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Typhoid fever in Malaysian children
1Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kuching.
Insights
This study on pediatric typhoid fever found common symptoms like fever and abdominal pain. Splenomegaly, thrombocytopenia, and leukopenia increased the risk of complications in children.
Area of Science:
- Pediatric Infectious Diseases
- Clinical Microbiology
Background:
- Typhoid fever remains a significant public health concern globally, particularly in resource-limited settings.
- Bacteriologically confirmed typhoid fever in children presents unique clinical challenges and complication profiles.
Purpose of the Study:
- To describe the clinical presentation, diagnostic findings, treatment outcomes, and complications of typhoid fever in children.
- To identify risk factors associated with the development of complications in pediatric typhoid fever cases.
Main Methods:
- A prospective study was conducted over five years involving 102 children with confirmed typhoid fever.
- Data collected included demographics, clinical symptoms, physical examination findings, laboratory results (Widal and Typhidot tests), treatment regimens, and complications.
- Statistical analysis was performed to identify correlations between clinical/laboratory findings and complications.
Main Results:
- Fever, abdominal pain, and diarrhea were the most common symptoms. Hepatomegaly and splenomegaly were frequent physical findings.
- Positive Widal and Typhidot tests were observed in 62.5% and 96% of patients, respectively. Anemia, leukopenia, and thrombocytopenia were also noted.
- Complications such as hepatitis, bone marrow suppression, and paralytic ileus occurred in one-third of patients. Splenomegaly, thrombocytopenia, and leukopenia were identified as risk factors for complications.
Conclusions:
- Typhoid fever in children presents with characteristic symptoms and laboratory findings, with a notable rate of complications.
- Early identification of risk factors like splenomegaly, thrombocytopenia, and leukopenia is crucial for timely intervention and management to prevent severe outcomes.
Abstract:
A prospective study of 102 children with bacteriologically confirmed typhoid fever, admitted to Hospital Universiti Sains Malaysia over 5 years was conducted. The average age at presentation was 91.3 (range 6 - 159) months. Fever (900%), abdominal pain (56%) and diarrhoea (44%) were common symptoms. Findings included: hepatomegaly (85.3%), splenomegaly (27.5%), anaemia (31%), leukopenia (15%). thrombocytopenia (26%), positive Widal (62.5%) and Typhidot test (96%). Patients were treated with ampicillin (n = 54) or chloramphenicol (n = 49) and 1/3 developed complications like hepatitis (n = 19), bone marrow suppression (n = 8) and paralytic ileus (n = 7). A patient with splenomegaly, thrombocytopenia or leukopenia was at higher risk of developing complications.