Frequency of Enteric Fever Among Children Presenting with Acute Febrile Illness
TL;DR
Culture-confirmed enteric fever was common in this group of febrile children and was associated with high-grade fever, and larger multicentre studies with susceptibility testing are needed.
Abstract
Background: Enteric fever is a frequent cause of acute febrile illness in children living in endemic areas. Pakistan carries one of the highest burdens worldwide, but recent culture-confirmed estimates from routine hospital practice that could guide testing in febrile children are limited. Objective: To determine the frequency of blood culture–positive enteric fever in children presenting with acute febrile illness. Method: This is a Cross-sectional study. Department of Paediatrics, Punjab Rangers Teaching Hospital, Lahore, from 1 March 2025 to 30 September 2025. After institutional ethical approval, 121 children with acute febrile illness of more than 48 hours’ duration were enrolled and assessed for enteric fever by blood culture. Data were analysed in SPSS version 25. Effect modifiers were addressed by stratification, and the chi-square test was used to test associations, with a p-value of ?0.05 taken as significant. Results: The mean age was 6.60 ± 3.53 years, and 68 children (56.2%) were male. The mean duration of fever at presentation was 5.45 ± 2.18 days, and the mean axillary temperature was 39.03 ± 0.60 °C. Blood culture was positive in 23 children (19.0%) and negative in 98 (81.0%). Among the positive cultures, S. Typhi accounted for 14 (60.9%) and S. Paratyphi for 9 (39.1%). On stratification, children with a temperature above 39 °C had a significantly higher rate of culture positivity (p = 0.041). Conclusion: Culture-confirmed enteric fever was common (19.0%) in this group of febrile children and was associated with high-grade fever. The single-centre design and modest sample size limit wider application, and larger multicentre studies with susceptibility testing are needed.