An algorithm for the clinical differentiation of malaria and typhoid: a preliminary communication

P N G Med J. 1992 Dec;35(4):298-302.

Abstract

The objective of this study was to determine which clinical features of typhoid and malaria are most helpful in distinguishing the two diseases among Papua New Guinean highlanders. In a study of 35 patients with culture-positive typhoid and 49 with blood-slide-positive malaria (Group 1), the odds of typhoid were increased most in patients with altered bowel habit, an illness of more than 2 week's duration, tremor or the presence of typhoid facies. The odds of typhoid were lowest in patients with pallor or jaundice. These findings were used to derive a clinical diagnostic algorithm, which was then evaluated in a further group of 34 typhoid patients and 41 malaria patients (Group 2). The sensitivity of the algorithm in diagnosing malaria was 91% in Group 1 and 71% in Group 2, with specificities of 85% and 79% respectively. For typhoid, the sensitivity of the algorithm was 85% and 79% for Groups 1 and 2, respectively, and the specificities were 91% and 71%. We conclude that the algorithm merits further evaluation in a primary health care setting and may prove useful in making an earlier diagnosis of typhoid.

Publication types

  • Comparative Study

MeSH terms

  • Algorithms*
  • Diagnosis, Differential
  • Diagnostic Errors
  • Discriminant Analysis
  • Humans
  • Malaria / blood
  • Malaria / diagnosis*
  • Malaria / epidemiology
  • Malaria / physiopathology
  • Odds Ratio
  • Papua New Guinea / epidemiology
  • Sensitivity and Specificity
  • Typhoid Fever / blood
  • Typhoid Fever / diagnosis*
  • Typhoid Fever / epidemiology
  • Typhoid Fever / physiopathology