Evaluation of clinical and laboratory profile of typhoid fever in Nepalese children-A hospital-based study

Background: Typhoid fever caused by bacteria Salmonella typhi is endemic in developing countries like Nepal where water and sanitary conditions are questionable. It disproportionately affects children with varied clinical presentations ranging from a mild illness with low grade fever to severe life threatening complications. Hence this study was carried out to improve the understanding of this disease process in the area, enable prompt diagnosis and effective management of patients to decrease the mortality from typhoid fever. Objective: To study the clinical and laboratory profile of typhoid fever in infants and children with possible gender differentiation. Methodology: A total of 74 infants and children with fever for ?5 days were enrolled for this study. Positive blood culture for S. typhi and/or Widal agglutination test 1:160 or more dilution for O and /or H antigen, clinical symptoms, signs and the results of laboratory investigations were recorded and the number and percentage noted, with respect to different ages. Results: Mean±Standard Deviation of age was found to be 7.6±3.9. The male to female ratio was 1.4:1 with most of the patients belonging to lower middle class. Headache, anorexia and irritability were statistically significant symptoms for typhoid fever. On the analysis of the signs according to age, there were no significant differences in the frequency of any signs in the three age groups. Most of the symptoms were similar in both sexes. In all the three age groups, fever with abdominal distention and hepatomegaly was the most common presentation. Conclusion: Typhoid fever should be suspected and investigated in all children with short and long duration fever without localizing signs. Early diagnosis and institution of appropriate antibiotics therapy is of paramount importance in the management of typhoid fever. Keywords: Fever, Infants, Typhoid fever