Abstract
Malaria and typhoid fever remain major public health challenges in tropical regions, particularly in Nigeria, where both diseases are endemic and may occur concurrently among patients presenting with febrile illness. This study aims to determine the prevalence, associated risk factors, and clinical outcomes of malaria–typhoid co-infection among patients attending the Federal University Wukari Teaching Hospital. A hospital-based cross-sectional design was employed involving 400 patients presenting with febrile illness. Malaria was diagnosed using microscopy and rapid diagnostic tests, whereas typhoid fever was assessed using the Widal test and blood culture. Demographic and clinical data were collected through structured questionnaires. The findings show prevalence rates of 45% for malaria mono-infection, 25% for typhoid mono-infection, and 30% for malaria–typhoid co-infection, with the highest prevalence of co-infection observed among individuals aged 15–35 years. Poor sanitation, consumption of untreated water, and seasonal variation were identified as major associated risk factors. Patients with co-infection experienced longer durations of fever, higher complication rates, and greater hospitalization than those with mono-infection. The study concludes that malaria–typhoid co-infection constitutes a substantial clinical and epidemiological burden among febrile patients in the study setting. These findings highlight the importance of integrated diagnostic approaches and coordinated preventive strategies targeting environmental sanitation, safe water use, and timely clinical management to reduce the burden and complications of co-infection in endemic areas.