Five hospitals research mgt of typhoid perforation

BY: Rebecca Quaicoe Duho
Prof. Debrah (arrowed) explaining a point at the workshop. On his right is Dr Banka Johnson

A four-year study into Surgical Management of Typhoid Perforation (SMTP) is being conducted in some health facilities in the country.

The study, which involves 140 typhoid fever patients, is being carried out at the Korle Bu Teaching Hospital, the Cape Coast University Hospital, the Koforidua Regional Hospital, the Tema General Hospital and the Kade Government Hospital.

Disease

Typhoid fever is a bacterial infection of the intestinal tract and bloodstream. It is a life-threatening illness caused by the bacterium Salmonella Typhi which only lives in humans.

The disease, which is mostly water-borne, manifests after five to 21 days of incubation leaving patients with fever, chills, headache, constipation or diarrhoea, among other symptoms.

The most affected age groups are those between four and 30 years of age, with men being in the majority.

Project

At a two-day workshop for surgeons and registered nurses from the research sites, the research consultant, Dr Loius Banka Johnson, who is a senior consultant colorectal surgeon and pelvic floor specialist, Malmo University Hospital, Sweden, said the study was aimed at reducing post-operative mortality rates among people with typhoid.

The workshop was sponsored by the Ghana Commercial Bank (GCB) and Cal Bank.

With support from Coloplast Sweden, a healthcare product and service developer, the study is also to help reduce the frequency of re-operative surgery in patients.

The study involves the use of two cohorts of patients where the first group is allowed to undergo normal typhoid perforation surgery. 

With the second group, a damage control policy would be adopted through the surgical removal of diseased portions of the bowel after which the small intestines are diverted using an artificial opening known as stoma on the abdominal wall so that faeces can still leave the body. 

He explained that this method allows for the healing of the area where the surgery was performed thereby reducing the rate at which the wound could reopen or at worse cause a burst stomach due to re-perforation.

Disease burden

For his part, Professor Seth Debrah of the Cape Coast University Hospital, who is one of the lead researchers on the project, said there was a huge burden of the disease on the African continent.

He said West Africa had a high perforation of the disease at 33 per cent and that most patients reported to hospitals late, making it difficult for their conditions to be treated.

Prof. Debrah said even though the disease could easily be treated, when not attended to early, it could affect the liver, blood stream, gall bladder and the bone marrow if it is not treated early.

He, however, indicated that if appropriate treatment was initiated within the first few days of full-blown illness, the disease would remit after about two days leading to the patient's condition improving markedly within 4-5 days. 

 

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