Typhoid Fever Report

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INTRODUCTION
This assignment is related to the common worldwide bacterial disease typhoid fever in children under the age of 16 in the two squatter settlements of Karachi, Pakistan (Sultanabad & Hijrat colony).This research was conducted by Fahad Javaid Siddiqui, Fauziah Rabbani, Rumina Hasan, Syed Qamaruddin Nizami, Zulfiqar Ahmed Bhutta, published in the “Journal of Infectious Disease, (2006), 10:215–222”.
Typhoid
Typhoid also called typhoid fever is the most common worldwide bacterial disease transmitted by the intake of contaminated food and water with feaces of infected person which contain the bacterium ‘Salmonella enterica serovar typhi’(Crump et al.,2003).
Bacteriology
Salmonella typhi is rod shaped gram negative bacteria found only
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OBJECTIVE
The objective of the study was to investigate the children under the age of 16, suffering from typhoid fever during (June 1999-Dec 2001), in the city of Karachi, Pakistan.
MATERIAL AND METHODS
The study was conducted in June 1999-Dec 2001 at the two squatter settlement of Karachi (Sultanabad and Hijrat colony). The research team comprised of Urban Health Program (UHP), faculty investigators from the Departments of Pediatrics and CHS, AKU along with a research officer and two field medical officers. Children under the age of 16 were taken under consideration. Fortnightly surveillance system was established. For the purpose of diagnosis two techniques were used. Blood culture using Bactec® system (Becton Dickinson, USA), a complete blood count taken and Typhidot®–ELISA test were performed. Data were stored and analyzed with EpiInfo version 6.04.Incidence calculations were made using Microsoft Excel 2000 (Siddiqui et al., 2006).
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To our knowledge, this study is the first kind of study conducted on community level to detect typhoid fever in Karachi. Based on person years of observation, the overall incidence of clinical typhoid in this study was 11.69/1000, out of which the sero-positive typhoid 7/1000 and culture-positive typhoid 1.68/1000 which is close to the culture-positivity rate of 1.98/1000 in Vietnam (Lin et al., 2000).
This study shows 50% of febrile episodes in children, whereas population-based experience of typhoid fever in Vietnam, Delhi and Egypt is different and blood culture positivity rates among febrile cases were only 8.5%, 5% and 4.2% respectively.
The study indicates culture-positive typhoid fever in the 5–10 years age group. However a high incidence among serologically positive cases found in the >10–15 year age group.
No culture-positive typhoid fever was detected in very young children, as the children were not brought to clinics for screening (Siddiqui et al., 2006).
Moreover, seasonality patterns is different in Karachi and Vietnam. The peak occurrence of typhoid fever was high in dry season in March and April whereas the

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