Estimated Percentage of Typhoid Fever in Adult Pakistani Population (TAP) Study

Abstract

Abstract

Typhoid fever is a serious infection with high morbi-dity and mortality in untreated cases. It is one of the very common infections in developing countries due to various factors involving hygiene and sanitation.

Objective:  To determine the estimated percentage of typhoid fever in Pakistani population and to find the commonly prescribed antibiotics for the disease.

Material and Methods:  This cross sectional study was conducted on 1036 patients, selected from forty five general practitioner clinics, between June to Octo-ber 2010. Patients of > 18 years of age with > 3 days history of fever (> 100ºF) and high index of suspicion for typhoid fever were tested for typhoid fever using Typhidot kits and positive cases were recruited for monitoring response to treatment. The febrile patients with clear cut history of urinary or respiratory infect-ion, hypovolemic shock or hepatobiliary disease were excluded and not tested by typhidot kit. The antibiotics prescribed to study population by various general prac-titioners were noted. Data was analysed on SPSS. Res-ults were expressed in percentages and proportions.

Results:  Total 1036 patients were recruited. Typhoi-dot test was negative in 63.9% and positive in 36.1% patients with highest percentages of positive cases in Karachi, Rawalpindi and Hyderabad. The maximum number of cases were reported in summer season espe-cially from June to August. Most of the patients were between ages of 19 - 39 years. The commonest anti-biotics prescribed were Ofloxacin, Ciprofloxacin and Levofloxacin.

Conclusion:  Typhoid fever is very common infection in Pakistan caused by Salmonella typhi which is trans-mitted among humans through faeco-oral route. Dise-ase can be controlled not only by antibiotics like fluo-roquinolones but by patient education, improvement in hygiene and sanitation, safe supply of clean drinking water and prophylactic vaccination as well. However, timely diagnosis and appropriate management with proper antibiotics is the key to avoid the acute compli-cations and chronicity of the disease.

Key Words:  Typhoid fever, Ofloxacin, Ciprofloxacin, Levofloxacin Typhidot test.