Typhoid fever in children: Clinical presentation and risk factors

Rabasa, AI; Mava, Y; Pius, Simon; Timothy, SY; Baba, UA

doi:10.4314/njp.v40i1.11

Cited by 5 publications

(9 citation statements)

References 4 publications

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“…This study has shown that suspected typhoid fever cases were common in children aged 5 years and above. This finding agrees with observations made in Nigeria and Pakistan where typhoid fever was more common in children aged 5–9 years [ 49 , 50 ]. A plausible explanation for high prevalence of typhoid fever in older children is the consumption of unsafe locally-made chilled drinks and ice creams at schools since these are school-aged children.…”

Section: Discussionsupporting

confidence: 93%

Prevalence of Bacterial Febrile Illnesses in Children in Kilosa District, Tanzania

et al. 2015

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IntroductionBacterial etiologies of non-malaria febrile illnesses have significantly become important due to high mortality and morbidity, particularly in children. Despite their importance, there are few reports on the epidemiology of these diseases in Tanzania, and the true burden of such illnesses remains unknown. This study aimed to identify the prevalence of leptospirosis, brucellosis, typhoid fever and urinary tract infections and their rate of co-infections with malaria.MethodsA cross-sectional study was conducted at Kilosa district hospital in Tanzania for 6 months. Febrile children aged from 2–13 years were recruited from the outpatient department. Patients were screened by serological tests such as IgM and IgG ELISA, and microscopic agglutination test.ResultsA total of 370 patients were enrolled; of these 85 (23.0%) had malaria parasites, 43 (11.6%) had presumptive acute leptospirosis and 26/200 (13%) had confirmed leptospirosis. Presumptive acute brucellosis due to B. abortus was identified among 26 (7.0%) of patients while B. melitensis was detected in 57 (15.4%) of the enrolled patients. Presumptive typhoid fever due to S. Typhi was identified in thirty eight (10.3%) of the participants and 69 (18.6%) had urinary tract infections. Patients presented with similar symptoms; therefore, the identification of these diseases could not be done based on clinical ground alone. Co-infections between malaria and bacterial febrile illnesses were observed in 146 patients (39.5%). Although antibacterials and/or anti-malarials were prescribed in most patients, some patients did not receive the appropriate treatment.ConclusionThe study has underscored the importance of febrile bacterial diseases including zoonoses such as leptospirosis and brucellosis in febrile children, and thus such illnesses should be considered by clinicians in the differential diagnoses of febrile diseases. However, access to diagnostic tests for discrimination of febrile illnesses is needed. This would allow febrile patients to receive the correct diagnoses and facilitation of accurate and prompt treatment.

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Section: Discussionsupporting

confidence: 93%

Prevalence of Bacterial Febrile Illnesses in Children in Kilosa District, Tanzania

et al. 2015

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“…This study aims to identify various socio-demographic, clinical, and laboratory parameters of typhoid which are significant. Male predominance found in this study is very similar to the finding of Rabasa et al and Ramaswamy et al [ 3 , 5 ]. This may be due to overindulgence in outdoor activities in more boys than girls, therefore exposure to sources of infection.…”

Section: Discussionsupporting

confidence: 92%

“…Socioeconomic status has a very important role to play in hygiene and sanitation and hence tends to affect the incidence of enteric fever. This was reflected in this study as 94% of the affected children belonged to lower or middle socio-economic status, which resembles the findings of a Nigerian study [3].…”

Section: Discussionsupporting

confidence: 87%

“…Common presentations are fever, vomiting, diarrhoea, abdominal pain, cough, headache, and lethargy. The gold standard for diagnosis is blood culture, but in 70% the culture is negative due to injudicious use of antibiotics before admission [ 3 ]. This study intended to determine the socio-demographic factors, clinical profile, complications, sensitivity pattern of antibiotics, the treatment used, and outcome in hospitalized children with enteric fever.…”

Section: Introductionmentioning

confidence: 99%

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Clinical and Laboratory Profile of Enteric Fever in Children From a Tertiary Care Centre in Odisha, Eastern India

Behera¹,

Rup²,

Dash³

et al. 2021

Cureus

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Background: Enteric fever is a major health problem in developing countries. Varied clinical presentation leads to diagnostic dilemmas resulting in fatal complications. Objective: To determine the socio-demographic, clinical manifestations, complications, antibiotic sensitivity pattern, treatment, and outcome in hospitalized enteric fever patients. Methods: A retrospective case record analysis of hospitalized patients in the age group one to 14 years with a discharge diagnosis of enteric fever was done in a tertiary care centre of Odisha over a period of three years (January 2017 to December 2019). Results: Of 112 patients, 75% of children belonged to the six to 14 years age group with a mean age of 7.6 +/- 3.6 years and a male to female ratio of 1.66:1. The peak of cases was seen during the month of January to June with 94% of cases occurring in low and middle socioeconomic status. The commonest presentation was fever in 98.21%; other features were vomiting (39.29%), pain in abdomen (21.43%), diarrhoea (26.79%), and anorexia (14.29%). Eosinopenia was found in 58.93%, transaminitis in 30.36%, and raised CRP in 73.21%. In 30 children blood culture was positive with sensitivity to third-generation cephalosporin. All isolates were nalidixic acid-resistant Salmonella Typhi (NARST). Complications were seen in 21.42%. All recovered and two left against medical advice. Conclusion: Enteric fever is a major threat in the paediatric age group. Early clinical diagnosis with rational use of antibiotics according to sensitivity pattern is important. Improved hygiene, vaccination, and awareness among people is necessary for prevention.

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“…In this prospective study, boys were affected more than girls, with a male-female ratio of 1.4:1, compatible with other studies [ 1 , 43 - 49 ]. Rabasa AI et al found male-female ratio of 3:2 in their study [ 50 ]. In multiple studies, EF was found considerably higher in females than males [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 92%

Clinical and Laboratory Features of Enteric Fever in Children and Antibiotic Sensitivity Pattern in a Tertiary Care Hospital of a Low- and Middle-Income Country

Nusrat¹,

Islam²,

Paul³

et al. 2022

Cureus

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Background: Globally, enteric fever (EF) significantly gives rise to an appalling death toll. It is an endemic illness in Bangladesh and South Asia. The condition manifests in a wide range of clinical features in children. Nowadays, antibiotic resistance is an international stumbling block that hampers the appropriate treatment and outcome of EF. Objective: The study evaluated the clinical and laboratory characteristics and antibiotic sensitivity pattern of Salmonella enterica in children. Methods: This prospective research was conducted at Delta Medical College and Hospital, Dhaka, Bangladesh, from January 2017 to December 2019. A total of 200 pediatric cases of EF were included in this study who were either culture positive or had significantly raised Widal test titer for Salmonella with suggestive clinical features. Results: All the patients had a fever, and most had coated tongue, vomiting, abdominal pain, organomegaly, and diarrhea. Among the selected 200 cases of EF, 43.5% were Salmonella typhi culture-positive. A high erythrocyte sedimentation rate (ESR) was observed in a substantial number (53%) of patients. Ceftriaxone was the most sensitive (100%) antibiotic through laboratory analysis, followed by cefotaxime (95.1%). Among the oral antibiotics used, cefixime (92.8%) was the most sensitive. Conclusion: EF in children can present with varied clinical manifestations. Selective antibiotic treatment according to sensitivity patterns is crucial for effective illness management and will reduce morbidity and mortality in the pediatric population.

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Typhoid fever in children: Clinical presentation and risk factors

Abstract: Objective: The diagnosis of typhoid fever based on widal test is on the rise despite its set back. We prospectively reviewed over one year

Cited by 5 publications

References 4 publications

Prevalence of Bacterial Febrile Illnesses in Children in Kilosa District, Tanzania

Prevalence of Bacterial Febrile Illnesses in Children in Kilosa District, Tanzania

Clinical and Laboratory Profile of Enteric Fever in Children From a Tertiary Care Centre in Odisha, Eastern India

Clinical and Laboratory Features of Enteric Fever in Children and Antibiotic Sensitivity Pattern in a Tertiary Care Hospital of a Low- and Middle-Income Country

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