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Childhood Typhoid Intestinal Perforation in Aba, Nigeria

Received: 14 October 2018     Accepted: 30 November 2018     Published: 3 January 2019
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Abstract

Typhoid intestinal perforation is still prevalent in many low and middle income countries. This may be due to lack of potable water, poor refuse disposal and health education. This study is to evaluate the outcome of management of typhoid intestinal perforation in children at the Abia State University Teaching Hospital Aba Nigeria. This is a prospective study of children who were managed for typhoid intestinal perforation at the Paediatric Surgery unit, department of Surgery of the Abia State University Teaching Hospital Aba Nigeria from November 2016 to September 2018. Proforma was opened for demography, clinical features, investigation, site of perforation, type of surgery, complications and outcome. Data collected were analysed using SPSS computer software version 17 for proportions and percentages. Results: Sixty patients were seen over the sixteen months study period. Forty males and twenty females with a male to female ratio {2:1}. Their ages ranged from 3 years to 15 years with a mean age of 8.9 years. Fever, abdominal pain, vomiting and abdominal distension were the commonest clinical features in over 50% of patients. Doubled layer closure and resection and anastomosis of ileal segment were done in equal number of patients [20 patients each]. Surgical site infection was the most common complications in 50 [83.3%] of patients. Five patients died giving a mortality rate of 8.3%. Typhoid intestinal perforation is still a persistent scourge in low income countries. Morbidity is still high despite low mortality in this series. Early presentation, good nutrition and public health education will improve outcome.

Published in American Journal of Pediatrics (Volume 4, Issue 4)
DOI 10.11648/j.ajp.20180404.17
Page(s) 110-113
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Typhoid, Intestinal Perforation, Childhood

References
[1] Aliyu S, Babayo UD, Tahir MB, Zarami AB, Ibrahim AG, et al. Typhoid Perforation: Presentation and Management Outcome North-Eastern Nigeria. J Gastrointest Dig Syst. 2017; 7: 526.
[2] Lilian Bulage, Ben Masiira, Alex R. Ario, Joseph K. B et al. Modifiable risk factors for typhoid intestinal perforations during a large outbreak of typhoid fever, Kampala Uganda, 2015, BMC Infectious Diseases (2017) 17: 641
[3] Ashraf MD, Robert C, Masahiro H, Emmanuel TO (Typhoid fever and its association with environmental factors in the Dhaka metropolitan area of Bangladash: Aspatial and time-Series approach. Trop Dis. 2013; 7: 1998.
[4] Gasem MH, Dolmans WM, Keuter MM, Djokomoeljanto RR. Poor hygiene and housing as risk factors for typhoid fever in Semarang Indonesia. Europ J Trop Med Int Health. 2001
[5] John W, Rene SH, Mathew LM. Typhoid Fever. The Lancet 2015; 385: 1136-1145.
[6] Kenneth A, Maetin N, Emmanuel O. Prevalence, morbidity and mortality patterns of typhoid Ileal perforation as seen at university of Nigeria teaching hospital Enugu Nigeria: An 8-year review. World J Surg 2014; 38: 2514-2518.
[7] Otegbayo JA, Daramola OO, Onyegbatulem H. C. Retrospective analysis of typhoid fever in a tropical tertiary health facility. Trop Gastroenteroj. 2002; 23: 9-12.
[8] Tade AO, Ayoade BA, Olawoye AA. Pattern of presentatation and Management of typhoid intestinal perforation in Sagamu. South-West Nigeria. NJM 2008; 17: 4, 9-12.
[9] Ugwu BT, Yiltok SI, Kidmas AT, Opalawa AS. Tyhoid intestinal perforation in North Central in North Central Nigeria. West Afr J Med. 2005; 24: 1-6.
[10] Irabor DA. Fifteen years of typhoid perforation Ibadan: still a millstone around the surgeons neck. NJSR 2003; 5: 3-4.
[11] Ugochukwu AI, Amu OC, Nzekwu MA. Ileal perforation due to typhoid fever. Inter J Surg 2013; 11: 218-222.
[12] Adesunkanmi ARK, Tajuden A, Balm MS, Ogudoyin S. Causes and determinants of outcome of intestinal perforation in a semi urban community. Ann Coll Surg. Hong Kong 2003; 7: 116-9.
[13] Parry CM, Tran TH, Dougan G. Typhoid Fever. N Engl J Med 2002; 347: 1770-1782.
[14] Agbakwuru EA, Adesunkanmi AR, Fadiora SO. A review of typhoid perforation in rural African hospital. West Afr J Med 2003; 22: 22-25.
[15] Ameh EA, Dogo PM, Attah MM, Nmadu PT, Comparison of 3 operations fpr typhoid perforations. Br J Surg 1997; 84: 558-559.
[16] Phillipo LC, Joseph BM, Mheta K Typhoid intestinal perforations at a University teaching hospital in Northwestern Tanzania: A surgical experience of 104 cases in a resource-limited setting. World J Emerg Surg 2012; 7: 4.
[17] Ekenze SO, Okoro PE, Amah CC, Ezike HA, Ikefuna AN Typhoid ileal perforation: Analysis of morbidity and mortality in 89 children. Niger J Clin Pract 2008; 11: 58-62.
[18] Anupama P, Ashok AC, Rudresh HK, Girish KS, Suhas KR Mortality in typhoid intestinal perforation: A declining trend. J Clin Diagn Res 2013; 7: 1946-1948.
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  • APA Style

    Samuel Chidi Ekpemo, Ndukuba Eleweke. (2019). Childhood Typhoid Intestinal Perforation in Aba, Nigeria. American Journal of Pediatrics, 4(4), 110-113. https://doi.org/10.11648/j.ajp.20180404.17

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    ACS Style

    Samuel Chidi Ekpemo; Ndukuba Eleweke. Childhood Typhoid Intestinal Perforation in Aba, Nigeria. Am. J. Pediatr. 2019, 4(4), 110-113. doi: 10.11648/j.ajp.20180404.17

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    AMA Style

    Samuel Chidi Ekpemo, Ndukuba Eleweke. Childhood Typhoid Intestinal Perforation in Aba, Nigeria. Am J Pediatr. 2019;4(4):110-113. doi: 10.11648/j.ajp.20180404.17

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  • @article{10.11648/j.ajp.20180404.17,
      author = {Samuel Chidi Ekpemo and Ndukuba Eleweke},
      title = {Childhood Typhoid Intestinal Perforation in Aba, Nigeria},
      journal = {American Journal of Pediatrics},
      volume = {4},
      number = {4},
      pages = {110-113},
      doi = {10.11648/j.ajp.20180404.17},
      url = {https://doi.org/10.11648/j.ajp.20180404.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20180404.17},
      abstract = {Typhoid intestinal perforation is still prevalent in many low and middle income countries. This may be due to lack of potable water, poor refuse disposal and health education. This study is to evaluate the outcome of management of typhoid intestinal perforation in children at the Abia State University Teaching Hospital Aba Nigeria. This is a prospective study of children who were managed for typhoid intestinal perforation at the Paediatric Surgery unit, department of Surgery of the Abia State University Teaching Hospital Aba Nigeria from November 2016 to September 2018. Proforma was opened for demography, clinical features, investigation, site of perforation, type of surgery, complications and outcome. Data collected were analysed using SPSS computer software version 17 for proportions and percentages. Results: Sixty patients were seen over the sixteen months study period. Forty males and twenty females with a male to female ratio {2:1}. Their ages ranged from 3 years to 15 years with a mean age of 8.9 years. Fever, abdominal pain, vomiting and abdominal distension were the commonest clinical features in over 50% of patients. Doubled layer closure and resection and anastomosis of ileal segment were done in equal number of patients [20 patients each]. Surgical site infection was the most common complications in 50 [83.3%] of patients. Five patients died giving a mortality rate of 8.3%. Typhoid intestinal perforation is still a persistent scourge in low income countries. Morbidity is still high despite low mortality in this series. Early presentation, good nutrition and public health education will improve outcome.},
     year = {2019}
    }
    

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    T1  - Childhood Typhoid Intestinal Perforation in Aba, Nigeria
    AU  - Samuel Chidi Ekpemo
    AU  - Ndukuba Eleweke
    Y1  - 2019/01/03
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    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    UR  - https://doi.org/10.11648/j.ajp.20180404.17
    AB  - Typhoid intestinal perforation is still prevalent in many low and middle income countries. This may be due to lack of potable water, poor refuse disposal and health education. This study is to evaluate the outcome of management of typhoid intestinal perforation in children at the Abia State University Teaching Hospital Aba Nigeria. This is a prospective study of children who were managed for typhoid intestinal perforation at the Paediatric Surgery unit, department of Surgery of the Abia State University Teaching Hospital Aba Nigeria from November 2016 to September 2018. Proforma was opened for demography, clinical features, investigation, site of perforation, type of surgery, complications and outcome. Data collected were analysed using SPSS computer software version 17 for proportions and percentages. Results: Sixty patients were seen over the sixteen months study period. Forty males and twenty females with a male to female ratio {2:1}. Their ages ranged from 3 years to 15 years with a mean age of 8.9 years. Fever, abdominal pain, vomiting and abdominal distension were the commonest clinical features in over 50% of patients. Doubled layer closure and resection and anastomosis of ileal segment were done in equal number of patients [20 patients each]. Surgical site infection was the most common complications in 50 [83.3%] of patients. Five patients died giving a mortality rate of 8.3%. Typhoid intestinal perforation is still a persistent scourge in low income countries. Morbidity is still high despite low mortality in this series. Early presentation, good nutrition and public health education will improve outcome.
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Author Information
  • Department of Surgery, Abia State University, Aba, Nigeria

  • Department of Surgery, Abia State University, Aba, Nigeria

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