Hundreds of children suffering from typhoid

PESHAWAR: Amid sizzling heat and hours-long power outages, the hospitals in Khyber Pakhtunkhwa have to deal with children suffering from extended drug resistant typhoid fever (XD-R Enteric or Typhoid fever). 

The provincial government and its health department seems to be unaware of the situation. 

“The government seems clueless as to what is happening. It doesn’t have any data about the number of the patients who have died of typhoid fever in recent weeks,” a paediatrician at the Hayatabad Medical Complex (HMC) told The News on condition of anonymity. 

In most of the hospitals in Peshawar, including the Lady Reading Hospital (LRH), Khyber Teaching Hospital (KTH) and Hayatabad Medical Complex (HMC), the paediatric wards are full of patients, 70 percent of them suffering from typhoid fever. 

The LRH is the largest health facility in KP and it receives huge funds from the provincial government.

However, after being declared as a Medical Teaching Institution (MTI), run by the board of governors (BoG), headed by Dr Nausherwan Burki, it has become difficult for patients to seek treatment there. 

It is because of the difficulties faced by the patients and their attendants that people avoid visiting the LRH. 

The KTH and HMC are sharing the burden of the patients, but these days when typhoid fever is quite common in KP particularly in Peshawar, it is difficult for patients to find a bed easily. 

According health experts, it is a waterborne disease that is caused by contaminated water and intake of food washed in contaminated water.

It develops typhoid fever and causes multiple complications to patients.

According to paediatricians, typhoid is a vaccine preventable disease. Sindh and Punjab have got rid of the disease by conducting mass vaccination campaigns. 

Sindh, which is always accused of mismanagement and corruption, was the first province that conducted a mass campaign against typhoid fever in 2018. The KP government has yet to take this step. 

A paediatrician and president elect- Pakistan Paediatric Association (PPA), Khyber Pakhtunkhwa chapter, Prof Mohammad Hussain, when reached, confirmed to The News that the situation was critical as hundreds of children were suffering from typhoid fever in the province.

Prof Dr Hussain, head of paediatric department of the Lady Reading Hospital, said that the only effective drug ( antibiotic) against XD-R Typhoid was Injection Meropenem,  an advanced,  expensive and precious antibiotic which needs to be preserved (as no new antibiotic has been discovered since 2000). 

“In the prevailing situation misuse of Meropenem is rampant, especially by quacks and promoters or unregistered drug companies. More than 70 percent of paediatric units in the teaching hospitals of the provincial capital are occupied by  XD-R enteric fever,” Prof Mohammad Hussain, widely known as a competent and honest paediatrician in the paediatric community.

In KTH, according to officials, a separate unit was created for accommodating patients suffering from typhoid fever. 

“We have created a separate unit as there are loads of patients so we are keeping them together in Ward-C - the new accredited ward of KTH. Though our patients are more as KTH has a 200 percentage occupancy rate. i.e. two patients or more per bed,” a paediatrician of KTH paediatric department told The News. 

The situation of HMC is not different from KTH and other public sector hospitals.

What the government or the health department should immediately do is to provide injections of Meropenem to the state-run hospitals, and develop strong monitoring of the injudicious use of Meropenem. 

The public health department is required to immediately take samples from sewerage water, from multiple sources/ areas in Peshawar and other districts for detection of the bacteria (Salmonella typhoid) causing the infectious disease.