Keywords
socioeconomic status
peritonitis
financial burden
cost
How to Cite
Abstract
Objective :
to describe the epidemiological, economic and prognostic aspects of the management of non-traumatic perforation of the small intestine (PNTIG) of typhoid origin in the regions of Maradi and Zinder in Niger.
Materials and method :
This was a retrospective bicentric study over a period of 6 years from January 2014 to December 2019) in the emergency department of the National Hospital of Zinder and the Regional Hospital Center (CHR) of Maradi in Niger. . Inclusion concerned all patients operated on for peritonitis by non-traumatic perforation of the small intestine suspected to be typhoid.
Results :
During the study period, 6,254 surgical acute abdomens were operated on, including 68.3% of peritonitis (n = 4271). Typhoid-induced PNTIG accounted for 46.9% (n = 2931). The median age of the patients was 11 years (IIQ: 7-17). Children made up over 72% (n = 2113). The male sex was 64.2% (n = 1881) or a sex ratio of 1.79. Rural origin represented 67.4% (n = 1976) and the indigent constituted 71.3% of cases (n = 2090). Geographic accessibility was difficult in 63.2% (n = 1852). The mean time to admission was 114.84 ± 62.2 hours. The mean time to intervention was 8.96 ± 4.5 hours. An ileostomy was performed in 61.3% (n = 1797). The average cost of emergency care was 192,500 ± 69,500 FCFA. The average cost of restoring digestive continuity was 124,500 ± 35,000 FCFA. The overall mortality was 11.2% (n = 328). It was significantly associated with long admission times before consultation and before surgery (p <0.005). The following variables were also statistically associated with mortality: socioeconomic status of indigent (OR=1.66; p=0.0023) rural origin (OR=1.47; p=0.021) and accessibility geographic difficult (OR=1.44; p=0.031).
Conclusion :
Perforation of the small intestine of typhoid origin is very common in our setting. This tragedy often affects vulnerable children from disadvantaged rural and socio-economic backgrounds. The financial burden associated with care is enormous and unbearable for households; hence the urgency to put in place an effective prevention and care system.
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Copyright (c) 2026 H Adamou, I Amadou Magagi, O Adakal, M Abdoulaye, M Doutchi, I Hamidine, M Rouga, L Sani Madjiri, M Maikassoua, O Habou, L James Didier, R Sani