ABSTRACT
Objective: To describe the demographic, clinical, laboratory and bacteriological profile ofchildren with diagnosis of typhoid fever over a six-year period. Methods: Case recordanalysis of hospitalized children (≤5 y) with culture positive typhoid fever. Results: Bloodculture was positive in 100 (61%) of 166 suspected cases, with 78 isolates of SalmonellaTyphi and 22 Salmonella Paratyphi A. Only 12 children were aged below two years.Hepatomegaly (32), splenomegaly (44), eosinopenia (42), positive widal (15, 21.1%) andpositive Typhidot IgM (18, 28.1%) were not consistently observed. High susceptibility toAmpicillin, Chloramphenicol, Cotrimoxazole (87, 89, and 94, isolates, respectively), 100%susceptibility to third generation cephalosporins and Azithromycin, and high resistance toNalidixic Acid [(S. Typhi 48 (61.5%)], S. Paratyphi A 16 (72.7%)) were observed. Conclusion:We observed a high isolation rate of salmonella in blood culture, despite prior use ofantibiotics. Most salmonella isolates were susceptible in vitro to standard drugs, exceptnalidixic acid.
ABSTRACT
Hexavalent vaccines containing diphtheria, tetanus, pertussis, Haemophilus influenzae type b, poliomyelitis, and hepatitis B virusantigens have the potential to be used for the primary series in India (6, 10, 14 weeks of age) and the toddler booster dose. Threehexavalent vaccines are available in India: DTwP-Hib/HepB-IPV (wP-hexa), DTaP-IPV-HB-PRP~T(2aP-hexa), and DTaP-HBV-IPV/Hib(3aP-hexa). In the three published phase-3 Indian studies, pertussis ‘vaccine response’ rates 1 month after a 6-10-14-week primaryseries were 68.4-75.7% for wP-hexa, 93.8-99.3% for 2aP-hexa, and 97.0-100% for 3aP-hexa; seroprotection rates for the other fiveantigens were 88.2-100%, 49.6-100%, and 98.6-100%, respectively. Studies outside India show: good immunogenicity/safety afterboosting dosing; immune persistence to age 4.5 years (2aP-hexa), 7-9 years (3aP-hexa) (all antigens), and 9-10 and 14-15 years,respectively (hepatitis B); and successful co-administration with other vaccines. Hexavalent vaccines could reduce the number ofinjections, simplify vaccination schedules, and improve compliance.