Frequency of Enteric Fever in Pediatric Patients With Acute Febrile Illness

Abstract

Background: Acute febrile illness (AFI) is a leading cause of pediatric healthcare utilization in low- and middle-income countries, where enteric fever remains endemic. While the burden of enteric fever in older children is well recognized, data focusing on infants and toddlers presenting with AFI are limited. This study aimed to determine the frequency of enteric fever among children aged 6–24 months presenting with acute febrile illness and to examine its association with selected demographic and clinical characteristics.

Methods: A cross-sectional study was carried out at one 2024 at one of the the Children Hospital and Institute of Child Health (ICH) in Peshawar. Sampling was conducted through consecutive sampling on children aged 624 months with acute febrile illness. Baseline demographics and clinical data were obtained and to establish the enteric fever, the blood cultures were done by the BACTEC system. The data were analyzed based on descriptive statistics and stratified analyses and the association was evaluated against the Chi-square test or Fisher test.

Results: A total of 200 children participated, with a mean age of 14.02 ± 4.86 months; 56.0% were male. Enteric fever was diagnosed in 44 children, resulting in a frequency of 22.0%. No statistically significant correlations were found between enteric fever and age group, gender, nutritional status, duration of fever, or recent antibiotic usage (p > 0.05 for all). Significantly, 41.0% of children had been administered antibiotics before presentation, indicating prevalent empirical antimicrobial utilization.

Conclusions: This study found that enteric fever contributed to one in five cases of acute febrile infections occurrences among children aged between 6 and 24 months of age, highlighting why enteric fever continues to be of public health importance among this vulnerable population. The inability to provide reliable clinical or demographic indicators contributes to the drawbacks of symptom-based diagnosis and the need to introduce regular laboratory validation, which will help to provide timely and proper care. The improvement of diagnostic abilities, the promotion of the use of antibiotics rationally, and the introduction of preventive strategies, including vaccination, plays an essential role in reducing the burden of diseases and resistance to antimicrobials in endemic conditions.