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Typhoid and paratyphoid fever in 192 hospitalized children in Thailand
Insights
This study on enteric fever in Thai children found Salmonella typhi and paratyphi A were common causes. Importantly, chloramphenicol-resistant Salmonella typhi significantly decreased over the study period.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Enteric fever, caused by Salmonella species, is a significant public health concern, particularly in developing countries.
- Understanding the epidemiology and clinical presentation of enteric fever in children is crucial for effective management and control.
Purpose of the Study:
- To describe the clinical features and causative agents of enteric fever in children treated at Children's Hospital, Bangkok.
- To investigate trends in antimicrobial resistance, specifically for Chloramphenicol-resistant Salmonella typhi.
Main Methods:
- Retrospective analysis of medical records of 192 children diagnosed with enteric fever between 1977 and 1984.
- Identification of Salmonella typhi and Salmonella paratyphi A isolates.
- Review of clinical symptoms, complications, and antimicrobial susceptibility patterns.
Main Results:
- Salmonella typhi was the predominant pathogen (85%), followed by Salmonella paratyphi A (15%).
- Common symptoms included sudden onset fever and gastrointestinal distress; diarrhea was more frequent in paratyphoid fever.
- Bronchitis and pneumonia were the most common complications (11%); acute hemolysis occurred in 3% of typhoid patients with specific genetic predispositions.
- A significant decline in Chloramphenicol-resistant Salmonella typhi was observed, from 70% in 1977 to less than 2% by 1982.
Conclusions:
- Salmonella typhi and paratyphi A are key causes of enteric fever in Thai children.
- The dramatic reduction in Chloramphenicol-resistant Salmonella typhi suggests successful interventions or changes in treatment practices.
Abstract:
From 1977 to 1984, Salmonella typhi was isolated from 85% and Salmonella paratyphl A was isolated from 15% of 192 Thai children with enteric fever at Children's Hospital, Bangkok. Children with enteric fever presented with sudden onset of fever and gastrointestinal symptoms. of fever presented with sudden onset Diarrhea occurred in 62% of children with paratyphoid fever and 36% of children with typhoid fever. Rose spots were seen in 15% of patients with typhoid and 7% of patients with paratyphoid fever. There were no deaths. Bronchitis and pneumonia occurring in 11% of patients were the most common complications. Acute hemolysis occurred in 3% of the patients with typhoid fever who had thalassemia or glucose-6-phosphate dehydrogenase deficiency. Chloramphenicol-resistant S typhi, which accounted for 70% of the isolates in 1977, has since 1982 accounted for less than 2% of isolates.