Comparative Study Of Typhoid Fever Presentation In Adults Vs. Children In Endemic Regions

Original Article

Abstract

Background: Typhoid fever is a systemic infection primarily caused by Salmonella Typhi, and it is primarily acquired by consuming contaminated food and water. Typhoid fever remains widely transmitted and endemic in several lower and middle-income countries. Additionally, the disease presents differently in adults and children. For precise and timely treatment and diagnosis, it is essential to recognize both the classical and unusual features of the infection in both adults and children. 

Objectives: to describe the adult and pediatric population in typhoid fever endemic countries relative to the disease clinical presentation, complications, and investigations. This will thus provide a basis for improved clinical management for each age group. 

Methodology: This study was conducted from July to December 2023 as a cross-sectional comparative study over six months at the Departments of  Pediatrics, Peshawar Institute of Medical Sciences, Peshawar. 120 patients attending the institute with a diagnosis of typhoid fever on blood culture and Widal test, and who met the inclusion criteria, were recruited. These patients were divided into two age categories, adults (≥ 18 years of age) and children (≤ 18 years of age). Patients’ clinical features, lab results, and clinical outcomes were documented and reviewed. Data were analyzed on SPSS 24.0 using descriptive and inferential statistics. A p-value ≤ 0.05 was considered statistically significant.

Results:120 patients were adults, and the rest were children. Adult patients, on Mean age  29.6 ± 8.4 years old, and children were 10.2 ± 3.7 years old. Children experienced fever and had abdominal pain and diarrhea, whereas adults chiefly had a headache with constipation and muscular pain. While the children had a greater incidence of leukopenia than the adults (p = 0.032), the adults had a greater incidence of elevated ALT results (p = 0.018). A greater number of younger patients had medically complicated conditions.

Conclusion: The clinical presentation of typhoid fever varies with age—children commonly exhibit gastrointestinal symptoms with hepatosplenomegaly, while adults show systemic involvement and altered liver function. Recognizing these age-related patterns is vital for timely diagnosis and improved treatment outcomes in resource-limited settings.