Pattern of typhoid presentations in children and surgical outcomes of perforated cases in a tertiary centre in North Central, Nigeria

Abstract

Background: Mortality in children with typhoid perforation is four (4) times higher than those without perforation in Nigeria. A high index of suspicion and early surgical intervention reduces morbidity and mortality in children with typhoid fever with and or typhoid perforation.
Methods: To determine the pattern and treatment outcome of typhoid enteritis with ileal perforations, leading to observed improvement of treatment of perforation due to prompt simple surgical management and determine whether the mortality of perforation in typhoid was still adamantly 4 times as high as before. A 5-year retrospective study of all managed children with perforated typhoid enteritis between March 2012 and March 2017 at Bingham University Teaching Hospital, Jos, North-Central Nigeria was undertaken. Effect of duration of illness at home before referral to hospital, impact of time lapse between perforation, operation and management were investigated.
Results: Sex differential of the152 admitted children was female 53(36%) and males 96 (64%) ratio F: M of 1:1.8 aged from 0.6 to 17 years. We had a mortality of nine cases (6 %) M: F ratio of 2:1.Age range of the group was 16.4; median was 8.0, standard deviation of 3.48, min of 0.6 and max of 17 and variance was 12.11.LoS was highest for male children. The QoL of the children and parents/guardians were better.
Conclusion: Quick diagnosis, immediate resuscitation and prompt surgical decision and simple surgical intervention were vital to the improved morbidity and mortality recorded in this study.