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

Abstract

Background: Enteric fever, commonly known as typhoid fever has becoming a global public health problem in the developing countries . It is one of the common infectious diseases of humans, fever lasting for more than 7 days. It is transmitted by feco-oral route and common in the societies of 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 . Fever is the most common clinical manifestation present in almost all patients with enteric fever. 

Methods: It is a descriptive cross-sectional research 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: Children admitted in Pediatric ward and PICU from 13 months to 15 years old.

 Result: A total of 920 children with the sign and symptom of 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 is 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 were  common findings of Enteric fever reported in 85.0% and 43.7%. On investigation, majority of the patients had normal leucocyte count (71.0%) and leucopenia reported in 20.0%. 

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