Typhoid Patients Research Articles

Study on clinical profile and antibiotic sensitivity pattern of enteric fever patients in a tertiary care hospital of East India

Background: Enteric fever is a global health problem which is endemic in the Indian subcontinent. With the changing pattern of clinical presentation and antibiotic sensitivity, physicians are facing a challenge to treat the disease in day-to-day practice. Aims and Objectives: The purpose of this study is to know the clinical profile of enteric fever and to study the pattern of antimicrobial susceptibility among Salmonella species. Material and Methods: This is an observational cross-sectional study including 50 cases of enteric fever admitted under General Medicine Department of a tertiary medical institute of Kolkata from January 2019 to December 2019, diagnosed on the basis of positive results found on blood culture, Widal test, and Typhi dot immunoglobulin M. Proper history taking, detailed clinical examinations, and relevant blood investigations were done. Results: The mean age of patients was 21.16±5.72 years with 32 males and 18 females. Fever was the most common symptom, followed by anorexia, abdominal pain, and headache. The predominant sign was coated tongue seen in 20 (40%) patients with hepatomegaly in 4 (8%) and splenomegaly in 9 (18%) patients. Salmonella Typhi and Salmonella Paratyphi A were isolated in 32 (64%) cases and 5 (10%) cases, respectively, with 100% sensitivity to 3rd generation cephalosporins, azithromycin, and meropenem. Fluoroquinolone resistance was approximately 90%. Conclusion: Widely varying clinical presentation makes early diagnosis and proper selection of antibiotics essential for the treatment and prevention of complications of enteric fever. Quinolone resistance still remains an area of concern.

Keeping Balance Body Temperature With The Application Of Hyperthermia Management

Background: Hyperthermia is a common nursing problem found in patients with typhoid fever. Nursing implementation through a nursing care approach is given to assist in decreasing body temperature. The purpose of this case study is to describe the implementation of hyperthermia management in patients with impaired body temperature balance. Methods: This research method is descriptive using the case study method. Implementation includes monitoring body temperature, and warm compresses, recommending bed rest, and collaborating on intravenous fluids and electrolytes. The research was conducted at a hospital in Palembang for typhoid fever patients with hyperthermia problems. Implementation is carried out 5 days in patient 1 and 3 days in patient 2. Result: the case study results showed a decrease in patient's body temperature, patient 1 from 38,5°C to 36,5°C while patient 2 from 39°C to 36,3 °C. Conclusion: The problem of hyperthermia in patients with typhoid fever can be resolved through an implementation approach to hyperthermia management.

Association of Drinking Water and Enteric Fever: A Disguised Source of Infection

Background: Enteric fever is an illness caused by Salmonella enterica serovars Typhi and Paratyphi A and B. The mode of transmission is the ingestion of contaminated food and water. Aim: To check that whether drinking water is the source of infection or not. Methodology: 202 water samples were collected from the various areas of Lahore. 120 samples were taken from houses and the neighbourhood of confirmed typhoid patients and 82 samples were randomly collected. The samples were centrifuged, enriched and then subcultured on XLD media. The isolated colonies were identified by biochemical reactions. The sero-typing confirmed Salmonella species were done. Results: The results showed that 23% of the drinking water in Lahore was fit for drinking, 76% samples were contaminated. The organisms isolated were Serratia spp. 22%, Enterobacter spp. 22%, E. coli 16%, Citrobacter spp. 12%, Pseudomonas spp. 9%, Proteus spp. 6%, Klebsiella spp. 4%, Salmonella Paratyphi A and Salmonella Rubislaw as 1%. No Salmonella Typhi was isolated from any water sample. Conclusion: The presences of large coliforms in drinking water were indicative of sewerage contamination. The Salmonella Paratyphi A might be source of infection in that specific area but overall the results suggested that drinking water of Lahore was not acting as a source of infection for Enteric caused by Salmonella Typhi. Keywords: Water-borne , Infection, Enteric fever, coliforms.

Molecular diagnostics and next-generation sequencing reveal real etiological characteristics of invasive Salmonella infection in febrile illness in Freetown, Sierra Leone

ABSTRACT Invasive Salmonella infection, which can cause typhoid/paratyphoid fever and invasive non-typhoidal salmonellosis, is a public health burden in Africa. Accurate diagnosis and etiological characterization are required to conduct prevalence and risk estimations for Salmonella infection; however, the utilization of optimal techniques and surveillance data are still insufficient. In this study, we performed a laboratory-based survey in Freetown, which is the biggest city in Sierra Leone with a high burden of typhoid fever, by using blood culture and molecular methods but not the Widal test, to estimate the prevalence and aetiology of invasive Salmonella infection among fever patients. We found a very low prevalence of typhoid fever in patients with fever during the investigation period, and this prevalence was clearly overestimated by the Widal test. Genome sequencing of the S. Typhi isolate from this work revealed that the strain carried multiple antibiotic resistance genes, and an epidemic clone that has existed in West Africa for years was also detected in Sierra Leone. By using metagenomic sequencing, one patient with invasive non-typhoidal salmonellosis was identified as having bacterial co-infections. Our data highlight that Salmonella surveillance based on accurate laboratory diagnosis and genome sequencing needs to be strengthened to provide a better estimation of the real epidemics and enable potential risk assessment by etiological analysis in Africa. Even in a laboratory with only basic equipment, it is possible to conduct next-generation sequencing for pathogen discovery in bloodstream infections and to determine the etiological characteristics of pathogene without complex combinations of laboratory methods.

Hematology Parameter Based on Tubex TF® Color Scale Result in Typhoid Fever Patients

BACKGROUND: Infection with Salmonella enterica subspecies serovar Typhi and Paratyphi A, B, and C causes typhoid and paratyphoid fever. This is a major source of mortality and morbidity, especially in youngsters. Typhoid fever frequently causes non-specific symptoms. Symptoms that appear obstructively are comparable to those seen in other infectious illnesses and have similar clinical manifestations. Complications can be avoided with early detection and treatment. AIM: This study will look at the hematology parameter profile to determine whether there are any hematological differences between patients with high and low antibodies. METHODS: The research was conducted in Bengkulu, Indonesia, in June 2020 until July 2021. Subject collection was done according to inclusion and exclusion criteria. Subjects have given informed consent. The research included a total of 39 subject patients. Demographic data were collected using a questionnaire and 3 mL of blood was taken. Blood was examined for Tubex TF® and hematological examination. Statistical analysis used independent t-test and performed with SPSS. RESULTS: The research included a total of 39 subject patients. Most were male and most were aged 21–25 years. The most common symptom felt by the subject was gastrointestinal complaints. The analysis was carried out based on the color scale value of the Tubex TF® which was divided into two groups, 4 color scale groups and 6 color scale groups. Hematological parameters of hemoglobin, hematocrit, WBC, platelets, monocytes, lymphocytes, and neutrophils showed no significant difference. However, color scale group 6 showed lower value than 4 color scale group. CONCLUSION: Hematological indicators in typhoid fever were not substantially changed in Tubex TF®-positive typhoid fever patients. Clinicians can offer the same therapy in instances with typhoid fever, despite having differing positive Tubex TF® scores.

W058 Salmonella infection among the suspected enteric fever patients

W058 Salmonella infection among the suspected enteric fever patients

Immunological Changes of HCV and Typhoid Fever Patient

Endeavors to appraise the sign of invigorated pointers CD4 and CD2 in patients tainted with HCV and evaluation of gamma - INF and IL-10 in serum positions in patients with intense HCV and intense typhoid fever An aggregate of (100) seropositive patients for HCV and 100 seropositive for typhoid fever were evaluated for this investigation .Patients went to general lab., in view of stomach torment , jaundice and loss of hunger and other liver grumbling, any serum tests communicated positive for against HCV antibodies and widal test straightforwardly choosed to show level of gamma - INF and IL-10 in serum of patient and show articulation of CD4 and CD2 in blood of HCV patients and typhoid patients. Results showed that serum tests were examined for IL-10 and gamma - INF by ELISA , showed profoundly huge increments (p<0.001) in serum level of HCV and typhoid patients as contrasted and sound benchmark groups , Actuated markers study uncovered high articulation of CD4 and CD2 in HCV and typhoid patients as contrasted and solid typical gatherings.

Analisis Ketepatan Kode Diagnosis Typhoid Fever Pada Rekam Medis Rawat Inap di Rumah Sakit Islam Karawang Tahun 2020

Medical record is a file containing records and documents regarding patient identity, examination, treatment, actions and other services that have been provided to patients. where one of the services provided is the management of patient medical record documents that contain coding of diagnoses and actions given to patients. The implementation of coding disease diagnoses in hospitals is a very important activity, namely by classifying disease diagnoses into several groups for the benefit of reports that the hospital does every month, both for internal reports and external reports and plays an important role in the financing system at the hospital itself. The purpose of this study was to determine the accuracy of the diagnosis code for typhoid fever in inpatients at the Karawang Islamic Hospital. The research methodology was carried out using quantitative descriptive methods, the population was 200 medical records of typhoid fever patients in 2020, with a total sample of 67 samples. The sampling technique used is simple random sampling. How to collect data is done by direct observation. The accuracy of the code obtained is 31 (46%) correct codes and 36 (54%) incorrect codes, the inaccuracy of the code is caused by the medical record professional staff in charge of the coding section who are still not focused and not careful with laboratory results to determine the results of the coding. It is correct and only codes for the H titer, while in determining the diagnosis of typhoid fever, it is seen from the O titer. Suggestions for coding the diagnosis carried out at the Karawang Islamic Hospital are expected that the coding is carried out correctly according to the diagnosis, history, and laboratory results.

The Levels of Antibiotic Use in Tyfoid Fever Patients in Interna Wards at the Hospital Makassar City

Typhoid fever is an acute infectious disease of the small intestine caused by the bacterium Salmonella typhi (S.typhi) which is an endemic systemic infectious disease, which is transmitted through the food or drink consumed. Antibiotics are a group of drugs that are often used today to treat typhoid fever. The purpose of this study was to find out the most antibiotics used for the treatment of typhoid fever in internal care at the Makassar City Hospital, to find out the rational use of antibiotics which includes, the right drug, the right indication, and the right patient. This research is an observational study conducted retrospectively (non-experimentally) and analyzed using descriptive methods. Sampling by purposive sampling method. The study sample was typhoid fever patients who met the inclusion criteria, had no complications and had complete medical record data. The data is compared with the standard of medical treatment at Makassar City Hospital. The results showed that the most use of antibiotics in typhoid fever patients at the Makassar City Hospital's Internal Care for the period January-February 2022 consisted of Ciprofloxacin (50.8%), Ceftriaxone (19.6%), Cefixime (9.8%), Chloramphenicol (6.5%), Cotrimoxazole (6.5%) Levofloxacin (4.9%) cefotaxim (1.6). Evaluation of the use of antibiotics is known to be the right indication (100%), the right drug (100%), the right patient (100%). The high accuracy of the drug, the right indication and the patient's accuracy is because the hospital has used antibiotics that are in accordance with existing guidelines.

The cost-effectiveness of using rapid diagnostic tests for the diagnosis of typhoid fever in patients with suspected typhoid fever: a systematic review

Introduction Despite the availability of several commercial rapid diagnostic tests (RDTs) developed to detect typhoid fever, the cost-effectiveness in resource-limited settings is unclear. This review aimed to explore the literature on typhoid economic evaluations in order to assess the cost-effectiveness of using typhoid RDTs in resource-limited settings. Areas covered A systematic review was conducted focusing on the identification of economic evaluations of typhoid RDTs to diagnose patients with suspected typhoid fever. Two studies were identified and included for narrative synthesis. Whilst highlighting a gap in the published literature, this review shows the use of typhoid RDTs to potentially be cost-effective in resource limited settings. Factors that appeared as significant in determining cost-effectiveness related to test characteristics (such as sensitivity, specificity and cost) and the prevalence of typhoid fever and should factor into any future evaluations. Expert opinion Concerted effort is needed in resource-limited settings with regards to medical device regulation to ensure that clinically effective and cost-effective typhoid RDTs are widely available and introduced into clinical practice. Typhoid modelling (with respect to typhoid testing and treatment strategies) represents an understudied area and further work is needed.

Integron-Associated Antibiotic Resistance in Salmonella typhi.

Salmonella enteric serovar Typhi (S. typhi) and paratyphi (S. paratyphi) bacteria exclusively found in humans, cause typhoid fever, an acute, and possibly deadly systemic infection. Typhoid fever is caused by a species of rod-shaped, Gram-negative Enterobacteriaceae called S. typhi. The present study aimed to examine the intI gene and investigate the possible relation between this gene and multi-drug resistance in S. typhi. A total of 30 blood samples were obtained from patients who were suspicious of typhoid fever using the direct strategy of inoculation. Each specimen was injected into a culture of a selective medium, such as XLD and SS agar, and then incubated at 37°C for 24 h. The genomic DNA was extracted through a boiling process. Tris-EDTA was used to suspend bacterial colonies cultured on MacConkey agar plates. The suspension of bacterial colonies was centrifuged for 5 min at 8000×g and for 20 min at -20°C which lyses the organisms and extracts the DNA from the buffer. The supernatant is then transferred to a fresh Eppendorf tube. Gel electrophoresis was carried out utilizing a UV transilluminator. The intI gene for S. typhi was found using a PCR test. The antibiotic sensitivity testing showed that the S. typhi isolates were classed as multi-resistant. These results were confirmed using the polymerase chain reaction (PCR) technique using intI gene where twenty specimens isolated from typhoid patients were positive for S. typhi.

Genetic polymorphisms in interleukin-1beta were associated with typhoid fever in Babylon City in Iraq

A total of 50 clinical samples were taken from the blood of typhoid fever patients who visited Al-Hillah Surgical Teaching Hospital and private laboratories in the AL-Hillah/Babylon region between February and August 2021. This research included 50 people who looked to be healthy and disease-free. Individuals with genotype GA were significantly represented among the patients with typhoid fever: 33 (66%), P-value = 0.0030, as compared with healthy control subjects, 18 (36%), and had an increased risk of developing typhoid fever infection. The IL-1beta (G) allele was less frequent among patients (51%, n =51) than control, and the (A) allele was more frequent among patients than control (49%, n =49). The results showed that there was a significant association between GA genotype and typhoid fever under most inheritance models. The A allele represents a risk factor for patients with typhoid fever and the inheritance of codominant, dominant, and overdominant models as risk factors. The GA genotype has an odd ratio of 4.07 (1.54–10.79) in the model of inheritance. Codominant and dominant models have a related odd ratio of 3.04 (1.21–7.60) and the overdominant model has a related odd ratio of 3.45 (1.52–7.85).

Genetic polymorphisms in interleukin-17A were associated with typhoid fever in Babylon City in Iraq

A total of 50 clinical samples were taken from the blood of typhoid fever patients who visited Al-Hillah Surgical Teaching Hospital and private laboratories in the AL-Hillah/Babylon region between February and August 2021. This research included 50 people who looked to be healthy and disease-free. Genotypes and allele frequency for rs1974226 showed individuals with two T alleles (homozygous for the TT) were significantly represented among the patients with typhoid fever: 14 (28%), P-value = 0.0061, as compared with healthy control subjects, 6 (12%), and had an increased risk of developing typhoid fever infection. The IL-17A (C) allele was less frequent among patients (62%, n =62) than control, and the (T) allele was more frequent among patients than control (38%, n =38). Genotypes and allele frequency for rs1974226 showed individuals with genotype TT were significantly represented among the patients with typhoid fever: 14 (28%), P-value = 0.0061, as compared with healthy control subjects, 6 (12%), and had an increased risk of developing typhoid fever infection. The data has been further examined for each genotype correlated with typhoid fever under different inheritance models.

Overview of Antibiotic Use Patterns in Typhoid Fever Patients at the Toto Kabila Hospital Inpatient Unit in 2019

Typhoid fever is an acute systemic infectious disease caused by Salmonella typhi. Indonesia has a fairly high incidence with an increasing number of cases. It is estimated that there are 600,000 and 1.5 million cases of typhoid fever per year. Antibiotics are the main therapy for the treatment of typhoid fever patients. This study aims to describe the pattern of antibiotic use in typhoid fever patients in the inpatient installation of Toto Kabila Hospital in 2019.
 The method in this study uses descriptive statistics with the type of observational research. Data collection was carried out retrospectively. The sample was taken from the medical records of adult patients with typhoid fever who were treated at the Toto Kabila Hospital in 2019. The subject selection technique used random sampling. The subjects in this study were adult patients with typhoid fever who were treated at the Toto Kabila Hospital in 2019. The total sample obtained was 44 typhoid fever patients.
 The results showed that the class of antibiotics used was a third generation cephalosporin (84.1%) of the type of antibiotic ceftriaxone (72.7%) with a dose of 1 gram (72.7%) twice a day and given for 10-14 days. It can be concluded that the pattern of antibiotic use at the Toto Kabila Hospital, Gorontalo Province in 2019 was in accordance with the disease suffered.

Overview of the Factors Affecting the Length of Treatment for Patients with Typhoid Fever in Children at Dr. Tadjuddin Chalid Hospital Makassar in 2018

Typhoid fever is one of the endemic diseases in Indonesia caused by Salmonella typhi bacteria. Typhoid fever transmission occurs due to personal hygiene behavior and poor environmental hygiene. Several factors can affect the length of treatment for typhoid fever patients in children. This study was conducted to determine the description of the length of treatment for typhoid fever patients in children at the Dr. Tadjuddin Chalid Hospital Makassar in 2018 based on age, nutritional status, and types of antibiotics. This research is a descriptive study using quantitative methods. The study sample was 75 patients with typhoid fever in children aged 1-18 years. The data was used in the form of secondary data in the form of medical records. The results of the study from 75 patients showed that short length of treatment based on age was found in the 11-14 year age group as many as 22 people (37.3%), the short length of treatment based on nutritional status was mostly found in normal nutritional status as many as 56 people (94.9%), the short length of treatment based on the type of antibiotic was found in the use of the antibiotic ceftriaxone as many as 39 people (66.1%). Most of the length of treatment for typhoid fever patients in children had a short duration of treatment as many as 59 people (78.7%).

ANALISIS SURVIVAL DENGAN COX PROPORTIONAL HAZARD PADA KASUS DEMAM TIFOID

A common problem found in survival data is the presence of censored data. The length of hospitalization of Typhoid fever patients until declared cured is one of example of this data. Here, we use Cox regression model to analysis this data. Partial likelihood is one of the methods of estimating parameters for Cox regression model. In many cases of censored data, two objects (patients) have the same length of hospitalization (ties). Therefore, to estimate the parameters of the model must use the right method. Here we used partial likelihood Breslow, Efron, and Exact methods. The study was motivated by how the three methods performed for Cox regression model. The data used for the implementation of these methods is length of hospitalization of Typhoid fever patients at Mekar Sari Hospital-Bekasi in 2020. Based on AIC criteria, we found that exact method is the best model (minimum AIC) for parameter estimation of Cox regression model. Referring to the Cox regression model by using a significance level of 10%, there are five predictor variables that affects the length of patient hospitalization. The five variables are age, vomiting, dirty tongue, hemoglobin, and leukocyte.Keywords: Typhoid fever, Cox regression, Breslow method, Efron method, exact method.MSC2020: 62N02, 62N03

Immunological Changes of Hcv and Typhoid Fever Patient

endeavors to appraise the sign of invigorated pointers CD4 and CD2 in patients tainted with HCV and evaluation of gamma - INF and IL-10 in serum positions in patients with intense HCV and intense typhoid fever An aggregate of (100) seropositive patients for HCV and 100 seropositive for typhoid fever were evaluated for this investigation .Patients went to general lab., in view of stomach torment , jaundice and loss of hunger and other liver grumbling, any serum tests communicated positive for against HCV antibodies and widal test straightforwardly choosed to show level of gamma - INF and IL-10 in serum of patient and show articulation of CD4 and CD2 in blood of HCV patients and typhoid patients. Results showed that serum tests were examined for IL-10 and gamma - INF by ELISA , showed profoundly huge increments (p<0.001) in serum level of HCV and typhoid patients as contrasted and sound benchmark groups , Actuated markers study uncovered high articulation of CD4 and CD2 in HCV and typhoid patients as contrasted and solid typical gatherings.

GyrA ser83 mutation among fluoroquinolone-resistant Salmonella enterica serovars from enteric fever patients in tertiary care hospital, Kathmandu

BackgroundThe management of enteric fever through antibiotics is difficult these days due to the emerging resistance of Salmonella to various antimicrobial agents. The development of antimicrobial resistance is associated with multiple factors including mutations in the specific genes. To know the current status of mutation-mediated fluoroquinolone-resistance among Salmonella enterica serovars; Typhi, Paratyphi A, B and C, this study was focused on detecting gyrA ser83 mutation by restriction digestion analysis of gyrA gene using HinfI endonuclease.ResultsA total of 948 blood samples were processed for isolation of Salmonella spp. and 3.4% of them were found to be positive for Salmonella growth. Out of the 32 Salmonella isolates, 2.2% were S. Typhi and 1.2% were S. Paratyphi A. More interestingly, we observed less than 5% of isolates were resistant to first-line drugs including chloramphenicol, cotrimoxazole and ampicillin. More than 80% of isolates were resistant to fluoroquinolones accounting for 84.4% to levofloxacin followed by 87.5% to ofloxacin and 100% to ciprofloxacin by disc diffusion methods. However, the minimum inhibitory concentration method using agar dilution showed only 50% of isolates were resistant to ciprofloxacin. A total of 3.1% of isolates were multidrug-resistant. Similarly, 90.6% of the Salmonella isolates showed gyrA ser83 mutation with resistance to nalidixic acid.ConclusionsThe increased resistance to fluoroquinolones and nalidixic acid in Salmonella isolates in our study suggests the use of alternative drugs as empirical treatment. Rather, the treatment should focus on prescribing first-line antibiotics since we observed less than 5% of Salmonella isolates were resistant to these drugs.

Phytochemical and Antibacterial Profile of Moringa oleifera lam Seed Extracts on Some Wound and Enteric Bacterial Pathogens

The seeds of Moringa oleifera were studied in this research to determine the phytochemicals present and assess the antibacterial activities of the seed extracts against some wound and enteric bacterial pathogens. The extracts of Moringa oleifera seeds were obtained. The phytochemical constituents of the extracts were evaluated, while the antibacterial efficacy of extracts (FMSE, FMSA and DMSE, DMSA) were tested against five bacterial organisms namely; Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Streptococcus pyogenes, and Salmonella typhi isolated from both wound and faeces of typhoid fever patients using agar diffusion technique (punch method). Two-fold tube dilution method was used for the Determination of the Minimum Inhibitory Concentration (MIC). The Minimum Bactericidal Concentration (MBC) was also ascertained. Phytochemical analysis of the extracts revealed the presence of saponin, flavonoids, alkaloids and tannins. Both the aqueous and ethanolic extracts exhibited antibacterial effects against all the test organisms. DMSE at 500mg/ml had the inhibition zone of S. aureus as the highest (38.00a) and that of E. coli and S. typhi as the lowest (10.00b), while FMSE had the highest zone of inhibition to be 20.00b against S. typhi and P. aeruginosa and the lowest zone of 14.00b against E. coli. This study suggests that seed extracts of Moringa oleifera possess antibacterial properties. Ethanolic extracts were effective than aqueous extracts, meaning that the potency is solvent dependent. Dried seed extracts were more effective than fresh extracts. Inhibition of Gram-positive and Gram-negative organisms portrays this plant as a potential source of broad-spectrum antibiotics. The findings from this work suggest further purification of the constituents of the plant for the development of novel antibiotics.

Analisis Average Length Of Stay Pasien Typhoid Fever di RSUD Harapan Doa Kota Bengkulu

Average Length Of Stay (LOS) is an important indicator in determining the success of therapy for a disease and is also related to the cost of care incurred by the patient. the ideal value of AvLOS is 6-9 days. The level of AvLOS is influenced by the complications experienced by the patient. Typhoid fever is an endemic disease in Indonesia that knows no age and gender boundaries, and can cause various complications in the form of bleeding and intestinal perforation which can often lead to death. Based on the initial survey, the visit of typhoid fever patients in the last three years at Harapan Doa Hospital, Bengkulu City has increased, namely 2017 (11.02%), 2018 (13.47%) and 2019 (17.935) of the total visits/year, however, in 2020 it decreased (15.08%) due to the Covid-19 pandemic. This affects the AvLOS value and the cost received by the hospital. The purpose of this study was to determine the AvLOS value of typhoid fever patients at Harapan Doa Hospital, Bengkulu City. The type of research used is descriptive with a cross sectional approach. The sample of this study used a total population of 121 patients who were analyzed univariately using the AvLOS formula. The results of the univariate analysis, from the calculation results obtained that the total length of stay (LD) of typhoid fever patients was 395 days/year with AvLOS 3.18 days/year, the number of typhoid fever patients was out of life 124 (100%) patients, AvLOS of typhoid fever patients based on age group. The highest was found in the age group >1-5 years, namely 5.17 days compared to the age group >44-65 years, namely 3.43 days and >65 years, namely 3 days, where typhoid fever was accompanied by complications/companies. AvLOS of typhoid fever patients based on gender was found in female sex at 3.31 days with a total of 59 patients compared to male sex at 3.23 days with a total of 5 people. It is hoped that the hospital will formulate a clinical pathway for Typhoid Fever Treatment so that the quality of service for typhoid fever cases is in the efficientcategory.