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There is no medical diagnosis known as "Malaria typhoid" in conventional medicine

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Joint Commentary by Dr. Thoi and Diktoor Pal Chol, Juba, South Sudan

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Stop assuming

September 16, 2016 (SSB) — Comment by Dr. Loi: There is no medical diagnosis known as “Malaria typhoid” in the conventional medicine. Please be careful in terms of where you go for treatment in Juba. It is very unfortunate that South Sudan Medical Council is silence about the malpractices in the country. Malaria is a parasitic disease transmitted to human by mosquito. Typhoid is a bacterial infection acquired through dinking contaminated drink or eating   contaminated food.

Avoid mosquito and you will not get malaria. Ensure that you drink clean water and eat clean, well cooked food and you will not experience symptoms and signs of typhoid in your entire life. Those who are inventing a new medical diagnosis known as “malaria typhoid” need to check their medical knowledge and probably check their medical qualification as well.

Dear Achol Salva make sure that you avoid mosquito, drink clean water and eat clean, well cooked food and you will never acquire any of the two diseases.  Please contact me in person at the Ministry of Health in Juba if you would like more discussion on this.

Commentary on Dr Loi ‘s post by Diktoor Pal Chol: The case of Malaria/Typhoid is unprofessional and is a concocted diagnosis by those it suits best. This scenario came into being after 2005 with the influx of foreign quack doctors coupled with their introduction  as a drug of choice, of Ceftriaxone injection, a third generation cephalosporin broad spectrum antibiotic. Malaria is caused by plasmodium parasites and it is transmitted by an infected female anopheles mosquito whereas Typhoid is caused by a bacterial salmonella typhi and the mode of transmission is through contaminated food and water.

 Both present with fever, headache and diarrhea. Typhoid patients present with constant headache and fever of 38-40 degree Celsius which is spiking in nature, may get complicated and the patient develops abdominal pain. If not treated, it may burst and leads to peritonitis which needs surgical attention. In rare cases, the two occur together. The cardinal point here is that not all headaches are due to typhoid fever. There are so many causes. This is clear. Sometimes, the patients who complains of headache, out of ignorance, ask to have typhoid tested when they see you in the Hospital or Clinic. They have been indoctrinated by these quack doctors that headache is due to typhoid.

Experience: A 40-year old female went to a certain clinic and was diagnosed with malaria/ typhoid. She was prescribed and artemether injection and Ceftriaxone IV bd for 10 days, therapeutic misadventure. She then came to us in Mawuna Medical complaining of the same headache despite the treatments given. On examination, her blood pressure was 160/100mmHg.Blood smear for malaria was negative and the Widal test for typhoid, which is not a reliable was non-reactive. Other routine investigations were inconclusive. She was put on low dose antihypertensive and low dose sedative.

 The next day, the blood pressure became 130/90 but she still had fever. I requested CT scan of brain with and without contrast, unfortunately, the result came out as an interventricular subdural haemorrhage. Very unfortunate. When I called the surgeon foe opinion. He said she had to be referred to Khartoum for neurosurgical management.

Finally, the Medical Council should embark on streamlining the medical practice in the country. Thank you Dr Loi for bring this important issue to the public attention.

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