Clinical Profile of Enteric Fever in Children of a Tertiary Care Centre in Kathmandu, Nepal

Abstract

Background: Enteric fever, commonly known as typhoid fever is a global public health problem. It is one of the common infectious diseases of humans, fever lasting for more than 7 days. It is transmitted by faecooral route and common in the areas with poor sanitation. Globally, majority of the Typhoid fever is caused by Salmonella enterica var typhi, one fifth of the infection is caused by Salmonella enterica var paratyphi. This study was conducted to describe clinical and laboratory parameters among children with enteric fever.

Methods: It was a descriptive cross-sectional study conducted in the Pediatric ward and Pediatric Intensive Care Unit (PICU) of Nepal Medical College Teaching Hospital (NMCTH), Atterkhel, Kathmandu, Nepal from 2015 January to 2015 December. Inclusion criteria: clinical details and laboratory parameters of children aged 13 months to 15 years old with diagnosis of enteric fever was obtained in the proforma and descriptive statistics were calculated.

Result: A total of 1,020 children with the sign and symptom suggestive of enteric fever were admitted in the inpatient department (Pediatrics) during the study period. All the enteric fever suspected children were tested for blood culture, Widal test and complete blood count, out of them 80 children were diagnosed as enteric fever. Male female ratio is 1.6:1. Fever was the most common clinical feature observed in 95% cases and other common features were loose motion (37.5%), vomiting (33.8%) and abdominal pain (27.5%). Hepato-splenomegaly is common finding of Enteric fever reported in 85.0% and 43.7%. Majority of the patients had normal leucocyte count (71.0%) and leucopenia reported in 20.0%.

Conclusion: Fever and hepato-splenomegaly were the major clinical presentation of typhoid fever in our study. Other less common features were loose motion, vomiting and abdominal pain. This finding may be useful for the pediatrician and other health professionals for the early diagnosis of enteric fever.