Profile of Enteric Fever in Children at Tertiary Care Hospital Sukkur Pakistan

Abstract

Background; Enteric fever (Typhoid fever) is widely recognized as a major public health problem in developing countries.

Objective: To study the clinical profile and complication of enteric fever in children.

Study Design: Prospective descriptive study.

Place and Duration of Study: This study was conducted at the Paediatric Department at Ghulam Muhammad Mahar Medical College Hospital Sukkur from January 2010 to December 2011.

Materials and Methods: This was a prospective study, included all patients of enteric fever, of both sex and age ranged from 1 year to 13 years. All cases of enteric fever were confirmed by serological test Typhidot IgM or IgM and IgG positive.

Results: A total of 360 patients of enteric fever were studied during 2 years. Mean age of presentation was 7.47 years and 166 (46.12%) patients were < 5 years whereas 194 (53.88%) were > 5years of age. Male: Female ratio was 2:1. Clinical profile of patients shows, that fever was present in all cases, vomiting 180 (50%), anorexia 180 (50%), headache 126 (35%), abdominal pain 108 (30%), diarrhea 108 (30%), weakness 102 (28.33%), cough 90 (25%), constipation 36 (10%) cases, and coated tongue was found in 275 (75%), tender abdomen 140 (38.88%), hepatomegaly 90 (25.0%), splenomegaly 76 (21.11%), toxic appearance 72 (20.0%), dehydration 70 (19.44%), pallor 54 (15%) and relative bradycardia 12 (3.33%) of cases. Complications were found in 88 (24.44%) of cases, raised ALT in 66 (18.3%) jaundice 6 (1.66%), intestinal hemorrhage in 4 (1.11%), peritonitis and osteomyelitis 3 (0.83%) respectively.

Conclusion: Common clinical features of enteric fever include fever, vomiting, anorexia, abdominal pain, headache, coated tongue, anemia, hepatomegaly and elevated liver enzymes. Diarrhea is more common in children < 5 years. Complication due to late diagnosis and drug resistance will persist in our part of country.