Clinical presentation of enteric fever include . These symptoms o.  Irrespective of the patient are treated with malaria drugs and antimircrobals The  initial treatment being
Outbreaks of Typhoid fever have been reported in 15 African countries since 1950, mostly south eastern Africa with the largest outbreak occurring in Kampala, Uganda between February and June 2015 (Kim et al., 2019). By 2014, African countries that had reported MDRTF included South Africa (1992), Kenya (2000), Nigeria (2005) and Egypt (2006) (Ugboko & De, 2014). Transposon-mediated MDR typhoid associated with composite transposons either on plasmids or in the chromosome is increasingly reported; driven by both H58 and non-H58 clades although the H58 clade previously associated with multiple antimicrobial resistances in Asia and in east, central and southern Africa, was not detected in Nigeria. However, antimicrobial associated with several plasmids, including the IncHI1 plasmid was common amongst the Nigerian isolates (International Typhoid Consortium, 2016)  

Diagnostics test

The current rapid enteric fever diagnostics test that are used globally are mostly serological testing to detect that detect immunogloblin IgM or IgG. Serological testing has been more widely used than nucleic acid testing due to the simplicity and cost in the resources needed for testing while compared to NAT which require laboratory facility. The popularly  available commercially available rapid serological tests like Typhidot (Malaysian Bioduagnostic Research Sdn Bhdd, KL, Malaysia) that detects the antibody against the S.typhi outer-membrane protein, Tubex TF (IDL Biotech, Sollentuna, Sweden) detects antibody against LPS an.­­­­-­­­­­­  However, serological testing  has been shown to have poor sensitivity and inadequate specificity. WIDAL test has been also demonstrated to be an due to (a) cross-reactivity with antibody from many other infections (b) establishing a baseline in the population where the infection is endemic and actively vaccinated (A and L, 2000). The Widal test being the most popular method  . Blood samples most popularly used for  diagnosis and stool samples are recommended to be avoided due to asymptomatic faecal shedding following the infection.  

While NAT tests have higher sensitivity and specificity, the NAT for enteric fever are not in use and the studies are currently limited to conventional PCR and LAMP. A recent stakeholders engagement summarized that the current challenges in diagnostics needs to improve the sensitivity of the tests to >90% and specificity >95% (Richard et al., 2019) 
Add WHO guidelines 

CRISPR Scissors for molecular detection

With the pressing need for a NAT for enteric fever, the gudiWHO the ASSURED (Affordable Specific Sensitive User-friendly Rapid Equipment-friendly Delivered) characteristic diagnostics for low-resource settings  \citep{S2016} . CRISPR-Cas based molecular detection are gaining popularity due to some of their ASSURED attributes like high sensitivity and specificity. Additionally, these methods rely on iso-thermal amplification of the target which results in rapid results and with dependency on simple equipment that could be battery powered for field deployment. However, to employ these methods for diagnosis of enteric fever, the ? needs to be further optimized to achieve affordability.
PCR has been the 'gold standard' for diagnostics due to his high sensitivity and specificity. However, using PCR depends on thermocycler which could be expensive and also slow .The discovery of isothermal methods of amplifying the nucleic acid target in the last two decades has revolutionized the POC diagnostics by reducing the amplification time and bypassing the need for expensive thermocycler. Recombinase polymerase amplification (RPA) \cite{Piepenburg_2006} and loop mediated isothermal amplification (LAMP)\cite{Notomi2000} are the two most popular PCR alternatives that could be applied for low cost POC diagnostics in LMICs. 
New approaches have been developed in recent years such as the CRISPR-Cas system to serve as a platform for point-of-care nucleic acid detection with the aim of improving sensitivity and specificities in the detection of infectious pathogens that can be employed to curb outbreaks and emerging epidemics. Cas proteins (Cas9, Cas12, Cas13, Cas14) have been leveraged to create highly accurate and sensitive diagnostic tools combined with technologies of signal amplification and fluorescent, potentiometric, colorimetric, or lateral flow assay detection . CRISPR-Cas based bacterial adaptive immunity depends on RNA to direct the Cas endonuclease to detect and destroy the foreign nucleic acid. Since the first demonstration of the ability of Cas13a  to cleave non-targeted RNA after recognizing and  cleaving the targeted RNA template \cite{East_Seletsky_2016},  CRISPR-Cas platform like Cas12-DETECTR \cite{Chen_2018}, Cas14-DETECTR  \cite{Harrington_2018}, Cas13-SHERLOCK \cite{Gootenberg_2017} are finding wide application in molecular diagnosis.  While Cas13a  recognizes  RNA as a template strand, Cas14 recognizes ssDNA and Cas12  recognizes ds/ss DNA. The choice of any these molecular scissors depends on the needs of the detection molecule and the end product.    CRISPR-Cas technique has now widely been applied to detect human papillomavirus  \cite{Chen_2018}, ZIKA virus \cite{Kellner_2019} and also the 2020 pandemic Sars-CoV-2 \cite{Broughton_2020,Ding_2020}