Affiliations: Department of Paediatrics and Child Health, University
Teaching Hospital, Ado-Ekiti, Nigeria | Paediatric Surgical Unit, Department of Surgery,
University Teaching Hospital, Ado-Ekiti, Nigeria
Note: [] Correspondence: Samuel Ademola Adegoke, Department of
Paediatrics and Child Health, University Teaching Hospital, Ado-Ekiti, Nigeria.
Tel.: +234 8035 0375 60; Fax: +234 8035 0375 60; E-mail: [email protected]
Abstract: Typhoid fever is a major public health problem globally; the greater
burden however occurs in the developing countries because of lack of potable
water and proper waste management. The disease is associated with a high
mortality rate especially in those with enteric perforation or intestinal
hemorrhage. The goal of this study was to identify the clinical and laboratory
factors that predicts the development of enteric perforation in children with
typhoid fever. This study was a retrospective case-control analysis of children
admitted for typhoid fever with or without enteric perforation over a three –
year period in a newly established teaching hospital in southwestern Nigeria.
Forty-seven children with typhoid fever and enteric perforation (cases) were
compared with 94 controls (those with typhoid fever but without enteric
perforation). Multivariate analysis using logistic regression was applied to
all the factors that were initially significantly associated with enteric
perforation. Male sex (Odd Ratio, OR=3.10, p=0.003); inadequate treatment (OR=3.03,
p< 0.001); short duration of illness (OR=2.36, p=0.030); neutrophilia (OR
=2.92, p=0.013) and elevated
erythrocyte sedimentation rate (ESR) (OR=1.07, p=0.041) were found to have independently contributed to development
of perforation in children with typhoid fever. This study has attempted to
outline the factors that may predict typhoid ileal perforation in children,
thereby helping in recognition of high risk cases and drawing up of screening
tool to facilitate effective and prompt management.
