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Objective: In this study our main aims to know the clinicalprofile of pediatric enteric fever and the sensitivity pattern ofthe disease to drugs in this region.Methodology: This prospective observational study conductedin a tertiary care hospital at Dhaka from March to December2016 among suspected case of Enteric fever as per casedefinition. Among 212 suspected enteric fever 117 childrenwere diagnosed as enteric fever by blood culture and/or Widaltest.Results: During the study, Male: female were 1.3: 1. Maximum(70%) children were in age group 5 years or more. Most of thechildren were from urban slum area (53.6%) of Dhaka city.Cases were admitted throughout the year. Commonpresentation were fever (100%), anorexia (100%), painabdomen (74.4%) and loose motions (46.1%). The commonsigns were hepatomegaly (41.9%), hepatosplenomegaly(5.1%) coated tongue (64.9%), pallor (74.4%). Thecomplications rate was 35.9% and commonest being UTI andpneumonia. The overall positivity of Widal test was 89.7% andthe culture positivity was 32.5%. Among isolates, 94.7%wereSalmonella typhi and 5.3% Salmonella paratyphi A. Amongthem18.1% isolates were multi drug resistant.Conclusion: Enteric fever is most prevalent during summer &rainy session. WASA supplied water may play a role.Hepatomegaly is common. UTI and pneumonia are thecommonest complication. Multidrug resistant cases are not soas high as other countries. Cefixime, Ceftriaxone. Meropenamand Ofloxacine are the drugs of choice. Ciprofloxacin is stillcould be chosen for the treatment of enteric fever. Higher rateof resistant to Azithromycin is alarming.
RESUMO
Objective: In this study our main goal is to evaluate clinicaloutcome of neonatal septicemia in Bangladesh.Methods: This cross-sectional study is conducted at Neonatalunit of the department of paediatrics, Sir Salimullah MedicalCollege and Mitford Hospital, Dhaka, From July 2005 to June2006. Among 90 clinically diagnosed septicemic neonates, 30were blood culture positive.Results: During the study, where low birth weight (60%),prematurity (53%), prolonged rupture of membrane wasdocumented in 17% of cases. 70% delivery occurred by normalvaginal route, among them 50% occurred at home and 20%occurred at hospital. 30% were delivered by LUCS. 13% caseshad H/O fever in last trimester. Lethargic and reluctant to feed,83% had respiratory distress. Jaundice was present in 60%cases, fever was present in 40% cases. Other presentationswere apnea, convulsion, abdominal distension, sclerema,vomiting, hypothermia and diarrhoea.Conclusion: From our result, we can conclude that, thepattern of organisms are changing and high incidence ofmultidrug resistance remains a major challenge to manageneonatal septicemia.
RESUMO
Aims: To make approaches to data collection and analysis for reviewing the impact of malnourishment upon the high incidence of infections and infestations among children in slum. Study Design: This prospective study was carried out among the total of 110 slum children and incidence of infections and infestations among them was observed. Data were collected by survey of dwelling condition, face to face interviews with the mother and examination of physical condition of children aged less than 12 years. To calculate the incidence rate for infections and infestation among the malnourished children and their association with aspects of demographic, socioeconomic, health and community factors Gomez's original classification and Waterlow classification was used and statistical analysis was done. Place and Duration of Study: The study was conducted from July 2011 to June 2012 in Kushtia Districts of Bangladesh. Methodology: The survey form was prepared in two sections. The first part was conducted in order to assess the nutritional status by taking anthropometric measurement and dietary history of the child and the second part was prepared for examining presence of any disease. Children were eligible for inclusion in the study if they were less than 12 years of age. For all dwellings with at least one eligible child data on socioeconomic and demographic variables were collected through structured face-to-face interviews. Where the main householder or career or mother was not available the interview was conducted with a secondary householder or career. Results: Of the total 110 slum children 67.27% were found moderately malnourished, 12.72% were severely malnourished and 11.81% were mild malnourished. It also found that a greater part of the children were wasted (52.72%) and 15.45% of the children were both wasted and stunted. In this study 45 children (40.9%) out of 110 were found to be infected with one or more of the infections. Among these infections the most prevalent are - cough (17.27%), skin abscess (14.54%), diarrhea (13.63%), tonsillitis (8.18%) and respiratory distress (15.45%) are also very common. Among the malnourished boys 43.24% were infected and the infestation rate among the malnourished boys was 45.94%. Among the malnourished girls the infection and infestation rate was 45.31% and 37.5% respectively. By sexes combined 44.5% malnourished children were infected and 40.6% were infested. Conclusion: The analysis proved that the factors which predispose the host to malnutrition also predispose to infection, thus establishing the vicious circle of infectionmalnutrition- infection. The analysis also revealed that intestinal parasitic infestations contribute significantly to poor growth and malnutrition in children.