-borne. In this instance, some villagers drink water from streams without purifying it. And by so doing, get infected with typhoid.

Clinical Features
The clinical manifestations of malaria include fever, chills and rigor, headache, malaise, joint pains, nausea and vomiting. Others are diarrhoea, convulsion (especially in young children) and coma. Malaria is a serious disease and can cause complications like anaemia, liver failure and jaundice, dehydration, low blood sugar, acute respiratory distress syndrome, swelling and rupturing of the spleen, kidney failure and pulmonary oedema.

Typhoid on its own can cause fever, colicky abdominal pain (perforation of the small intestine can occur), joint pains, diarrhoea, cough ,nausea and vomiting headache, muscle pain, confusion and can mimic some of the symptoms of malaria.


Diagnosis
Diagnosis of malaria involves various approaches which include using microscope to observe the presence of the parasite in blood, rapid diagnostic test (RDT), serological test to determine presence of antibodies against the parasite, and more importantly, a high degree of suspicion. This is of particular importance in a resource-poor setting where a microscope may not be readily available. In this case, the interpretation of the RDT must be done with good clinical acumen because as false positive and false negative results can be obtained...


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