Typhoid fever, a classical disease of enteric origin caused by Salmonella species of bacteria, is among the most important diseases threatening public health in Africa. The African continent is a marker for both low resources within the healthcare system and poor disease control policy formulations in managing endemic
infectious diseases. Since the colonial era, the Widal serological test has been used to confirm
typhoid fever in Africa, however recent studies recommend blood culture, and when blood culture cannot be obtained, clinical findings, laboratory Widal test confirmation, and ruling out other febrile illnesses as confirmatory pathway to diagnose
typhoid fever in Africa. Managing
typhoid fever relies on antimicrobials. In 1980s
chloramphenicol was the medication of choice. Years later,
amoxicillin and
co-trimoxazole were adopted. However, the instantaneous rise of resistant strains of Salmonella enterica confers an important challenge to treat the burdensome
enteric fever. The current treatment algorithm of
typhoid fever in Africa relies significantly on the use of
fluoroquinolones,
macrolides, and
cephalosporins. Developed nations have successfully addressed and controlled
typhoid fever via improvement in accessing safe water and food, better sanitary and hygienic behaviours, and
vaccines development. Nevertheless, there is significant evidence to infer improvement in the diagnosis management of
typhoid fever over the last few decades, and efforts are underway to control the disease spread in Africa. This review aims to provide an overview of the latest developments in
typhoid fever diagnosis and management in Africa and provide key recommendations for a coordinated approach to mitigate
typhoid in the continent.