Do you have typhoid or malaria? How to tell the difference

Differentiating between malaria and typhoid fever is important for proper diagnosis and treatment.

Malaria is transmitted through bites from infected mosquitoes, while typhoid is caused by Salmonella typhi, a gramme-negative salmonella bacterium, through ingestion of contaminated food and drinks.

While both diseases can cause fever, several key features can help distinguish them.

Fever patterns

Malaria frequently appears with cyclical fevers known as paroxysms. This means that the fever rises and decreases in separate stages.

Typhoid fever typically follows a "stepladder" pattern, rising gradually over several days.

Symptoms

Malaria and typhoid are two separate diseases with distinct symptoms though most times they are diagnosed together.

Malaria symptoms include chills and shivering, a high fever, an enlarged spleen and liver, and anaemia. It may also result in a low blood platelet count, abnormal white blood cells, jaundice, abdominal pain, diarrhoea, and sweating.

Headaches are more severe in typhoid fever. Typhoid, on the other hand, is characterised by gastrointestinal disorders such as constipation or diarrhoea, stomach pain, a high fever lasting around 10 days.

Typhoid also leads to an enlarged spleen, impaired liver function, a small red-dot skin rash on the abdomen and chest, and disseminated intravascular coagulation and anaemia.

Diagnosis

Diagnosing malaria and typhoid involves various tests, but malaria is easier to diagnose compared to typhoid fever.

Doctors may use wild, typhi dot, bone marrow, and stool tests for typhoid, while a complete blood count and malarial parasite test are required for malaria.

Complications

Malaria leads to seizures, coma, and death, with a mortality rate of 15.3 per 100,000 cases.

Typhoid fever, on the other hand, can lead to complications like intestinal perforation and peritonitis, and untreated cases can be fatal.

Blood testing

Anaemia and splenomegaly (enlargement of the spleen) can occur in both infections, but typhoid is more common.

Typhoid is associated with relative bradycardia, which is characterised by a slower heart rate in comparison to body temperature.

A decrease in white blood cells is more common in typhoid.

In situations where both malaria and typhoid are common, it may be required to do both blood tests to definitively differentiate the two infections.