Management Of Typhoid Fever Research Articles

Assessment of blood culture and tube agglutination serology test for the diagnosis of typhoid fever amongst malaria-negative patients: a one-year hospital-based study

Salmonella serotypes, including Salmonella Typhi, S. Paratyphi A, S. Paratyphi B, and S. Paratyphi C, are responsible for the systemic, protracted febrile sickness known as typhoid fever. Various antibody-based tests are being used for diagnosing typhoid fever. This study was carried out to assess the performance of the widal test and blood culture for the diagnosis of typhoid fever among malaria-negative patients in a tertiary care hospital in east Delhi, India. The study was conducted from July 2021 to June 2022 in the Department of Microbiology of a tertiary care hospital in Delhi. Patients, including the adult and pediatric population, were evaluated for typhoid fever and participated in an observational, prospective study on febrile patients that was malaria-negative. Venous blood samples were obtained under strict aseptic conditions and further processed for widal serology and blood culture tests for typhoid fever. In our study, the prevalence of blood culture-positive Salmonella species was 0.3% (30/10,000 = 0.3%) Among antimicrobial susceptibility patterns, S. Typhi revealed the highest resistance rates for Ciprofloxacin (43.33%), Azithromycin (36.66%), and third-generation cephalosporins. Out of 30 blood culture-positive Salmonella Typhi of typhoid fever patients, 5 (17%) samples were negative for the Widal test. Among 30 samples, all were blood culture positive, but only 25 samples show Widal titer above the baseline i.e. >1:64. Although blood culture is the gold standard for the diagnosis of typhoid fever, the Widal test does play a role in the diagnosis and management of typhoid fever, especially in suspected cases when blood culture is negative, especially in government tertiary care hospitals.

Effectiveness of Ayurveda Remedies in the Management of Typhoid Fever

Abstract Typhoid fever is a systemic infection associated with fever that is most often caused by Salmonella typhi, which remains a serious problem in developing countries. Once the bacteria are ingested, it quickly multiplies within the stomach, liver, or gallbladder and finally enters the bloodstream, causing symptoms such as fever and headache. The national incidence of typhoid fever in India is 360 cases/100,000 person-years, with an annual estimate of 4.5 million cases and 8930 deaths, assuming a 0.2% case fatality rate. A 10-year-old girl patient visited our outpatient department with complaints of fatigue, anorexia, malaise, occipital headache, and loose stool. Examination and history lead to the diagnosis of typhoid confirmed by the Widal test and Typhi Dot (Immunoglobulin [Ig] G and IgM). This case was managed with Balachaturbhadra Churna 3 g twice per day with lukewarm water after food and Kumaryasava 5 mL twice a day before food. It was given for 5 weeks, and follow-up period was 15 days with a weekly visit. From the result obtained, it can be concluded that therapy with this Ayurvedic combination of drugs showed significant relief in symptoms after 5 weeks of treatment. Ayurveda can be the choice of the ailment.

Beta-lactamase production and conjugative ability of multidrug resistant Salmonella Typhi in Southern Benue, Nigeria

Objective: To examine multidrug resistant (MDR) Salmonella (S.) Typhi isolates obtained from the stool samples of patients attending secondary health centers in Southern Benue, Nigeria, for extended spectrum beta-lactamase (ESBL) production and conjugative ability. Methods: The double disc synergy test was used to screen for ESBL production in MDR isolates. The ability of S. Typhi to transfer resistance gene was determined by conjugation experiments using standard protocols, with slight modifications. Escherichia (E.) coli ATCC 25922 was used as the recipient organism. Result: The donor S. Typhi isolates showed resistance to all the classes of antibiotics except aminoglycosides and carbapenems. All isolates except TKP 106, APA 55, APA 78 and OGB 106 were positive for ESBL production. Reduction in the zones of inhibition of E. coli after incubation with S. Typhi showed evidence of conjugation and transfer of antibiotic resistance from S. Typhi to E. coli. Conclusions: The presence of ESBL-producing S. Typhi capable of conjugation poses a significant risk to the treatment and management of typhoid fever, which highlights the need for the regulation of antibiotic use through relevant policies and strategies that aim at halting the spread of MDR and ESBL-producing S. Typhi in such rural settings.

PEMBERIAN KOMPRES AIR HANGAT TERHADAP PENURUNAN SUHU TUBUH PADA ASUHAN KEPERAWATAN DENGAN DEMAM TYPOID DI RUMAH SAKIT BHAYANGKARA M HASAN PALEMBANG TAHUN 2022

Typhoid fever is an acute infectious disease that usually affects the digestive tract with symptoms of fever that last more than one week. Non-pharmacological techniques in reducing fever body temperature are warm water compresses. The purpose of this study is to find out a description of the provision of warm water compresses to decrease body temperature in typhoid fever.The design of this research is descriptive analytic with Case Study method. The management of typhoid fever is giving warm water compresses to decrease body temperature which is carried out at Bhayangkara M Hasan Hospital Palembang from June 14, 2022 to June 16, 2022. The subjects of this study were 2 patients with Typhoid Fever. The plan given is the provision of warm water compresses to decrease body temperature in typhoid fever. The research instrument used is the format of nursing care and medical records. While the instrument for measuring body temperature uses a thermometer and the instrument for giving warm water compresses uses nierbeken, warm water (43-46℃), washcloth and swab. After giving warm water compresses for 3 days, both patients experienced a decrease in body temperature. The body temperature of Mrs. "S" before giving a warm compress was 40.2℃ and after giving a warm compress of 36.1℃. Meanwhile, for Ms. "A" before giving a warm compress of 40.1℃ and after giving a warm compress of 36.0℃. After giving warm water compresses for 3 days, both patients experienced a decrease in body temperature.

Ethnobotanical study of plants used by traditional healers in Lubumbashi (Democratic Republic of Congo) in the management of typhoid fever

No documented study reports the ethnobotanical knowledge of the medicinal plants involved in the management of typhoid fever in Lubumbashi. This study aims to identify plants and recipes used by traditional medicine practitioners (TMPs) in Lubumbashi to manage typhoid fever. The cross-sectional descriptive survey was carried out on TMPs through a direct interview, making it possible to collect ethnobotanical data. Fifty TMPs consulted (sex ratio M / F = 2.5, age = 45 ± 11 years, experience: 20 ± 13 years) made it possible to list 57 plants. These taxa are mostly shrubs (52%), Microphanerophytes (52%), endemic to tropical Africa (32%), belonging to 28 botanical families dominated by Fabaceae and indicated in 47 other causes of consultation for which diarrhea comes first position. From these 57 plants derived, 67 anti-typhoid recipes were administered orally. The stem bark was the most used part (33%), and the decoction (72%) was the most common preparation method. This study reports for the first time the ethnobotanical anti-typhoidal use of 25 species, among which Ficus sur Forssk. (0.22), and Monotes katangensis DeWild (0.18) has the highest consensus indexes (CI) and Diplorhynchus condylocarpon (Müll.Arg.) Pichona (UVp = 0.19) followed by Albizia antunesiana Harmsa (0.17), the highest usual values ​​(UVp). TMPs use several plants in Lubumbashi to treat typhoid fever. Some are specific to the ecological environment, and others are used in other regions of the continent. Pharmacological studies are underway to assess the therapeutic efficacy of lesser-known plants among those listed.

Ethnobotanical study of plants used by traditional healers in Lubumbashi (Democratic Republic of Congo) in the management of typhoid fever

Ethnobotanical study of plants used by traditional healers in Lubumbashi (Democratic Republic of Congo) in the management of typhoid fever

British Infection Association guidelines for the diagnosis and management of enteric fever in England

Enteric fever (EF) is an infection caused by the bacteria called Salmonella Typhi or Paratyphi. Infection is acquired through swallowing contaminated food or water. Most EF in England occurs in people returning from South Asia and other places where EF is common; catching EF in England is rare. The main symptom is fever, but stomach pain, diarrhoea, muscle aches, rash and other symptoms may occur. EF is diagnosed by culturing the bacteria from blood and/or stool in a microbiology laboratory. EF usually responds well to antibiotic treatment. Depending on how unwell the individual is, antibiotics may be administered by mouth or by injection. Over the past several years, there has been an overall increase in resistance to antibiotics used to treat enteric fever, in all endemic areas. Additionally, since 2016, there has been an ongoing outbreak of drug-resistant EF in Pakistan. This infection is called extensively drug-resistant, or XDR, EF and only responds to a limited number of antibiotics. Occasionally individuals develop complications of EF including confusion, bleeding, a hole in the gut or an infection of the bones or elsewhere. Some people may continue to carry the bacteria in their stool for a longtime following treatment for the initial illness. These people may need treatment with a longer course of antibiotics to eradicate infection. Travellers can reduce their risk of acquiring EF by following safe food and water practices and by receiving the vaccine at least a few weeks before travel. These guidelines aim to help doctors do the correct tests and treat patients for enteric fever in England but may also be useful to doctors and public health professionals in other similar countries.

A rare case of an imported typhoid fever caused by extensively drug-resistant salmonella typhi in the UAE

The emergence of extensively drug-resistant (XDR) strains of Salmonella enterica serovar Typhi-resistant to multiple first-line antibiotics started in the Sindh Province in Pakistan is a cause of concern in the management of typhoid fever. Recently, we experienced a case of XDR typhoid fever in a 4-year-old unvaccinated girl who contracted it during her visit to Pakistan in the summer of 2019, improved with meropenem and azithromycin. This is the first reported case of paediatric XDR typhoid diagnosed and treated in the UAE. Awareness of the on-going outbreak of XDR typhoid fever in Pakistan is very important for clinicians in the evaluation and management of febrile illnesses in a child with a history of travel to Pakistan.

ASSESSMENT OF CLINICAL AND LABORATORY PARAMETERS IN TYPHOID FEVER IN PEDIATRIC CASES ADMITTED TO NMCH, PATNA

India has a very high disease burden (214.2 per 1,00,000 individuals/year), primarily affecting children 5 to 15 years. Recently, there have been concerns of increasing proportion of infections in very young children, rising paratyphoid infections, and emerging drug resistance. Also, there are challenges in diagnosis and management of enteric fever due to lack of laboratory-based investigations. While blood culture remains the gold standard of diagnosis, the mainstays in developing countries are serological tests, which are suboptimal due to lack of standardization and uniformity. Hence based on above condition the present study was planned for Assessment of Clinical and Laboratory Parameters in Typhoid Fever in Pediatric Cases Admitted to NMCH, Patna.
 The present study was planned in Department of Pediatrics, Nalanda Medical College and Hospital, Patna, Bihar, India. The study was planned from January 2018 to November 2018. In the present study 50 childrens of age up to 18 years having fever more than 7 days were enrolled. These cases were enrolled based on the Widal positive or positive culture were enrolled in the present study.
 The data generated from present study concludes that Typhoid fever manifestations are diverse. The most common symptoms apart from fever were anorexia, vomiting, pain abdomen, diarrhoea followed by headache and cough. Also the Serum parameters are also seen changed in the Thyphoid affected patients. Typhoid fever remains a major public health problem in the developing countries predominantly seen in school going children among pediatric age group.
 Keywords: Clinical, Laboratory Parameters, Typhoid Fever, Pediatric Cases, etc.

Ethnobotanical survey of medicinal plants used for the treatment of typhoid fever in Kaduna Metropolis, Nigeria

Typhoid fever had become one of the most serious infectious diseases among the urban populace of Kaduna metropolis, Northern Nigeria due to its escalating cost of treatment via the conventional system, current economic melt-down, and drug-resistant strategy of the Salmonella spp. People, therefore, resorted back to the use of medicinal drugs that are cost-effective with no side effects. An ethnobotanical survey was conducted to identify the medicinal plants used for the treatment of typhoid fever in Kaduna metropolis to establish a check-list of the pharmacognostic activity of the most frequently used plant. Self-structured questionnaires were administered among herbalists and individuals representing the consumer population. Plant specimen were also collected along the line, identified and authenticated at the herbarium of the Department of Botany, Ahmadu Bello University, Zaria, Nigeria. The results obtained revealed that 40 different plant species representing 29 families of plants were used in the treatment of typhoid fever in Kaduna. Among the most frequently used species include Alchornea cordifolia, Balanites aegyptiaca, Blighias apida, Datarium microcarpum, Gardenia aqualla, Grewia mollis, Lawsonia inermis, Morinda lucida, Nanclei latifolia, Ocimum gratissimum, Plumeria rubra, and Mangifera indica. It was found that the leaves and stem were the major parts used for herbal preparation and were administered orally in the form of decoction and infusion. Furthermore, need for incorporating the traditional herbalists in the management of typhoid fever by orienting them through seminars and workshops on how to formulate standard doses for the treatment strategies. Thus, medicinal herbs are effective in the treatment of typhoid fever.

Current trends in the epidemiology and management of enteric fever in Africa: A literature review

Enteric fever remains a tropical disease of public health significance in Africa, due to its high endemicity and transmission rates, more in sub-Saharan Africa with 7.2 million cases of typhoid fever annually and incidence rate of 762 per 100 000 person-years when compared with Northern Africa with a reported incidence rate of 557 per 100 000 person-years and lower. Recent studies show that almost all regions of sub-Saharan Africa are tending towards high incidence rates, especially Central and Western Africa. Though clinically indistinguishable from paratyphoid fever, typhoid fever causes more morbidity and mortality than paratyphoid fever, with a greater threat to children. Risk factors include consumption of contaminated water, patronizing food vendors and a history of contact with a case or a chronic carrier, amongst others. Environmental factors such as the rainy season, open sewers, contaminated water bodies and areas of low elevation have been implicated. Diagnosis in Africa is challenging due to resource constraints, as many centres still depend on clinical diagnosis and serodiagnosis using Widal test, in an era where more sensitive and specific tests exist. The polymerase chain reaction is one of the most sensitive diagnostic methods, while culture (particularly bone marrow) is considered to be one of the most specific. Quinolones (ciprofloxacin) and third-generation cephalosporins, amongst others, remain potent in the management of enteric fever, with resistance to quinolones gradually on the rise. Poor diagnostics, poor antibiotic stewardship and lack of drug (antibiotic) regulation are contributors to the problem of antibiotic resistance in Africa. Prevention of typhoid fever through vaccination, especially in children is still under investigation, with steady progress being documented. Overall, long term prevention strategies for typhoid fever should be based on improved sources of drinking water, good sanitation and hygiene, food safety and poverty alleviation.

Management of Typhoid Fever - Clinical and Historical Perspectives in Korea.

Typhoid fever, showed a dramatic decrease in its incidence from 56 per 100,000 population just after Korea's independence to <1 per 100,000 population in 2000s. The clinical features of patients with typhoid fever in Korea were not too different from those reported in textbooks. Beyond cultures and Widal test, other diagnostic techniques such as string capsule culture and polymerase chain reaction have been tried in Korea. As chloramphenicol is not used anymore in Korea, ampicillin, cotrimoxazole, fluoroquinolones, and third-generation cephalosporins have been administered for therapy of typhoid fever. Especially, ciprofloxacin and ceftriaxone were successfully tried with shorter duration of treatment (1 week). However, cases of treatment failure and resistance in ciprofloxacin were reported in Korea, which requires a great caution. As preventive vaccines, parenteral Vi polysaccharide vaccine and oral live attenuated vaccine are mainly used in Korea. The decline in the number of chronic carriers of typhoid fever in Korea by the roles of doctors and patient management from the health care authorities such as Korea Centers for Diseases Control and Prevention, prescription of effective antimicrobial agents, and increased piped water supply ratio are considered to be the major contributing factors to the reduction in the outbreak of typhoid fever in Korea.

Knowledge regarding prevention and management of typhoid fever among patients and care givers attending OPD in Government Area Hospital at Bhadrachalam, Telangana.

Knowledge regarding prevention and management of typhoid fever among patients and care givers attending OPD in Government Area Hospital at Bhadrachalam, Telangana.

Typhoid Fever due to Extended Spectrum β-Lactamase-Producing Salmonella enterica Serovar Typhi: A Case Report and Literature Review

Emergence of cephalosporin-resistant strains of Salmonella enterica serovar Typhi is a cause of concern in the management of enteric fever. Cephalosporin resistance in Salmonella species is mainly due to the production of extended-spectrum β-lactamases (ESBLs). The majority of ESBLs in Salmonella enterica serovar Typhi are derivatives of the TEM, SHV, and CTX-M β-lactamase families. Of these, CTX-M appears to be predominant. This paper discusses the detection and molecular characterization of an ESBL-producing Salmonella enterica serovar Typhi strain isolated from a patient who was admitted to a private hospital in Sri Lanka. The three main types of β-lactamases such as TEM, SHV, and CTX-M were identified in this isolate. This case report from Sri Lanka contributes to the knowledge of the increasingly reported cases of typhoid fever due to Salmonella enterica serovar Typhi resistant to β-lactamase by ESBL production.

Analysis of Trends in Resistance to Fluoroquinolones and Extended Spectrum Beta-Lactams among &amp;lt;i&amp;gt;Salmonella&amp;lt;/i&amp;gt; Typhi Isolates Obtained from Patients at Four Outpatient Clinics in Nairobi County, Kenya

Typhoid fever caused by the bacterium Salmonella enterica serovar Typhi (S. Typhi) causes an estimated 25 million illnesses and approximately 200,000 deaths annually mostly in developing countries. Although the management of typhoid fever has been effectively through antibiotic treatment, S. Typhi is increasingly becoming resistant to the currently recommended drugs. This study utilized a quasi-experimental design focusing on archived samples to describe antimicrobial susceptibility patterns of S. Typhi and determine the genetic basis of resistance to the two most commonly used classes of antimicrobials. A total sample size of 287 isolates of S. Typhi isolates stored in -80°C freezer at the Centre for Microbiology Research was utilized. Isolates were subjected to anti-microbial susceptibility testing to commonly available antimicrobials using disk diffusion method, then analyzed for trends in resistance to fluoroquinolones and extended spectrum beta lactams. Among the 287 isolates 158 (55.5%) were found to be Multi Drug Resistant (MDR). This implied that these isolates were resistant to all first line classes of treatment such as ampicillin, chloramphenicol and sulfamethoxazole-trimethroprim. In addition to this, these isolates were also resistant to at least one of the currently recommended drugs of choice, either a β-lactam or a fluoroquinolone. This study observed resistances at 18.2% and 15.4% to fluoroquinolones and cephalosporins respectively. PCR results revealed presence of blaTEM, blaINT and blaCTX-M genes coding for resistance to β-lactams in 80% of the isolates that had combined resistance to β-lactams and fluoroquinolones. It is likely that recent heavy use of these classes of antimicrobials is driving resistances to these antimicrobials.

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

Genetic characterization and evaluation of antimicrobial resistance patterns of human salmonella typhi isolates in kenyatta national hospital in nairobi, kenya

The rapid increase and subsequent management of Typhoid fever in Kenya has been complicated by the emergence and rise of antimicrobial resistance to the Salmonella Typhi pathogen. This situation is yet to be addressed due to the paucity of information regarding the circulating strains and their antimicrobial resistance profiles. This study was hence designed to genetically characterize and evaluate the antimicrobial resistance patterns of human Salmonella Typhi isolates circulating among patients in Kenyatta National Hospital the largest referral health facility in Kenya. Fifty (n=50) Salmonella Typhi archived sample isolates were obtained from stool samples of patients suffering from typhoid fever who attended the facility from 2010 to 2015. The isolates were evaluated for phylogenetic relationships targeting 16s rRNA gene sequences and antimicrobial susceptibilities against a panel of 12 drugs by disk diffusion method. Phylogenetically, the isolates clustered close to Salmonella Typhi strain CT18 and its plasmid pHCM1 and plasmid IncHI1 of Salmonella Typhi strain R27 both associated with drug resistance. Antimicrobial susceptibility tests showed that 73% of the isolates were resistant to the Aminopenicillin, Sulfonamide, Phenicol and Aminoglycoside classes of drugs. A resistance of between 7% to 19% was observed for the Beta-lactamase, Fluoroquinolone and Cephalosporin classes of drugs. Only one of the isolates was fully susceptible to all the antimicrobial drugs used. A total of 23% of the isolates were intermediately resistant to all the 12 drugs used. The high resistance patterns of Salmonella Typhi evidenced necessitates the re-evaluation of the currently used antibiotic regimen and also underscores the importance of continued drug resistance monitoring for this pathogen. Key Words Salmonella Typhi, Antimicrobial resistance, Phylogenetic, Susceptibility

Influence of Knowledge on the Management of Typhoid Fever in Bungoma County in Kenya

Influence of Knowledge on the Management of Typhoid Fever in Bungoma County in Kenya

Impact of Cultural Factors on the Management of Typhoid Fever in Bungoma County, Kenya

Health for all by the year 2000 was an objective by the World Health Assembly in 1979 following the International Conference on Primary Health Care in 1978.Follow-ups to this declaration indicated that, this objective was not realised because of the strategy used, which mainly focused on the delivery of the health services and on the role of the health sector in improving health outcomes. World Health Organization (WHO) and other member states have acknowledged that the social factors responsible for persisting inequalities in health in society are poverty, limited national resources, lack of education, population increase, poor sanitation and lack of awareness of the importance of health. There is also abundant evidence that major determinants of health lie outside the health sector and consequently, health cannot be achieved in isolation from other sectors. Despite the fact that most governments are making an effort to achieve health for all, the prevalence of typhoid fever is still very high. The objective of the study was to investigate the cultural factors that impact on the management of typhoid fever in Bungoma County. Descriptive survey research design was used. The target population was 876,491, 42 health staff and 16 village elders. Multi-stage, stratified, snowball, purposive and simple random sampling techniques were used to select the study samples. Data collection instruments were interview schedules, observations, and focus group discussions. Data was analysed using the descriptive statistics. Culture was found to impact on the management of the fever. The study recommended that the health sector should work with other sectors in the management of typhoid fever since the determinants of health and hence typhoid lie outside the health sector.

A case report of typhoidal acute acalculous cholecystitis.

Introduction. Acalculous cholecystitis in the setting of typhoid fever in adults is an infrequent clinical encounter, reported sparsely in the literature. In this case report we review the presentation and management of enteric fever involving the biliary system and consider the literature surrounding this topic. The aim of this case report is to alert clinicians to the potential diagnosis of extraintestinal complications in the setting of typhoid fever in the returned traveller, requiring surgical intervention. Presentation of Case. We report the case of a 23-year-old woman with acalculous cholecystitis secondary to Salmonella Typhi. Discussion. There is scarce evidence surrounding the optimal treatment and prognosis of typhoidal acalculous cholecystitis. In the current case, surgical invention was favoured due to failure of medical management. Conclusion. Clinical judgement dictated surgical intervention in this case of typhoidal acute acalculous cholecystitis, and cholecystectomy was safely performed.