Frequency and risk factor of typhoid fever in Khyber Pakhtunkhwa, Pakistan

Paper Details

Research Paper 01/06/2019
Views (375) Download (14)

Frequency and risk factor of typhoid fever in Khyber Pakhtunkhwa, Pakistan

Tabbassum Imran, Sarah Arif, Raheela Bano, Nighat Aziz, Mahrukh Naseem, Humera Nazir, Arshia Sumbal, Nayab Khan, Lawang Gurganari, Abdul Jabbar
Int. J. Biosci.14( 6), 21-27, June 2019.
Certificate: IJB 2019 [Generate Certificate]


Typhoid fever, caused due to Salmonella Typhi (S. Typhi), is considered as one of the deadliest diseases, and a serious public health problem around the world. The prevalence of typhoid fever in city of Saidu Sharif Sawat, Khyber Pakhtunkhwa province of Pakistan was investigated in this study from October 26, 2017 to February 25, 2018. The blood samples of 400 patients of age group 1- 50 years old were used for clinical diagnosis applying widal test and their results were compared for analysis. A total of 76 patients were found positive of S. Typhi. The ratio of typhoid occurrence in males (66%) was found higher as compared to typhoid positive cases of females (34%). The ratio of typhoid patients was greater in young people having ages between 11-30 years. This study provides significant statistics regarding net incidence of typhoid in the city of Saidu Sharif Sawat that would help in proposed future health policies. Preventive strategies such as immunization programs, improved sanitary standards, clean water supply and proper sewerage system should be the focus of typhoid control in cities like Saidu Sharif Sawat.


Abdullah FE, Shaikh A, Abid M, Talib A. 2013. Enteric Fever in a Cross-section of Patients in Karachi: Current Correlation of Positive Blood Cultures with the Widal Agglutination and the Typhoid Immunoassay Tests. Journal of Dow University of Health Sciences 7, 89-93.

Acosta CJ, Galindo CM, Ali M, Elyazeed RA, Ochiai RL, Danovaro-Holliday MC. 2005. A multi-country cluster randomized controlled effectiveness evaluation to accelerate the introduction of VI polysaccharide typhoid vaccine in developing countries in Asia: rationale and design. Tropical Medicine and International Health 10, 1219-1228.

Adhikari A, Rauniyar R, Raut PP, Manandhar, KD, Gupta BP. 2015. Evaluation of sensitivity and specificity of ELISA against Widal test for typhoid diagnosis in endemic population of Kathmandu. BMC Infectious Diseases 15, 523.

Ayaz A, Pervaiz MK, Azad MD, Pervaiz G. (2006). Risk Factors of Enteric Fever in Children Less Than 15 Years of Age. Journal of Statistics 13(1), 84-100.

Aziah I, Ravichandran M, Ismail A. 2007. Amplification of ST50 gene using dry-reagent based PCR for the detection of S. typhi. Diagnosis and Microbiology of Infectious Diseases 59, 373-377.

Ivanoff B, Levine M, Lambert P. 1994. Vaccination against typhoid fever: Present status. Bulletin of the World Health Organization 72, 957-971.

Bhan MK, Bahl R, Bhatnagar S. 2005. Typhoid and paratyphoid fever. Lancet 366, 749-762.

Buckle GC, Walker CLF, Black RE. 2012. Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010. Journal of Global Health 2(1), 010401.

Cheesbrough M. 1985. Medical Laboratory Manual for Tropical Countries, 1st edition. Butterworth, Cambridge 257-261.

Clerc O, Greub G. 2010. Routine use of point-of-care tests: usefulness and application in clinical microbiology. Clinical Microbiology and Infection. 16(8), 1054-1061.

Choo KE, Razif AR, Oppenheimer SJ, Ariffin WA, Lau J, Abraham T. 1993. Usefulness of the widal test in diagnosing childhood typhoid fever in endemic areas. Journal of Paediatrics and Child Health 29, 36-39.

Choo KE, Oppenheimer SJ, Ismail AB, Ong, 1994. Rapid sero diagnosis of typhoid fever by dot enzyme immunoassay in an endemic area. Clinical Infectious Diseases 19, 172-176.

Crump JA, Morrissey AB, Nicholson WL. 2013. Etiology of severe non-malaria febrile illness in Northern Tanzania: a prospective cohort study. PLOS Neglected Tropical Diseases 7, e2324.

Haraga A, Ohlson MB, Miller SI. 2008. Salmonellae interplay with host cells. Nature Reviews Microbiology 6, 53-66.

Ismail A, Hai OK, Kader ZA. 1991. Demonstration of an antigenic protein specific for S. typhi. Biochemical Biophysical Research Communication. 181, 301-305.

Ismail AB, Kader ZSA, Ong KH. 1991. Dot enzyme Immunosorbent assay for the sero-diagnosis of typhoid fever. The Southeast Asian Journal of Tropical Medicine and Public Health 22, 563-566.

John J, Van-Aart CJ, Grassly NC. 2016. The burden of typhoid and paratyphoid in India: systematic review and meta-analysis. PLOS Neglected Tropical Diseses 10(4), e0004616.

Karkey A, Thompson CN, Tran-Vu-Thieu N, Dongol S, Le-Thi-Phuong T, Voong-Vinh P. 2013. Differential Epidemiology of Salmonella typhi and paratyphi A in Kathmandu, Nepal: A Matched Case Control Investigation in a Highly Endemic Enteric Fever Setting. PLOS Neglected Tropical Diseases 7(8), e2391.

Kalsoom F, Akbar M, Younas U, Tasneem M, Suleman S, Ali S, Roohi A. 2014. Prevalence of typhoid fever in five Southern districts of Khyber Pakhtunkhwa, Pakistan: A preliminary study. International Journal of Biosciences 4(1), 325-330.

Khan MN, Shafee M, Hussain K, Samad A, Arif AM, Manan A, Wadood A. 2013. Typhoid fever in pediatric patients in Quetta, Balochistan, Pakistan. Pakistan Journal of Medical Sciences 29(4), 929-932.

Kirkwood BR, Hurt L, Amenga-Etego S, Tawiah C, Zandoh C, Danso S. 2010. Effect of vitamin A supplementation in women of reproductive age on maternal survival in Ghana (ObaapaVitA): a cluster-randomized, placebo-controlled trial. Lancet. 375, 1640-1649.

Masoumi AH, Gouya MM, Nabavi M, Aghili N. 2013. Epidemiology of Typhoid Fever in Iran during Last Five Decades from 1962-2011. Iranian Journal of Public Health 42(1), 33-38.

Mogasale V, Ramani E, Park IY, Lee JS. 2017. A forecast of typhoid conjugate vaccine introduction and demand in typhoid endemic low- and middle-income countries to support vaccine introduction policy and decisions. Human Vaccines & Immuno-therapeutics 13(9), 2017–2024.

Naheed A, Ram PK, Brooks WA. 2010. Burden of typhoid and paratyphoid fever in a densely populated urban community, Dhaka, Bangladesh. International Journal of Infectious Diseases. 15: 93-99.

Niemann GS, Brown RN, Gustin JK, Stufkens A, Shaikh-Kidwai AS, Li J, McDermott JE, Brewer HM, Schepmoes A. 2011. Discovery of novel secreted virulence factors from Salmonella enterica serovar typhimurium by proteomic analysis of culture supernatants. Infection and Immunity 79 33-43.

Ochiai RL, Wang X, von-Seidlein L, Yang J, Bhutta ZA, Bhattacharya SK. 2005. Salmonella paratyphi A rates, Asia. Emerging Infectious Diseases. 11(11), 1764–1766.

Parajapati B, Rai SK, Rai GK, Singh G. 2008. Prevalence of Salmonella typhi and paratyphi in Children: A Hospital Based Study. Nepal Medical College Journal 10(4), 238-241.

Reddy EA, Shaw AV, Crump JA. 2010. Community-acquired bloodstream infections in Africa: a systematic review and meta-analysis. The Lancet Infectious Diseases 10, 417-432.

Shah SM, Yousafzai M, Lakhani NB, Chotani RA, Nowshad G. 2003. Prevalence and correlates of diarrhea. Indian Journal of Pediatrics. 70(3), 207-211.

Shen X, Ou L, Chen X, Zhang X, Tan X. 2013. The Application of the Grey Disaster Model to Forecast Epidemic Peaks of Typhoid and Paratyphoid Fever in China. PLOS ONE. 8(4), e60601.