Multidrug-Resistant Typhoid in Children: Presentation and Clinical Features

Bhutta, Zulfiqar Ahmed; Naqvi, Shehla H.; Razzaq, Raza A.; Farooqui, Badr J.

doi:10.1093/clinids/13.5.832

Cited by 98 publications

(54 citation statements)

References 28 publications

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“…In contrast to findings from other parts of Asia, [19][20][21][22] our data support the contention that the Widal test has poor diagnostic value in children with typhoid fever. 23,24 Most of the children presented in the second week of their illness and we used a cut-off titer of 1:80.…”

Section: Discussionsupporting

confidence: 79%

Rapid serologic diagnosis of pediatric typhoid fever in an endemic area: a prospective comparative evaluation of two dot-enzyme immunoassays and the Widal test.

Bhutta

Mansurali²

1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. We evaluated the diagnostic sensitivity and specificity of two dot-enzyme-linked immunoassays (Typhidot and Typhidot-M; Malaysian Biodiagnostic Research SDN BHD, Kuala Lumpur, Malaysia), assessing IgG and IgM antibodies against the outer membrane protein (OMP) of Salmonella typhi, and the Widal test in comparison with blood culture in a consecutive group of children with suspected typhoid fever. Of 97 children with suspected typhoid fever, the disease was confirmed bacteriologically in 46 (47%), whereas 25 (26%) were considered to have typhoid fever on clinical grounds. An alternative diagnosis was made in 26 (27%). The Typhidot and Typhidot-M were superior to the Widal test in their diagnostic sensitivity and specificity, although values (sensitivity ϭ 85-94% and specificity ϭ 77-89%) were significantly lower than in other regional reports. The lower specificity of the Typhidot in our series may represent regional differences in the genomic structure and plasticity of the OMP of S. typhi and merits further evaluation of these tests in diverse geographic locations.

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Section: Discussionsupporting

confidence: 79%

Rapid serologic diagnosis of pediatric typhoid fever in an endemic area: a prospective comparative evaluation of two dot-enzyme immunoassays and the Widal test.

Bhutta

Mansurali²

1999

The American Journal of Tropical Medicine and Hygiene

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“…All our patients were very toxic on presentation. This is in agreement with the findings of Bhutta et al [19], who found children infected with multiresistant strains to be more toxic than those infected with sensitive strains. Three of our patients were successfully treated with intravenous ceftriaxone; in two of them, the drug was chosen as they could not take oral therapy because of vomiting.…”

Section: Discussionsupporting

confidence: 93%

“…Recently many reports of strains of S. typhi resistant to the three first line drugs against typhoid fever came from the Indian subcontinent [2][3][4]19]. Due to the large numbers of Indian and Pakistani nationals working in Saudi Arabia and annual influx of nationals from these countries to perform Haj, one would expect to encounter such strains in this country.…”

Section: Discussionmentioning

confidence: 99%

Enteric Fever Due To Multi-Resistant Salmonella Typhi

et al. 1993

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“…Finally, differences in the age-specific attack rates need to be evaluated with some caution since the majority of cases may be asymptomatic or have a mild nonspecific illness, 65 especially young children and infants. 66,67 However, in one study, the highest case fatality rate from typhoid fever was seen in young children, 68 who also have the highest all-cause death rates in refugee and civil war settings. 69 In the United States, the Vi and Ty21a vaccines are licensed for use in children more than 2 and 5 years of age, respectively.…”

Section: Choice Of Vaccine and Target Groups For Immunizationmentioning

confidence: 94%

Considerations regarding mass vaccination against typhoid fever as an adjunct to sanitation and public health measures: potential use in an epidemic in Tajikistan.

Tarr

Kuppens²,

Jones³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. We report on the ongoing epidemic of typhoid fever in Tajikistan that started in 1996. It has involved more than 24,000 cases to date, and is characterized by multiple point sources, overflow of sewage, contaminated municipal water, and person-to-person spread. Of the Salmonella typhi isolates available for testing in western laboratories, more than 90% are multidrug-resistant (MDR). Most recently, 28 (82%) of 34 isolates are resistant to ciprofloxacin, representing the first reported epidemic of quinolone-resistant typhoid fever. In the past, mass immunization during typhoid fever epidemics has been discouraged. A review of this policy is recommended in light of the alarming emergence of quinolone-resistant strains of S. typhi, the availability of improved vaccines, and the ongoing epidemic in Tajikistan. Mass immunization may be a useful measure for the control of prolonged MDR typhoid fever epidemics, as an adjunct to correction of municipal infrastructure and public health intervention.

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Multidrug-Resistant Typhoid in Children: Presentation and Clinical Features

Cited by 98 publications

References 28 publications

Rapid serologic diagnosis of pediatric typhoid fever in an endemic area: a prospective comparative evaluation of two dot-enzyme immunoassays and the Widal test.

Rapid serologic diagnosis of pediatric typhoid fever in an endemic area: a prospective comparative evaluation of two dot-enzyme immunoassays and the Widal test.

Enteric Fever Due To Multi-Resistant Salmonella Typhi

Considerations regarding mass vaccination against typhoid fever as an adjunct to sanitation and public health measures: potential use in an epidemic in Tajikistan.

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