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A retrospective study of patients with blood culture-confirmed typhoid fever in Fiji during 2014–2015: epidemiology, clinical features, treatment and outcome

Getahun, Aneley, Parry, Christopher, Crump, John A, Rosa, Varanisese, Jenney, Adam, Naidu, Ravi, Mulholland, Kim and Strugnell, Richard A (2020) 'A retrospective study of patients with blood culture-confirmed typhoid fever in Fiji during 2014–2015: epidemiology, clinical features, treatment and outcome'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol 113, Issue 12, pp. 764-770.

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Abstract

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.

Item Type: Article
Subjects: WC Communicable Diseases > Infection. Bacterial Infections > Enteric Infections > WC 260 Enterobacteriaceae and other enteric infections
WC Communicable Diseases > Infection. Bacterial Infections > Enteric Infections > WC 270 Typhoid fever
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1093/trstmh/trz075
Depositing User: Stacy Murtagh
Date Deposited: 20 Mar 2020 12:55
Last Modified: 20 Mar 2020 12:58
URI: https://archive.lstmed.ac.uk/id/eprint/14033

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