A study on clinico-epidemiological profile of typhoid fever in a rural based medical college & hospital; West Bengal; India

Sudipta Bandyopadhyay, Abhay Charan Pal, Subhendu Dey, Subhendu Samanta, Snehansu Chakraborti, Ramkrishna Mandal

Abstract


Introduction: Typhoid fever is estimated to have caused 26.9 million cases and 5.74 lakhs deaths worldwide in 2010. It remains a major public health problem in India and other part of developing world. Background: Non- provision of safe drinking water and sanitation measures, non-implementation of adequate vaccination strategies and emergence of multidrug resistant salmonella strains is responsible for why typhoid fever is till now remaining an important health problem in some parts of world and the disease is even becoming more complex. Objective:  This study was conducted in a tertiary care centre to find out the clinico-epidemiological profile of patients admitted with typhoid fever. Design: Cross sectional observational study. Subjects: 460 Widal positive typhoid fever pediatric cases admitted from 1st June 2016 to 30th November 2016. Methods: Both clinical and laboratory data of all the patients were retrieved, compiled and analyzed. Results: Out of 460 patients 238(51.74%) were males and 222 (48.26%) were females. Fever (100%), vomiting (49.13%), diarrhea (30.21%), cough (30.0%) and hepatomegaly (73.26%) were commonly observed.Response to injection Ceftriaxone was excellent.355(77.17%) patients responded to Ceftriaxone alone and 99 (21.52%) patients needed addition of oral Azithromycin.Average hospital stays in our study ranged from 3-9 days. Conclusion: In the present series typhoid fever accounted for 10.94% of pediatric admissions. Though mortality has significantly reduced typhoid fever continues to be an important cause of hospitalization in pediatric population.High incidence among lower age group indicates high endemicity and emphasizes the need of widespread use of vaccination.

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Bhan MK, Bahl R, Bhatnagar S. Typhoid and paratyphoid fever.Lancet. 2005 Aug 27-Sep 2;366 (9487): 749-62.

Kidgell C, Reichard U, Wain J, Linz B, Torpdahl M, Dougan G, Achtman M. Salmonella typhi, the causative agent of typhoid fever, is approximately 50,000 years old.Infect Genet Evol. 2002 Oct;2(1): 39-45.

Osler W. The principles and practice of medicine: designed for the use of practitioners and students of medicine. 8th edn. New York: D Appleton, 1912: 1–46.

Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ. 2004 May;82(5):346-53.

Woodward TE, Smadel JE, Ley HL Jr, Green R, Mankikar DS. Preliminary report on the beneficial effect of chloromycetin in the treatment of typhoid fever. 1948. Wilderness Environ Med. 2004 Fall;15 (3): 218-20.

Mirza SH, Beeching NJ, Hart CA. Multi-drug resistant typhoid: a global problem.J Med Microbiol. 1996 May;44(5):317-9.

Rowe B, Ward LR, Threlfall EJ. Multidrug-resistant Salmonella typhi: a worldwide epidemic. Clin Infect Dis. 1997 Jan; 24 Suppl 1: S106-9.

Mehta G, Randhawa VS, Mohapatra NP. Intermediate susceptibility to ciprofloxacin in Salmonella typhi strains in India. Eur J Clin Microbiol Infect Dis. 2001 Oct;20(10):760-1.

Harish BN, Madhulika U, Parija SC. Isolated high-level ciprofloxacin resistance in Salmonella enterica subsp. enterica serotype Paratyphi A. J Med Microbiol 2004; 53: 819.

Saha SK, Talukder SY, Islam M, Saha S. A highly ceftriaxone-resistant Salmonella typhi in Bangladesh. Pediatr Infect Dis J. 1999 Apr;18 (4): 387.

Buckle GC, Walker CL, Black RE. Typhoid fever and paratyphoid fever: systematic review to estimate global morbidity and mortality for 2010. J Glob Health 2012; 2: 10401.

Wain J, Hendriksen RS, Mikoleit ML, Keddy KH, Ochiai RL. Typhoid fever. Lancet. 2015 Mar 21; 385 (9973):1136-45. doi: 10.1016/S0140-6736 (13)62708-7. Epub 2014 Oct 21.

Mirza S, Kariuki S, Mamun KZ, Beeching NJ, Hart CA. Analysis of plasmid and chromosomal DNA of multidrug-resistant Salmonella enterica serovar Typhi from Asia. J ClinMicrobiol 2000; 38: 1449–52.

Holt KE, Phan MD, Baker S, et al. Emergence of a globally dominant IncHI1 plasmid type associated with multiple drug resistant typhoid. PLOS Negl Trop Dis 2011; 5: e1245.

Typhoid vaccines: WHO position paper.Wkly Epidemiol Rec. 2008 Feb 8;83(6):49-59.

DeRoeck D, Ochiai RL, Yang J, Anh DD, Alag V, Clemens JD. Typhoid vaccination: the Asian experience. Expert Rev Vaccines 2008; 7:547–60.

Punjabi NH, Hoffman SL, Edman DC, Sukri N, Laughlin LW, Pulungsih SP, Rivai AR, Sututo, Moechtar A, Woodward TE. Treatment of severe typhoid fever in children with high dose dexamethasone. Pediatr Infect Dis J. 1988 Aug;7 (8): 598-600.

Rogerson SJ, Spooner VJ, Smith TA, Richens J. Hydrocortisone in chloramphenicol-treated severe typhoid fever in Papua New Guinea.Trans R Soc Trop Med Hyg. 1991 Jan-Feb; 85(1): 113-6.

Mandal S, Mandal MD, Pal NK. Combination effect of ciprofloxacin and gentamicin against clinical isolates of Salmonella enterica serovar typhi with reduced susceptibility to ciprofloxacin.Jpn J Infect Dis. 2003 Aug; 56(4):156-7.

Dutta P, Mitra U, Dutta S, De A, Chatterjee MK, Bhattacharya SK. Ceftriaxone therapy in ciprofloxacin treatment failure typhoid fever in children. Indian J Med Res. 2001 Jun;113:210-3.

Ganesh R, Janakiraman L, Vasanthi T, Sathiya-sekeran M. Profile of typhoid fever in children from a tertiary care hospital in Chennai-South India. Indian J Pediatr. 2010 Oct; 77(10):1089-92. doi:10.1007/s12098-010-0196-9. Epub 2010 Sep 30.

Desai P, Vijapura A.Y. Profile of typhoid fever in admitted pediatric patients from tertiary care hospital. Pediatr Rev: Int J Pediatr Res 2015; 2(4):75-79.doi:10.17511/ijpr.2015.4.009.

Kundu R, Ganguly N, Ghosh TK, Yewale VN, Shah RC, Shah NK; IAPTask Force.IAP Task Force Report: diagnosis of enteric fever in children.Indian Pediatr. 2006 Oct;43(10):875-83.

Background Document: The diagnosis, treatment and prevention of typhoid fever. WHO /V&B/03.07 (case definitions taken directly from this document without alterations).

Wain J, Hosoglu S. The laboratory diagnosis of enteric fever.J Infect Dev Ctries. 2008 Dec 1;2(6): 421-5.

Walia M, Gaind R, Paul P, Mehta R, Aggarwal P, Kalaivani M. Walia M, Gaind R, Paul P, Mehta R, Aggarwal P, Kalaivani M. Trans R Soc Trop Med Hyg. 2006 Oct;100(10):942-8.

Siddiqui FJ, Rabbani F, Hasan R, Nizami SQ, Bhutta ZA. Typhoid fever in children: some epidemiological considerations from Karachi, Pakistan. Int J Infect Dis. 2006 May;10(3):215-22. Epub 2006 Jan 23.

Verma M, Chhatwal J, Saini V, Singh T. Enteric fever below 2 years of age. Indian Pediatr. 1996 Mar;33(3):229-30.

Saha SK, Baqui AH, Hanif M, Darmstadt GL, Ruhulamin M, Nagatake T, Santosham M, Black RE. Typhoid fever in Bangladesh: implications for vaccination policy.Pediatr Infect Dis J. 2001 May;20 (5): 521-4.

Sinha A, Sazawal S, Kumar R, Sood S, Reddaiah VP, Singh B, Rao M, Naficy A, Clemens JD, Bhan MK. Typhoid fever in children aged less than 5 years. Lancet. 1999 Aug 28;354(9180):734-7.

Ochiai RL, Acosta CJ, Danovaro-Holliday MC, Baiqing D, Bhattacharya SK, Agtini MD, Bhutta ZA, Canh DG, Ali M, Shin S, Wain J, Page AL, Albert MJ, Farrar J, Abu-Elyazeed R, Pang T, Galindo CM, von Seidlein L, Clemens JD; Domi Typhoid Study Group. A study of typhoid fever in five Asian countries: disease burden and implications for controls.Bull World Health Organ. 2008 Apr;86(4):260-8.

Kundu R, Ganguly N, Ghosh TK, Yewale VN, Shah RC, Shah NK; IAP Task Force. IAP Task Force Report: management of enteric fever in children. Indian Pediatr. 2006 Oct;43(10):884-7.

Ganesh R, Janakiraman L, Vasanthi T, Sathiya-sekeran M. Profile of typhoid fever in children from a tertiary care hospital in Chennai-South India. Indian J Pediatr. 2010 Oct;77(10):1089-92.doi: 10.1007/s12098-010-0196-9. Epub 2010 Sep 30.

Lavanya V, Shivakumar S Solabannavar,Suresh B Sonth. Comparison of Results Obtained by Semi-quantitative Slide Agglutination and Tube Widal Tests in the Diagnosis of Suspected Typhoid Fever Cases. International Journal of Biological & Medical Research. 2013; 4(1): 3001-3003.

Rasaily R, Dutta P, Saha MR, Mitra U, Bhattacharya SK, Manna B, Mukherjee A, Chakravorty S Pal SC.Value of a single Widal test in the diagnosis of typhoid fever.Indian J Med Res.1993May;97:104-7.


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