Blood culture confirmed typhoid fever in a provincial hospital in the Philippines.

Epidemiological features of blood culture confirmed typhoid fever and antibiotic sensitivity of isolated Salmonella typhi strains were investigated in Bohol Province in Central Philippines from where no earlier information of these was avialable. Typhoid fever is endemic elsewhere in the Philippines (eg Metropolitan Manila and surroundings) where also multidrug resistant S. typhi strains have been detected. A laboratory for surveillance of invasive bacterial infections was established in a tertiary care government hospital, in Bohol, Central Philippines, in 1994. Patients with suspected typhoid fever or other serious infection were managed and blood cultures from them were taken according to clinicians' judgment. Blood cultures were processed and the isolated bacteria identified using generally accepted methods. S. typhi and other Salmonella isolates were identified using commercial antisera. Patient data were collected from hospital records. Of a total of 4,699 blood cultures done during a period of 3 3/4 years, 1,530 (32%) were requested for suspected typhoid fever. S. typhi was the most common pathogen isolated from 422 patients (8.9%), followed by S. paratyphi A from 55 patients (1%). Most patients were young adults (43%) and school age children (28%). Male:female ratio was 1.5:1. Among the 422 patients, there were 9 (2%) deaths due to typhoid fever, all with complications. All S. typhi isolates were sensitive to chloramphenicol, cotrimoxazole, and ampicillin. Our observation on blood culture confirmed typhoid fever demonstrates its importance as a major infectious disease in Bohol and gives a sound basis for treatment of typhoid patients and for further clinical and epidemiologic studies of typhoid fever and for following antibiotic sensitivity of S. typhi in Bohol and elsewhere in the Philippines.

Etiology of acute lower respiratory infection in Filipino children under five years.

This study conducted at the Research Institute for Tropical Medicine from April 1990 to December 1992, identified the etiology of acute lower respiratory tract infection (ALRI) in 119 (36.9%) of 317 hospitalized children < 5 years of age. A higher proportion of respiratory viruses (27.2%) than bacterial agents (10.7%) were identified. Viral agents (adenovirus, RSV, parainfluenza 3, influenza A and influenza B) and bacterial agents (mainly Haemophilus influenzae and Streptococcus pneumoniae) are the pathogenic agents involved in ALRI among Filipino children less than 5 years old.

Evaluation of a single Widal test in the diagnosis of enteric fever.

The usefulness of a single Widal test was evaluated in an endemic area. This test was done on 62 bacteriologically proven enteric fever cases, 69 non-enteric fever cases and healthy individuals. Using an 0 antibody cut-off of greater than or equal to 1:20, the Widal tube agglutination test yielded a sensitivity of 61% and a specificity of 88%. At a pre-test probability of around 50%, the positive predictive value was 83% and the negative predictive value was 72%. A 4% prevalence of 0 antibodies was noted in the healthy population.