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Full-Text Articles in Medicine and Health Sciences

Burden Of Ileal Perforations Among Surgical Patients Admitted In Tertiary Care Hospitals Of Three Asian Countries: Surveillance Of Enteric Fever In Asia Project (Seap), September 2016-September 2019, Saqib Hamid Qazi, Mohammad Tahir Yousafzai, Irum Fatima Dehraj, Rozina Thobani, Afshan Akhtar, Abdul Momin Kazi, Aneeta Hotwani, Najeeb Rahman, Junaid Mehmood, Farah Naz Qamar Dec 2020

Burden Of Ileal Perforations Among Surgical Patients Admitted In Tertiary Care Hospitals Of Three Asian Countries: Surveillance Of Enteric Fever In Asia Project (Seap), September 2016-September 2019, Saqib Hamid Qazi, Mohammad Tahir Yousafzai, Irum Fatima Dehraj, Rozina Thobani, Afshan Akhtar, Abdul Momin Kazi, Aneeta Hotwani, Najeeb Rahman, Junaid Mehmood, Farah Naz Qamar

Section of Paediatric Surgery

Background: Typhoid fever is caused by Salmonella enterica subspecies enterica serovar Typhi (S. Typhi) and can lead to systemic illness and complications. We aimed to characterize typhoid-related ileal perforation in the context of the population-based Surveillance of Enteric Fever in Asia Project (SEAP) in Bangladesh, Nepal and Pakistan.
Methods: Between September 2016 and September 2019, all cases of nontraumatic ileal perforation with a clinical diagnosis of typhoid were enrolled from 4 tertiary care hospitals in Karachi, 2 pediatric hospitals in Bangladesh, and 2 hospitals in Nepal. Sociodemographic data were collected from patients or their caregivers, and clinical and outcome data …


Spatial Heterogeneity Of Enteric Fever In 2 Diverse Communities In Nepal, Dipesh Tamrakar, Krista Vaidya, Alexander T. Yu, Kristen Aiemjo, Shiva Ram Naga, Yanjia Cao, Caryn Bern, Rajeev Shrestha, Biraj M. Karmacharya, Farah Naz Qamar Dec 2020

Spatial Heterogeneity Of Enteric Fever In 2 Diverse Communities In Nepal, Dipesh Tamrakar, Krista Vaidya, Alexander T. Yu, Kristen Aiemjo, Shiva Ram Naga, Yanjia Cao, Caryn Bern, Rajeev Shrestha, Biraj M. Karmacharya, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: Typhoid fever is endemic in the urban Kathmandu Valley of Nepal; however, there have been no population-based studies of typhoid outside of this community in the past 3 decades. Whether typhoid immunization should be prioritized in periurban and rural communities has been unclear.
Methods: We performed population-based surveillance for enteric fever in 1 urban catchment (Kathmandu) and 1 periurban and rural catchment (Kavrepalanchok) as part of the Surveillance for Enteric Fever in Asia Project (SEAP). We recruited individuals presenting to outpatient and emergency departments at 2 study hospitals with suspected enteric fever and performed blood cultures. Additionally, we conducted …


Diagnostic Value Of Clinical Features To Distinguish Enteric Fever From Other Febrile Illnesses In Bangladesh, Nepal, And Pakistan, Kristen Aiemjoy, Dipesh Tamrakar, Shampa Saha, Shiva R. Naga, Alexander T. Yu, Ashley Longley, Kashmira Date, Caitlin Hemlock, Farah Naz Qamar, Samir K. Saha Dec 2020

Diagnostic Value Of Clinical Features To Distinguish Enteric Fever From Other Febrile Illnesses In Bangladesh, Nepal, And Pakistan, Kristen Aiemjoy, Dipesh Tamrakar, Shampa Saha, Shiva R. Naga, Alexander T. Yu, Ashley Longley, Kashmira Date, Caitlin Hemlock, Farah Naz Qamar, Samir K. Saha

Department of Paediatrics and Child Health

Background: Enteric fever, a bacterial infection caused by Salmonella enterica serotypes Typhi and Paratyphi A, frequently presents as a nonlocalizing febrile illness that is difficult to distinguish from other infectious causes of fever. Blood culture is not widely available in endemic settings and, even when available, results can take up to 5 days. We evaluated the diagnostic performance of clinical features, including both reported symptoms and clinical signs, of enteric fever among patients participating in the Surveillance for Enteric Fever in Asia Project (SEAP), a 3-year surveillance study in Bangladesh, Nepal, and Pakistan.
Methods: Outpatients presenting with ≥3 consecutive days …


Antimicrobial Resistance In Typhoidal Salmonella: Surveillance For Enteric Fever In Asia Project, 2016-2019, Farah Naz Qamar, Mohammad Tahir Yousafzai, Irum Fatima Dehraj, Sadia Shakoor, Seema Irfan, Aneeta Hotwani, Muhammad J. Hunzai, Rozina Thobani, Najeeb Rahman, Junaid Mehmood, Ashraf M. Memon Dec 2020

Antimicrobial Resistance In Typhoidal Salmonella: Surveillance For Enteric Fever In Asia Project, 2016-2019, Farah Naz Qamar, Mohammad Tahir Yousafzai, Irum Fatima Dehraj, Sadia Shakoor, Seema Irfan, Aneeta Hotwani, Muhammad J. Hunzai, Rozina Thobani, Najeeb Rahman, Junaid Mehmood, Ashraf M. Memon

Department of Paediatrics and Child Health

Background: Clinicians have limited therapeutic options for enteric as a result of increasing antimicrobial resistance, and therefore typhoid vaccination is recommended as a preventive measure. As a part of the Surveillance for Enteric Fever in Asia Project (SEAP), we investigated the extent measured the burden of antimicrobial resistance (AMR) among confirmed enteric fever cases in Bangladesh, Nepal, and Pakistan.
Methods: From September 2016-September 2019, SEAP recruited study participants of all age groups from its outpatient, inpatient, hospital laboratory, laboratory network, and surgical sites who had a diagnosis of febrile illness that was either suspected or blood culture confirmed for enteric …


Illness Severity And Outcomes Among Enteric Fever Cases From Bangladesh, Nepal, And Pakistan: Data From The Surveillance For Enteric Fever In Asia Project, 2016-2019, Ashley T. Longley, Caitlin Hemlock, Kashmira Date, Stephen P. Luby, Jason R. Andrews, Samir K. Saha, Isaac I. Bogoch, Mohammad Tahir Yousafzai, Denise O. Garrett, Farah Naz Qamar Dec 2020

Illness Severity And Outcomes Among Enteric Fever Cases From Bangladesh, Nepal, And Pakistan: Data From The Surveillance For Enteric Fever In Asia Project, 2016-2019, Ashley T. Longley, Caitlin Hemlock, Kashmira Date, Stephen P. Luby, Jason R. Andrews, Samir K. Saha, Isaac I. Bogoch, Mohammad Tahir Yousafzai, Denise O. Garrett, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: Enteric fever can lead to prolonged hospital stays, clinical complications, and death. The Surveillance for Enteric Fever in Asia Project (SEAP), a prospective surveillance study, characterized the burden of enteric fever, including illness severity, in selected settings in Bangladesh, Nepal, and Pakistan. We assessed disease severity, including hospitalization, clinical complications, and death among SEAP participants.
Methods: We analyzed clinical and laboratory data from blood culture-confirmed enteric fever cases enrolled in SEAP hospitals and associated network laboratories from September 2016 to September 2019. We used hospitalization and duration of hospital stay as proxies for severity. We conducted a follow-up interview …


Healthcare Utilization Patterns For Acute Febrile Illness In Bangladesh, Nepal, And Pakistan: Results From The Surveillance For Enteric Fever In Asia Project, Jason R. Andrews, Krista Vaidya, Shampa Saha, Mohammad Tahir Yousafzai, Caitlin Hemlock, Ashley Longley, Kristen Aiemjoy, Alexander T. Yu, Isaac I. Bogoch, Farah Naz Qamar Dec 2020

Healthcare Utilization Patterns For Acute Febrile Illness In Bangladesh, Nepal, And Pakistan: Results From The Surveillance For Enteric Fever In Asia Project, Jason R. Andrews, Krista Vaidya, Shampa Saha, Mohammad Tahir Yousafzai, Caitlin Hemlock, Ashley Longley, Kristen Aiemjoy, Alexander T. Yu, Isaac I. Bogoch, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: Characterizing healthcare-seeking patterns for acute febrile illness is critical for generating population-based enteric fever incidence estimates from facility-based surveillance data.
Methods: We used a hybrid model in the Surveillance for Enteric Fever in Asia Project (SEAP) to assess incidence of enteric fever at 6 study hospitals in 3 countries. We recruited individuals presenting to the hospitals and obtained blood cultures to evaluate for enteric fever. For this analysis, we undertook cluster random household surveys in Dhaka, Bangladesh (2 sites); Karachi, Pakistan; Kathmandu, Nepal; and Kavrepalanchok, Nepal between January 2017 and February 2019, to ascertain care-seeking behavior for individuals with …


Antibiotic Use Prior To Hospital Presentation Among Individuals With Suspected Enteric Fever In Nepal, Bangladesh, And Pakistan, Krista Vaidya, Kristen Aiemjoy, Farah Naz Qamar, Samir K. Saha, Dipesh Tamrakar, Shiva R. Naga, Shampa Saha, Caitlin Hemlock, Ashley T. Longley, Kashmira Date Dec 2020

Antibiotic Use Prior To Hospital Presentation Among Individuals With Suspected Enteric Fever In Nepal, Bangladesh, And Pakistan, Krista Vaidya, Kristen Aiemjoy, Farah Naz Qamar, Samir K. Saha, Dipesh Tamrakar, Shiva R. Naga, Shampa Saha, Caitlin Hemlock, Ashley T. Longley, Kashmira Date

Department of Paediatrics and Child Health

Background: Antibiotic use prior to seeking care at a hospital may reduce the sensitivity of blood culture for enteric fever, with implications for both clinical care and surveillance. The Surveillance for Enteric Fever in Asia Project (SEAP) is a prospective study of enteric fever incidence in Nepal, Bangladesh, and Pakistan. Nested within SEAP, we evaluated the accuracy of self-reported antibiotic use and investigated the association between antibiotic use and blood culture positivity.
Methods: Between November 2016 and April 2019, we collected urine samples among a subset of SEAP participants to test for antibiotic use prior to the hospital visit using …


Typhoid And Paratyphoid Cost Of Illness In Pakistan: Patient And Health Facility Costs From The Surveillance For Enteric Fever In Asia Project Ii, Nelly Mejia, Farah Naz Qamar, Mohammad Tahir Yousafzai, Jamal Raza, Denise O. Garrett, Kashmira Date, Taiwo Abimbola, Sarah W. Pallas Dec 2020

Typhoid And Paratyphoid Cost Of Illness In Pakistan: Patient And Health Facility Costs From The Surveillance For Enteric Fever In Asia Project Ii, Nelly Mejia, Farah Naz Qamar, Mohammad Tahir Yousafzai, Jamal Raza, Denise O. Garrett, Kashmira Date, Taiwo Abimbola, Sarah W. Pallas

Department of Paediatrics and Child Health

Background: The objective of this study was to estimate the cost of illness from enteric fever (typhoid and paratyphoid) at selected sites in Pakistan.
Methods: We implemented a cost-of-illness study in 4 hospitals as part of the Surveillance for Enteric Fever in Asia Project (SEAP) II in Pakistan. From the patient and caregiver perspective, we collected direct medical, nonmedical, and indirect costs per case of enteric fever incurred since illness onset by phone after enrollment and 6 weeks later. From the health care provider perspective, we collected data on quantities and prices of resources used at 3 of the hospitals, …


Burden Of Culture Confirmed Enteric Fever Cases In Karachi, Pakistan: Surveillance For Enteric Fever In Asia Project (Seap), 2016-2019, Mohammad Tahir Yousafzai, Seema Irfan, Rozina Thobani, Abdul Momin Kazi, Aneeta Hotwani, Ashraf M. Memon, Khalid Iqbal, Saqib Hamid Qazi, Nasir S. Saddal, Najeeb Rehman, Irum Fatima Dehraj, Mohammed J. Hunzai, Junaid Mehmood, Farah Naz Qamar Dec 2020

Burden Of Culture Confirmed Enteric Fever Cases In Karachi, Pakistan: Surveillance For Enteric Fever In Asia Project (Seap), 2016-2019, Mohammad Tahir Yousafzai, Seema Irfan, Rozina Thobani, Abdul Momin Kazi, Aneeta Hotwani, Ashraf M. Memon, Khalid Iqbal, Saqib Hamid Qazi, Nasir S. Saddal, Najeeb Rehman, Irum Fatima Dehraj, Mohammed J. Hunzai, Junaid Mehmood, Farah Naz Qamar

Department of Paediatrics and Child Health

Background: The Surveillance for Enteric Fever in Asia Project (SEAP) is a multicenter, multicountry study conducted in Pakistan, Nepal, and Bangladesh. The objectives of the study were to characterize disease incidence among patients with enteric fever. We report the burden of enteric fever at selected sites of Karachi, Pakistan.
Methods: During September 2016 to September 2019, prospective surveillance was conducted at inpatient, outpatient, surgical departments, and laboratory networks of Aga Khan University Hospital, Kharadar General Hospital, and surgery units of National Institute of Child Health and Jinnah Postgraduate Medical Centre. Socio-demographic, clinical, and laboratory data were obtained from all suspected …