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Typhoid ileal perforation in children: a scourge in developing countries
1Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. ameh@abu.edu.ng
Annals of Tropical Paediatrics
|March 15, 2000
Summary
Typhoid perforation significantly impacts children under 12, with higher risks in older children. Early presentation is crucial for survival, as late diagnosis leads to high mortality from sepsis.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Public Health
Background:
- Typhoid perforation is a severe complication of Salmonella Typhi infection.
- It disproportionately affects children in developing countries.
- Understanding epidemiological and clinical features is vital for management.
Purpose of the Study:
- To analyze the incidence, clinical presentation, and outcomes of typhoid perforation in children.
- To identify risk factors associated with mortality.
- To inform public health strategies for prevention and early intervention.
Main Methods:
- Retrospective analysis of 64 pediatric cases of typhoid perforation over 10 years.
- Data collection on demographics, clinical features, seasonality, treatment, and outcomes.
- Statistical analysis to determine factors influencing mortality.
Main Results:
- Children under 12 accounted for 56% of typhoid perforations.
- Perforation rates increased with age, peaking in the 10-12 year group (29.3%).
- Common symptoms included fever and abdominal pain; 20.3% had associated hemorrhage. High morbidity (53%) and mortality (39%) were observed, with sepsis being a major cause of death. Late presentation (>7 days) significantly correlated with increased mortality (p < 0.05).
Conclusions:
- Typhoid perforation remains a critical health issue in pediatric populations in resource-limited settings.
- Improved sanitation, safe water, and public awareness are essential for prevention and early detection.
- Timely medical intervention is crucial to reduce the high morbidity and mortality rates.