Occurrence of Typhoid Fever Complications and Their Relation to Duration of Illness Preceding Hospitalization: A Systematic Literature Review and Meta-analysis.



Cruz Espinoza, Ligia María, McCreedy, Ellen, Holm, Marianne ORCID: 0000-0002-0747-4116, Im, Justin, Mogeni, Ondari D ORCID: 0000-0001-5133-3735, Parajulee, Prerana, Panzner, Ursula, Park, Se Eun, Toy, Trevor, Haselbeck, Andrea
et al (show 7 more authors) (2019) Occurrence of Typhoid Fever Complications and Their Relation to Duration of Illness Preceding Hospitalization: A Systematic Literature Review and Meta-analysis. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 69 (Suppl ). S435 - S448.

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Abstract

BACKGROUND:Complications from typhoid fever disease have been estimated to occur in 10%-15% of hospitalized patients, with evidence of a higher risk in children and when delaying the implementation of effective antimicrobial treatment. We estimated the prevalence of complications in hospitalized patients with culture-confirmed typhoid fever and the effects of delaying the implementation of effective antimicrobial treatment and age on the prevalence and risk of complications. METHODS:A systematic review and meta-analysis were performed using studies in the PubMed database. We rated risk of bias and conducted random-effects meta-analyses. Days of disease at hospitalization (DDA) was used as a surrogate for delaying the implementation of effective antimicrobial treatment. Analyses were stratified by DDA (DDA <10 versus ≥10 mean/median days of disease) and by age (children versus adults). Differences in risk were assessed using odds ratios (ORs) and 95% confidence intervals (CIs). Heterogeneity and publication bias were evaluated with the I2 value and funnel plot analysis, respectively. RESULTS:The pooled prevalence of complications estimated among hospitalized typhoid fever patients was 27% (95% CI, 21%-32%; I2 = 90.9%, P < .0001). Patients with a DDA ≥ 10 days presented higher prevalence (36% [95% CI, 29%-43%]) and three times greater risk of severe disease (OR, 3.00 [95% CI, 2.14-4.17]; P < .0001) than patients arriving earlier (16% [95% CI, 13%- 18%]). Difference in prevalence and risk by age groups were not significant. CONCLUSIONS:This meta-analysis identified a higher overall prevalence of complications than previously reported and a strong association between duration of symptoms prior to hospitalization and risk of serious complications.

Item Type: Article
Uncontrolled Keywords: Humans, Typhoid Fever, Anti-Bacterial Agents, Hospitalization, Prevalence, Risk Factors, Retrospective Studies, Prospective Studies, Cross-Sectional Studies, Adult, Child
Depositing User: Symplectic Admin
Date Deposited: 02 Dec 2019 08:30
Last Modified: 12 Sep 2022 19:12
DOI: 10.1093/cid/ciz477
URI: https://livrepository.liverpool.ac.uk/id/eprint/3064166