A retrospective study of patients with blood culture-confirmed typhoid fever in Fiji during 2014-2015: epidemiology, clinical features, treatment and outcome.
Salmonella Typhi
Fiji
antimicrobial susceptibility
clinical features
complications
typhoid fever
Journal
Transactions of the Royal Society of Tropical Medicine and Hygiene
ISSN: 1878-3503
Titre abrégé: Trans R Soc Trop Med Hyg
Pays: England
ID NLM: 7506129
Informations de publication
Date de publication:
01 12 2019
01 12 2019
Historique:
received:
12
03
2019
revised:
25
06
2019
accepted:
15
07
2019
pubmed:
23
10
2019
medline:
20
9
2020
entrez:
23
10
2019
Statut:
ppublish
Résumé
Typhoid fever is endemic in Fiji. We sought to describe the epidemiology, clinical features and case fatality risk of blood culture-confirmed typhoid fever from January 2014 through December 2015. Blood culture-positive patients were identified from a typhoid surveillance line list. A standardised case investigation form was used to record data from patients' medical records. Of 542 patients, 518 (95.6%) were indigenous Fijians (iTaukei) and 285 (52.6%) were male. The median (IQR) age was 25 (16-38) y. Mean (SD) time from the onset of illness to admission was 11.1 (6.9) d. Of 365 patients with clinical information, 346 (96.9%) had fever, 239 (66.9%) diarrhoea, 113 (33.5%) vomiting, and 72 (30.2%) abdominal pain. There were 40 (11.0%) patients with complications, including 17 (4.7%) with shock, and 11 (3.0%) with hepatitis. Nine patients died for a case fatality risk of 1.7%. Of the 544 Salmonella Typhi isolates tested, none were resistant to first line antimicrobials; 3(0.8%) were resistant to ciprofloxacin and 5(1.4%) to nalidixic acid. In Fiji, most blood culture-confirmed typhoid fever cases were in young adults. Common clinical manifestations were fever and gastrointestinal symptoms. Further studies are required to elucidate the factors associated with complications and death.
Sections du résumé
BACKGROUND
Typhoid fever is endemic in Fiji. We sought to describe the epidemiology, clinical features and case fatality risk of blood culture-confirmed typhoid fever from January 2014 through December 2015.
METHODS
Blood culture-positive patients were identified from a typhoid surveillance line list. A standardised case investigation form was used to record data from patients' medical records.
RESULTS
Of 542 patients, 518 (95.6%) were indigenous Fijians (iTaukei) and 285 (52.6%) were male. The median (IQR) age was 25 (16-38) y. Mean (SD) time from the onset of illness to admission was 11.1 (6.9) d. Of 365 patients with clinical information, 346 (96.9%) had fever, 239 (66.9%) diarrhoea, 113 (33.5%) vomiting, and 72 (30.2%) abdominal pain. There were 40 (11.0%) patients with complications, including 17 (4.7%) with shock, and 11 (3.0%) with hepatitis. Nine patients died for a case fatality risk of 1.7%. Of the 544 Salmonella Typhi isolates tested, none were resistant to first line antimicrobials; 3(0.8%) were resistant to ciprofloxacin and 5(1.4%) to nalidixic acid.
CONCLUSIONS
In Fiji, most blood culture-confirmed typhoid fever cases were in young adults. Common clinical manifestations were fever and gastrointestinal symptoms. Further studies are required to elucidate the factors associated with complications and death.
Identifiants
pubmed: 31638153
pii: 5602275
doi: 10.1093/trstmh/trz075
pmc: PMC6907003
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
764-770Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
Lancet. 2005 Aug 27-Sep 2;366(9487):749-62
pubmed: 16125594
Lancet. 2018 Nov 10;392(10159):1736-1788
pubmed: 30496103
Intern Med J. 2015 Feb;45(2):148-55
pubmed: 25404003
PLoS One. 2014 Nov 06;9(11):e111768
pubmed: 25375784
N Engl J Med. 2002 Nov 28;347(22):1770-82
pubmed: 12456854
Trop Med Int Health. 2014 Oct;19(10):1284-92
pubmed: 25066005
Lancet. 2018 Nov 10;392(10159):1789-1858
pubmed: 30496104
Epidemiol Infect. 2001 Dec;127(3):405-12
pubmed: 11811872
Pac Health Dialog. 2005 Sep;12(2):53-9
pubmed: 18181494
Lancet Glob Health. 2014 Oct;2(10):e570-80
pubmed: 25304633
Am J Trop Med Hyg. 2014 Jun;90(6):1031-8
pubmed: 24710618
BMJ. 2006 Jul 8;333(7558):78-82
pubmed: 16825230
Bull World Health Organ. 2008 Apr;86(4):260-8
pubmed: 18438514
PLoS One. 2012;7(12):e51823
pubmed: 23284780
BMC Infect Dis. 2014 Feb 10;14:73
pubmed: 24512443
Clin Microbiol Rev. 2015 Oct;28(4):901-37
pubmed: 26180063
J Glob Health. 2015 Dec;5(2):020407
pubmed: 26649174