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      Burden of Dengue–Typhoid Coinfection in Pediatric Patients: A 6-year Experience from a Tertiary Care Center

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          ABSTRACT

          Background

          India is endemic to both typhoid and dengue, which also mimic in their clinical presentations. This poses a diagnostic dilemma especially for pediatric patients. Literature on such coinfections is limited.

          Methodology

          We retrospectively analyzed six years data (2017–2022). All pediatric culture proven typhoid cases with concurrent dengue infection were included in the study. Patient clinical and demographic profiles were extracted from the hospital information system.

          Results

          We report four such cases of coinfection. Along with the expected reduced platelet counts, most of the patients had associated deranged TLC, liver enzymes, hypoalbuminemia and gallbladder changes.

          Conclusion

          Our study contributes to the body of literature on dengue–typhoid coinfection in pediatric patients and the pitfall in accepting a single pathogen etiology. Awareness needs to be raised among healthcare workers on the potential dengue–typhoid coinfection, especially in endemic countries.

          How to cite this article

          Anjana A, Adhikary R, Bhavana MV. Burden of Dengue–Typhoid Coinfection in Pediatric Patients: A 6-year Experience from a Tertiary Care Center. Pediatr Inf Dis 2023;5(2):42-44.

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          The global distribution and burden of dengue

          Samir Bhatt, Peter W. Gething, Oliver J Brady … (2013)
          Dengue is a systemic viral infection transmitted between humans by Aedes mosquitoes 1 . For some patients dengue is a life-threatening illness 2 . There are currently no licensed vaccines or specific therapeutics, and substantial vector control efforts have not stopped its rapid emergence and global spread 3 . The contemporary worldwide distribution of the risk of dengue virus infection 4 and its public health burden are poorly known 2,5 . Here we undertake an exhaustive assembly of known records of dengue occurrence worldwide, and use a formal modelling framework to map the global distribution of dengue risk. We then pair the resulting risk map with detailed longitudinal information from dengue cohort studies and population surfaces to infer the public health burden of dengue in 2010. We predict dengue to be ubiquitous throughout the tropics, with local spatial variations in risk influenced strongly by rainfall, temperature and the degree of urbanisation. Using cartographic approaches, we estimate there to be 390 million (95 percent credible interval 284-528) dengue infections per year, of which 96 million (67-136) manifest apparently (any level of clinical or sub-clinical severity). This infection total is more than three times the dengue burden estimate of the World Health Organization 2 . Stratification of our estimates by country allows comparison with national dengue reporting, after taking into account the probability of an apparent infection being formally reported. The most notable differences are discussed. These new risk maps and infection estimates provide novel insights into the global, regional and national public health burden imposed by dengue. We anticipate that they will provide a starting point for a wider discussion about the global impact of this disease and will help guide improvements in disease control strategies using vaccine, drug and vector control methods and in their economic evaluation. [285]
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            Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010

            Geoffrey Buckle, Christa L Fischer Walker, Robert E Black (2012)
            Background Typhoid and paratyphoid fever remain important causes of morbidity worldwide. Accurate disease burden estimates are needed to guide policy decisions and prevention and control strategies. Methods We conducted a systematic literature review of the PubMed and Scopus databases using pre-defined criteria to identify population-based studies with typhoid fever incidence data published between 1980 and 2009. We also abstracted data from annual reports of notifiable diseases in countries with advanced surveillance systems. Typhoid and paratyphoid fever input data were grouped into regions and regional incidence and mortality rates were estimated. Incidence data were extrapolated across regions for those lacking data. Age-specific incidence rates were derived for regions where age-specific data were available. Crude and adjusted estimates of the global typhoid fever burden were calculated. Results Twenty-five studies were identified, all of which contained incidence data on typhoid fever and 12 on paratyphoid fever. Five advanced surveillance systems contributed data on typhoid fever; 2 on paratyphoid fever. Regional typhoid fever incidence rates ranged from <0.1/100 000 cases/y in Central and Eastern Europe and Central Asia to 724.6/100 000 cases/y in Sub-Saharan Africa. Regional paratyphoid incidence rates ranged from 0.8/100 000 cases/y in North Africa/Middle East to 77.4/100 000 cases/y in Sub-Saharan Africa and South Asia. The estimated total number of typhoid fever episodes in 2010 was 13.5 million (interquartile range 9.1–17.8 million). The adjusted estimate accounting for the low sensitivity of blood cultures for isolation of the bacteria was 26.9 million (interquartile range 18.3–35.7 million) episodes. These findings are comparable to the most recent analysis of global typhoid fever morbidity, which reported crude and adjusted estimates of 10.8 million and 21.7 million typhoid fever episodes globally in 2000. Conclusion Typhoid fever remains a significant health burden, especially in low- and middle-income countries. Despite the availability of more recent data on both enteric fevers, additional research is needed in many regions, particularly Africa, Latin America and other developing countries.
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              Dengue and Typhoid Co-infection- Study from a Government Hospital in North Delhi.

              Yukti Sharma, Vandana Arya, Sanjay Jain … (2014)
              Concurrent infection with two agents can result in an illness having overlapping symptoms creating a diagnostic dilemma for the treating physician. The symptoms of dengue may mimic other diseases such as leptospirosis, influenza A, Salmonella Typhi, Japanese encephalitis, chikungunya and malaria. There is paucity of data regarding dengue and typhoid co- infection both in the developed and developing countries. This study attempts to find the current co- infection rates in North Delhi.
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                Author and article information

                Journal
                Journal ID (publisher-id): PID
                Title: Pediatric Infectious Disease
                Abbreviated Title: PID
                Publisher: Jaypee Brothers Medical Publishers
                ISSN (Electronic): 2582-4988
                Publication date (Print): April-June 2023
                Volume: 5
                Issue: 2
                Pages: 42-44
                Affiliations
                [1-3 ]Department of Laboratory Medicine, Manipal Hospitals, Bengaluru, Karnataka, India
                Author notes
                Aravinda Anjana, Department of Laboratory Medicine, Manipal Hospitals, Bengaluru, Karnataka, India, Phone: +91 9560348696, e-mail: anjoo.prabhu@ 123456gmail.com
                Article
                DOI: 10.5005/jp-journals-10081-1375
                SO-VID: 99455de1-95cb-423f-ae60-64fead568302
                Copyright © Copyright © 2023; The Author(s).
                License:

                © The Author(s). 2023 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 08 September 2022
                Date accepted : 19 October 2022
                Date: 30 June 2023
                Categories
                Subject: ORIGINAL ARTICLE
                Custom metadata
                file-pdf pid-05-042.pdf

                ScienceOpen disciplines: Pediatrics
                Keywords: Typhoid,Coinfection,Dengue
                Data availability:
                ScienceOpen disciplines: Pediatrics
                Keywords: Typhoid, Coinfection, Dengue

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