ANALYSIS OF RISK FACTORS FOR ENTERIC PERFORATION IN CASES OF TYPHOID FEVER

Main Article Content

Saddam Hussain
Jamal Shah
Mian Maroof Shah Bahadri
Muhammad Asim Jamal
Dr. Muhammad Zeb
Safa Ansari
Dr. Mehmood Ahmed
Dr. Niaz Ali Khan

Keywords

analysis, risk factor, Diseases, Diagnosed, Fever

Abstract

Introduction: Typhoid fever is a bacterial infection caused by Salmonella enterica serotype Typhi and characterized by insidious onset of sustained fever, marked headache, abdominal pain, constipation, and diarrhoea.Objectives: The basic aim of the study is to find the risk factors for enteric perforation in cases oftyphoid fever. Material and methods: This retrospective cohort study was conducted in Lady Reading Hospital Peshawar during September 2022 to June 2023. Data was collected from 120 patients from both genders. Data collection for this retrospective cohort study was conducted by systematically extracting relevant information from electronic medical records of patients diagnosed with typhoid fever. The process involved identifying cases using International Classification of Diseases (ICD) codes specifically designated for typhoid fever. Results: The study consisted of 120 patients with a mean age of 32.4 years (range: 8 - 72 years). Gender distribution was nearly equal, with 59 (49.2%) male and 61 (50.8%) female patients. The duration of illness before admission varied, with 42 (35%) patients presenting within 7 days of symptom onset, while 78 (65%) had a longer duration of illness, with a maximum duration of 21 days.Conclusion: It is concluded that our study has successfully identified several significant risk factors associated with the development of enteric perforation in cases of typhoid fever. These findings underscore the critical importance of early diagnosis and timely treatment to mitigate the risk of this severe complication.

Abstract 312 | pdf Downloads 129

References

1. Bulage, L., Masiira, B., Ario, A.R. et al. Modifiable risk factors for typhoid intestinal perforations during a large outbreak of typhoid fever, Kampala Uganda, 2015. BMC Infect Dis 17, 641 (2017). https://doi.org/10.1186/s12879-017-2720-2
2. Ahmed HN, et al. Typhoid perforation still a common problem: situation in Pakistan in comparison to other countries of low human development. JPMA. J Pak Med Assoc. 2006;56(5):230–2.
3. Lutterloh E, et al. Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border. Clin Infect Dis. 2012;54(8):1100–6.
4. Kabwama SN, Bulage L, Nsubuga F, Pande G, Oguttu DW, Mafigiri R, et al. A large and persistent outbreak of typhoid fever caused by consuming contaminated water and street-vended beverages: Kampala, Uganda, January – June 2015. BMC Public Health. 2017;17(1):23.
5. Edino ST, Yakubu AA, Mohammed AZ, Abubakar IS. Prognostic factors in typhoid ileal perforation: a prospective study of 53 cases. J National Med Assoc 2007;99:1042-45
6. Karmacharya B, Sharma VK. Results of typhoid perforation management: Our experience in Bir Hospital, Nepal. Kathmandu University Medical Journal 2006; 4: 22-4.
7. Hosoglu, Salih, et al. "Risk Factors for Enteric Perforation in Patients with Typhoid Fever." American Journal of Epidemiology, vol. 160, no. 1, 2004, pp. 46-50, https://doi.org/10.1093/aje/kwh172.
8. Hosoglu S, Aldemir M, Akalin S, Geyik MF, Tacyildiz IH, Loeb M. Risk factors for enteric perforation in patients with typhoid Fever. Am J Epidemiol. 2004 Jul 1;160(1):46-50. doi: 10.1093/aje/kwh172. PMID: 15229116.
9. Chalya, P.L., Mabula, J.B., Koy, M. et al. Typhoid intestinal perforations at a University teaching hospital in Northwestern Tanzania: A surgical experience of 104 cases in a resource-limited setting. World J Emerg Surg 7, 4 (2012). https://doi.org/10.1186/1749-7922-7-4
10. Gedik E, Girgin S, Taçyildiz IH, Akgün Y. Risk factors affecting morbidity in typhoid enteric perforation. Langenbecks Arch Surg. 2008 Nov;393(6):973-7. doi: 10.1007/s00423-007-0244-8. Epub 2007 Nov 20. PMID: 18026981.
11. Singh H, Mishra A, Sharma D, Somashekar U. A simple prognostic scoring system for typhoid ileal perforation peritonitis. Trop Doct. 2010 Oct;40(4):203-7. doi: 10.1258/td.2010.090135. Epub 2010 Sep 24. PMID: 20870678.
12. Nguyen VS. Perforations typhiquesen milieu tropical. A propos de 83 observations [Typhus perforation in the tropics. Apropos of 83 cases]. J Chir (Paris). 1994 Feb;131(2):90-5. French. PMID: 8207102.
13. Honorio-Horna CE, Díaz-Plasencia J, Yan-Quiroz E, Burgos-Chavez O, Ramos-Domínguez CP. Factores de riesgo de morbilidad y mortalidadenpacientes con perforacióntífica ileal [Morbidity and mortality risk factors in patients with ileal typhoid perforation]. Rev Gastroenterol Peru. 2006 Jan-Mar;26(1):25-33. Spanish. PMID: 16622485.
14. Zida M, Ouedraogo T, Bandre E, Bonkoungou GP, Sanou A, Traore SS. Iléostomie première des perforations iléalesd'originetyphique: 62 cas à Ouagadougou (Burkina Faso) [Primary ileostomy for typhoid-related ileal perforation: a 62-case series in Ouagadougou, Burkina Faso]. Med Trop (Mars). 2010 Jun;70(3):267-8. French. PMID: 20734596.
15. Qamar FN, Azmatullah A, Bhutta ZA. Challenges in measuring complications and death due to invasive Salmonella infections. Vaccine. 2015;33 Suppl 3:C16-C20.

Contini S. Typhoid intestinal perforation in developing countries: Still unavoidable deaths? World J Gastroenterol 2017; 23(11): 1925-1931 [PMID: 28373758 DOI: 10.3748/wjg.v23.i11.1925]
16. Bitar R, Tarpley J. Intestinal perforation in typhoid fever: a historical and state-of-the-art review. Rev Infect Dis. 1985;7:257-271
17. Ekenze SO, Okoro PE, Amah CC, Ezike HA, Ikefuna AN. Typhoid ileal perforation: analysis of morbidity and mortality in 89 children. Niger J Clin Pract. 2008;11:58-62.
18. Osifo OD, Ogiemwonyi SO. Typhoid ileal perforation in children in Benin city. Afr J Paediatr Surg. 2010;7:96-100
19. Sarwar Khan J, Hassan H, Bhopal FG, Mehmood N, Taj N, Alam Khan J, Iqbal M. Typhoid Perforation: A ten year experience in a Surgical Unit. J Rawal Med Coll. 2002;6:70-73.
20. Mogasale V, Desai SN, Mogasale VV, Park JK, Ochiai RL, Wierzba TF. Case fatality rate and length of hospital stay among patients with typhoid intestinal perforation in developing countries: a systematic literature review. PLoS One. 2014;9:e93784.

Most read articles by the same author(s)