Volume : 6, Issue : 9, September - 2017

Diagnostic and Therapeutic Protocol in Treatment of Enteric Fever in Children

Dr. Himanshu Dua, Dr. Anjali Edbor, Dr. Roopal B. Khobragade

Abstract :

<p>&nbsp;<span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">Present study was done </span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">for retrospective analysis of Diagnostic and treatment protocol for management of suspected and probable cases of Enteric fever in children. </span><b style="text-align: justify;"><span style="font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">Methods: </span></b><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">Observational descriptive study </span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">conducted on data of case papers of Enteric fever patients admitted &amp; treated during January 2015 to January 2016.</span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"> In the</span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"> </span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">pediatric population in the age group of 2 to 20 years </span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">at NKPSIMS, Digdoh, Hingna, Nagpur. </span><b style="text-align: justify;"><span style="font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">Results: </span></b><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">Out of the 41 children with enteric fever, male to female ratio was 1.3:1 with common age group between 11-20 years.</span><b style="text-align: justify;"><span style="font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"> </span></b><span lang="IT" style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">Maximum i.e. 20 cases are from urban areas, 13 from Rural and 8 are from Suburban area.<b> </b></span><i style="text-align: justify;"><span style="font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">S typhi </span></i><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">was isolated in &hellip; cases while S. <i>paratyphi </i>in &hellip; cases. Clinical features of <i>S. typhi </i>and <i>S. paratyphi </i>were indistinguishable.</span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"> None of the children were immunized for Typhoid fever. Fever with or without chills are the commonest symptoms.</span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"> Average duration of stay is 6.8 days and a No relation of age of child with hospital stay during </span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">treatment</span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"> of typhoid fever cases.</span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"> No significant relevance of pre hospital duration of fever with patient&rsquo;s hospital stay &amp; hence response to antibiotic treatment. Significant Co-morbidities have not been seen .Blood culture though a </span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif; color: red;">gold standard test </span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">is of limited use in resource limited scenario, especially in children with prior antibiotics treatment. Ceftriaxone as a solo drug is effective in the treatment of majority of patients of enteric fever.</span><b style="text-align: justify;"><span lang="EN-IN" style="font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">Conclusion:</span></b><span lang="EN-IN" style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"> </span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;">Public health interventions to minimize human carrier contact,</span><span lang="EN-IN" style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"> improvement in environmental sanitation,</span><span style="text-align: justify; font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"> improved personal hygienic measures including health care behavior strategies, typhoid vaccination and rational antibiotic selection based on sensitivity pattern to prevent resistance will help to reduce the morbidity and mortality of this global health problem.</span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:normal;mso-layout-grid-align:none;text-autospace:none"><span style="font-size: 12pt; font-family: &quot;Times New Roman&quot;, serif;"><o:p></o:p></span></p>