Predictor of mortality in children with typhoid intestinal perforation in a Tertiary Hospital in Nigeria

Abstract

Development of postoperative fecal fistula significantly predicted mortality. Prioritizing the prevention of typhoid fever than its treatment and attention to surgical details may significantly reduce mortality of TIP in children in this setting.

Typhoid Intestinal Perforations: Has the Clinical Importance Decreased in Eastern Anatolia for 36 Years?

“…The presentation time, number and localization of the perforations, extensity of the abdominal contamination and the kind of the surgical operation are discussed as risk factors affecting morbidity [3,7] and mortality [3,7,8,[10][11][12][13][14] in TF.…”

Host factors and typhoid fever-associated intestinal perforation in children in Nigeria

“…We compliment Nasir et al [1] for their meticulous study on forecasters of mortality-associated typhoid with an intestinal perforation in Nigeria. The contribution by different host factors, such as MHC and human leukocyte antigen (HLA), that might have been responsible for the occurrence of a high proportion of intestinal perforations in typhoid fever in Nigerian children merits an exploration, and this could be assessed through studies on confirmed cases with and without intestinal perforations.…”

“…Apart from pulsed field-gel electrophoresis typing (PFGE) of isolates from cases with intestinal perforation [1], their genotypic characterization would be valuable to rule out the presence of abnormal flagellar antigenic components responsible for the intestinal perforations in Nigeria. A S. typhi strain carrying the flagellar antigen variant H1-j was associated with acute appendicitis in a Chinese woman in Hong Kong [4].…”

Challenges in measuring complications and death due to invasive Salmonella infections

“…Individual studies with age disaggregated case fatality rates in enteric fever* Region/Author Asia 0-5 years 5-10 years 10-17 years >12 years/Adults Asia Kabra 2000 (5) 0/100 (0.0%) Malik 2001 (6) 0/102 (0.0%) Shwe 2002 (7) 0/37 (0.0%) Cifti 2003/4 (8,9) 0/9 (0.0%) Panhothra 2004 (10) 0/100 (0.0%) Mathura 2003 (11) 0/11 (0.0%) Walia 2005/2006 (12,13) 0/30 (0.0%) Nazar 2005 (14) 0/27 (0.0%) 3/41 (7.3%) 1/20 (5.0%) Wang 2005 (15) 2/76 (2.6%) Ganesh 2010 (16) 0/7 (0.0%) Owais 2010 (17) 0/316 (0.0%) Leung 2012 (18) 0/16 (0.0%) Emary 2012 (19) 0/37(0.0%) 0/43 (0.0%) Chheng 2013 (20) 0/36 (0.0%) 2/56 (3.6%) 0/36(0.0%) Mtove 2010 (21) 0/22 (0.0%) Africa…”

“…Data on a series of 153 cases showed a case fatality of 9.5-13.0% depending on whether the perforation was single or multiple. Postoperative fecal fistula formation was an independent risk factor for mortality in children with a typhoid intestinal perforation [16]. Other studies from the same region have reported a higher mortality with significant postoperative complications particularly malnutrition [17].…”