Typhoid Enteric Perforation in Children in Calabar, Nigeria

Abstract

Typhoid enteric perforation, a severely debilitating illness with a high mortality rate in children was studied in Calabar. The aim of the study was to determine the role that ingestion of herbal preparations, laxatives and enemas has on perforation and whether there is a relationship between the observed perforation and its occurrence within the first week of illness. Fifty-two patients with typhoid enteric perforations were selected from a pool of 178 cases of acute abdomen in children. Clinical, laboratory and radiological assessments were used to diagnose the condition and confirmation obtained intra-operatively. Results showed a male: female ratio of 3:1; with delayed presentation after 6 hours being a common feature in all patients with perforations. Sixty-three percent of the patients who were perforated had either consulted a traditional healer or chemist and had ingested a herbal concoction, a laxative or had an enema administered to them. Mortality was also higher within this group. Early resuscitation and surgical intervention within 24 hours of onset of illness led to a significant reduction in mortality. Seasonal variation was noted in the occurrence of typhoid fever. It was rampant during the dry season but rare during the rainy season.

Key words: typhoid perforation, traditional healers, late presentation, seasonal variation

Journal of Medical Laboratory Sciences Vol.12(1) 2003: 41-45