Unpacking Enteric Fever in Pakistan: Insights into Clinical Patterns and Financial Burdens

Typhoid fever (TF) and paratyphoid fever (PTF), collectively known as enteric fever (EF), are acute febrile illnesses that are common and cause significant morbidity and mortality. EF is responsible for about 26.9 million cases of mortality and morbidity worldwide, with Asian nations accounting for over 90% of all EF deaths. There is not enough data to determine the burden of TF in Pakistan, where it is thought to be endemic. Multidrug-resistant H58 clade Salmonella enterica serovar Typhi has expanded far beyond Asia and Africa. The development of multidrug resistance is expected to significantly increase the difficulty and cost of diagnosing and treating EF, particularly in rural areas where resources are scarce.  Hospitalisation costs, prescription drugs, diagnostic testing, and other medical services are included in out-of-pocket expenses (OOPE) for patients with EF in rural areas. The fact that the majority of these patients take antibiotics without consulting a doctor is a serious concern. This needs the implementation of antibiotic stewardship in rural areas of Pakistan and an increase in diagnostic facilities.  Key Words: Multidrug-resistant, Paratyphoid fever, Typhoid fever.