HOW TO PREVENT TYPHOID FEVER IN CHILDREN

A parent of my sons’ school mate called on phone at the weekend to seek for my expert opinion and requesting for a consultation with her child. We had a very short conversation over the child’s condition. She has been convinced by the previous caregiver that the child has Malaria and typhoid fever.

I tried to convince her that her child may not have typhoid fever based on the history of the illness. The following conversation ensues:

Mrs O: Good evening doctor, I am Mrs O, A parent of your sons’ school mate

Dr: Ok, good evening ma

Mrs O: My Child developed fever a week ago which persisted till now, I have taken her to hospital, we have done test and was told its Malaria and typhoid fever.

Dr Adesanya: How old is your child

Mrs O: less than 2 years

Dr Adesanya: What tests were ordered by your doctor?

Mrs O: MP and Widal test. The result of the test was explained to me that its malaria and typhoid.

Dr Adesanya: Was any test done to screen for infections. Was the ear and throat examined?

Mrs O: Not at all. Could it be teething?

Dr Adesanya: It’s possible, it could be teething or any other conditions that causes fever like viral, bacteria and other infections.

There is need for public enlightenment on diagnosis and management of Typhoid fever, this condition has been severally overdiagnosed, misdiagnosed, wrongly treated. Laboratory tests for typhoid fever is also over requested, inadequate and misinterpreted.

Typhoid fever is a bacterial infection. Children can become very sick or even die without treatment. Typhoid fever is common in areas with poor sanitation.

Signs and symptoms

Signs and symptoms appear about 7 to 14 days after catching the disease and may include a persistent fever that rises gradually to 39ºC to 40ºC, a headache a sore throat, tiredness, low energy, stomach pain, constipation, diarrhoea rash with pink spots on the stomach or chest

 Causes

Typhoid fever is caused by bacteria. The bacteria is most often found in food or water contaminated by an infected person. Infection can also occur when food or drink is served by an infected person who has not washed after using the bathroom.

Risk factors

Having close contact with an infected person increases chances of infection. Children with weak immune systems are also at a greater risk of getting sick. A Child is at higher risk of infection if he or she travels to a country where the fever is common.

Complications

If typhoid fever is not treated quickly, the child may become very ill and develop other complications which may include: severe weight loss, severe diarrhoea, persistent high fever, becoming unresponsive, delirium or hallucinations

Laboratory test

Widal test may suggest infection with salmonella typhi however, they are diagnostic because of the number of false-positive and false-negative.Isolation of Salmonella( bacteria that causes typhoid) from cultures of stool, blood, urine, or bone marrow are necessary to confirm the diagnosis of typhoid fever.

Monitor the fever and complete the antibiotics

The fever and any pain usually go away 48 hours after starting antibiotic therapy. It is important to complete the antibiotics according to prescriptions inorder to prevent recurrence, antibiotic resistance, and complications. 

Prevention

Prevention is the best way to protect the child against typhoid fever. Some simple steps to reduce chances of catching this infection are listed below:

Drink Pure or bottle water

Contaminated drinking water is a common source of the infection. Boil your water and allow to cool before drinking or Stick to pure satchets /bottle water .

Hand washing

Teach children to wash hands frequently. Wash with warm, soapy water before eating food. Also wash after using the toilet. Public education campaigns encouraging people to wash their hands after defecating and before handling food are an important component in controlling spread of the disease. Alcohol-based Hand sanitizer can kill germs when water is not available.

Wash fruits and vegetables thoroughly

Raw fruit or vegetables may have been washed in contaminated water. There is need to rewash the fruits and vegetables.

Vaccinations

Typhoid vaccine is readily available and can be used in children from 2 years of age. Adults can also be given the Typhoid vaccination to prevent them from Typhoid fever.