Enteric fever in Children at Dhulikhel Hospital

Abstract

Introduction: Typhoid fever is one of the most common public health problems in Nepal. It occurs in all parts of the world where water supplies and sanitation are sub-standard. In Dhulikhel hospital, this is one of the top acute febrile illnesses in inpatient department. The objectives of this study were to evaluate the clinical and laboratory parameters including culture and sensitivity, the response to therapy, and complications of enteric fever among child cases at Dhulikhel Hospital. . Statistical analysis was done with SPSS. Results: There were total of 138 cases of enteric fever admitted. There were 73 (53%) male and 65 (47%) female. Eighty-one percent were above five years of age. The most common clinical presentation was fever (100%) followed by headache and G I symptoms. Hepatomegaly was the most common sign seen among the cases and was seen in 110cases (79.71%). Most of the patients had normal WBC count 100 (72.46%) Widal test was positive in 70 (50.72%) cases and blood culture was positive in 52(37.68%) cases. Nalidixic acid was found to be resistant in 26 (50%) cases. Complications were seen in only 7 (5%) enteric fever cases. Conclusion: Typhoid fever is predominant in school going children in Nepal with slight male predominance. Fever lasting over 3 days followed by headache and GI symptoms are the major presenting symptoms. In making the diagnosis, the isolation of bacteria from blood is the "gold standard". Nalidixic acid resistant Salmonella typhi is on the increasing trend. Pneumonia was found to be the most common complication among all other complications seen in enteric cases. In Dhulikhel Hospital this is one of the top acute febrile illnesses in inpatient department.

Profile of Culture Positive Enteric Fever in Children Admitted in a Tertiary Care Hospital

“…This is similar to the observations by Chandrasekhar et al, 1 Gupta et al, 3 Jog et al, 4 Chowta et al, 15 Singh et al 16 and Malla et al 17 studies.…”

“…Majority of the study population were from upper middle class 58.82% (30), whereas lower middle class contributes 31.37% (16) and hardly few cases were noticed in upper class and upper-lower class i.e. 5.88% (3) and 3.92% (2) respectively.…”

Antimicrobial resistance trend of Salmonella typhi and paratyphi from 2011-2013: A descriptive study from tertiary care hospital of Nepal

“…This demonstrates that ST and SPA are fully susceptible to ceftriaxone. These results are consistent with other studies from Nepal which have shown full susceptibility to ceftriaxone [14][15][16] . An important implication of these fi ndings is that ceftriaxone is a very good choice for empirical treatment of suspected enteric fever.…”

“…Other studies have also reported similar fi nding 14,15 . However, because of toxicity its use is limited.…”

Clinical profile of enteric fever in tertiary care hospital of Kashmir

“…Other large series include those by Chowta et al, S. jog et al and Walia et al 2,12,13 Most of the clinical symptoms and signs reported by us are similar to those reported earlier. [14][15][16] Children in this study commonly presented with fever, headache and gastrointestinal symptoms and diarrhea was more common than constipation. Our observation of fever as a common complaint in all the children and diarrhea being more common than constipation, similar findings were also observed by other author.…”