Our research is focused on addressing enteric fever diagnostic needs in Cameroon, where the disease is widely recognized as a national public health concern and Global Health Data Exchange data estimates there were 45,000 cases and 580 deaths in 2016 \cite{ghdx}. Fluoroquinolones or third generation cephalosporins are the drugs of choice for the treatment of typhoid fever in Cameroon \cite{Nkemngu_2005}. While outbreaks of AMR typhoid fever have been reported in 15 African countries since 1950, the reports of those outbreaks in Cameroon are limited due to limitation in facilities available for testing. These outbreak are 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 MDR in Asia and in east, central and southern Africa, was not detected in west Africa. However, antimicrobial associated with several plasmids, including the IncHI1 plasmid was common amongst the Nigerian isolates (International Typhoid Consortium, 2016) .
The challenges in clinical typhoid management in Cameroon needs 1. rapid NAT testing 2. AMR rapid genotype based testing (reword these)
CRISPR Scissors for molecular detection
PCR and real-time PCR has been the 'gold standard' method for diagnostics due to his high sensitivity and specificity. However, they depend 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 LAMP \cite{Notomi2000} are the two most popular PCR alternatives that has seen a wide spread application in rapid-low-cost POC diagnostics. LAMP relies on a single polymerase and a complex(I am looking for another word) primer design for amplification at 65C. RPA depends on polymerase, recombinase, single strand binding protein for amplification at 37C.