Ultrasound as a triaging tool for the diagnosis of malaria and typhoid in a resource constrained setting: A proposed frame-work

Abstract

Introduction: Ultrasound has proven to have great potentials in the diagnosis and work-up of patients affected by tropical diseases. Its role in the diagnosis of malaria and typhoid abounds, but its value as a triaging tool in a resource-constrained settings is indistinct. Our review aimed is aimed at assessing the utility of ultrasound in diagnosis and prognosis of malaria and typhoid.

Materials and method: Extensive literature search was conducted using the PubMed electronic database, for original peer reviewed articles in English language within 1964-2023. Keywords like "malaria", "typhoid", "S. Typhi", "Salmonella Typhi", "enteric fever", "ultrasound", "sonography" and "ultrasonography" were searched, using Boolean operators such as (OR, AND) applying the following filters (English, Human). A systematic synthesis of the literature was done.

Result: Our initial search yielded 749 potentially relevant references out of which 55 were found to be eligible. Organs assessed include the liver, spleen, kidneys, intestines, mesenteric lymph nodes, among others. For malaria, pathognomonic conditions like splenic enlargement, hepatomegaly, renal abnormalities as well as mesenteric lymph nodes and intestinal wall thickening in patients with typhoid fever.

Conclusion: Ultrasound by experienced clinicians adds significantly to the diagnosis and work-up of patients with malaria and typhoid fever. However, it is important to note that ultrasound alone may not be sufficient for definitive diagnosis as laboratory tests may still be required for confirmatory diagnosis.

Implication for practice: This study provide information on ultrasound in diagnosis of Malaria and typhoid by evaluating the morphological changes in abdominal and other organs of the body. This can be a guide to clinicians and other healthcare providers for early diagnosis and work-up of patients in endemic areas where resources are scarce.

Keywords: Diagnosis; Malaria; Resource constrained; Triaging; Typhoid; Ultrasound.