TYPHOID FEVER CASE STUDY

Arranged by:

Group 6

1. Annisya Firdaus (PO.71.34.1.18.007)

2. Prabella Yunike Putri (PO.71.34.1.18.026)
3. Rika Damayanti (PO.71.34.1.18.030)
4. Shafa Putri Tama (PO.71.34.1.18.032)
5. Titiek Nurhidayah (PO.71.34.1.18.037)
6. Wan Jusli Alfisyar (PO.71.34.1.18.039)
7. Yulia Pratiwi (PO.71.34.1.18.040)

Lecturer: Pratiwi Lestari, M.Pd.

Health Polytechnic Ministry Of Health

Palembang
2018
 ABSTRACT
Typhoid patients who are in 7 Ulu Palembang Health Center are the disease with the
highest number of patients if compared to other diseases related to the environment from
July to September 2018. Thypoid in 7 Ulu region is increasing. Therefore we conducted
this research to find out the cause of Typhoid fever,the signs and symptoms, how to
diagnose, and how it is handled. We took one pasient of 7 Ulu Palembang Health Center
as the sample. From this study it was found that patient has a Typhoid fever due to a dirty
environment which is a nest of germs and bacteria. Therefore, food, drink or water that
has been contaminated by bacteria called salmonella is the main cause. This disease can
cause headache, weakness and fatigue, until diarrhea. Therefore, environmental
cleanliness must be maintained to prevent the growth of germs and bacteria that cause
disease.

Keywords : Typhoid,Patient,Health

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INTRODUCTION
Based on descriptive epidemiological research methods applied at the 7 Ulu
Palembang Health Center in 2018 (July - September), it was shown that typhoid
fever cases were ranked first of the top three types of diseases in 7 ulu Palembang
Health Center. The total cases of typhoid fever reached 64 patients, and none of
the patients with typhoid fever died at the 7 Ulu Palembang Health Center.
Typhoid fever is still an endemic disease in Indonesia. This disease includes
infectious diseases listed in Law Number 6 of 1962 concerning the outbreak. This
group of infectious diseases can attack many people so that it can cause an
outbreak.
Various kinds of bacterial infectious diseases that exist in the territory of
Indonesia are the biggest problems suffered by the community, especially typhoid
fever. The problem of this disease is also felt by the people around 7 Ulu, South
Sumatera. And based on case data obtained epidemiological research in 7 Ulu
Palembang Health Center the biggest disease problem with the highest number of
sufferers for the last 3 months between July - September in 2018 was typoid fever,
so the authors were interested in exploring and identifying about the epidemiology
of typhoid fever.

This study was conducted to find out cause of typhoid, the signs and
symptoms of typhoid, how to diagnose typhoid, and how it is handled.

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METHODS
The study was conducted at 7 Ulu Palembang Community Health Center on
November 29, 2018.We took some document from that 7 Ulu Palembang
community health center and we also interviewed one patient and one nurse there.
The research method carried out is a descriptive epidemiological case study with
the aim of describing thypoid fever problems or health phenomena that occur in
that community.
This method is done by data collection techniques with document
techniques and interviews. Document techniques are data collection techniques
that are obtained from health center data 7 Ulu. Interviews are conducted by
researchers with the aim of completing the data obtained from the interview
process. As an interview motto, what is this, why, when, who, and where is used
as a guideline in this research interview. Following are the questions related to
descriptive epidemiology. These questions are as follows:
A. Who is affected?
B. When does this occur?
C. How did it happen?
D. Where is the incident?
E. How many people are affected?
F. How is it spread?
G. What are the characteristics of the person affected?
After that, we collected data and analyzed it to get results from interviewees

Based on descriptive epidemiological research methods applied at the 7 Ulu

Palembang Health Center. The authors obtained secondary data from the medical
record field about 5 major numbers of diseases in July to September 2018, which
were caused by the environment as well as information about the causes of illness
through patient-centered interviews.
We did this study at in 7 Ulu with the total patients 139, we collected the
data from puskesmas 7 ulu, and we analyzed the data with descriptive procedure.

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Descriptive procude is an analysis technique that will be used to analyze a data by
describing or using data that has been collected so that it can be used to make
general results.

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RESULT
From this study it was found that there are 3 types of diseases experienced
by the patients and handled by the health center in 7 Ulu.
Typhoid fever became the first disease suffered by patients who had been
previously recorded by 7 Ulu Palembang Health Center. Table 1 shows the clear
data.

Table 1. Disease data experienced at 7 ulu Palembang Heath Center

Major illnesses experienced at the 7 ulu Palembang Health Center.

Disease July August September Amount

Typhoid
Fever 25 18 21 64

Diarrhea 15 20 17 52

Dengue
Hemorrhagic
Fever
5 10 8 23

Source:Disease data experienced at the 7 ulu Palembang Health Center.

Based on Table 1, from July to September there were 64 patients who
suffered typhoid fever, 52 patients suffering diarrhea and 23 patients suffering
dengue hemorrhagic fever.It means percentage of typhus is 46%,Diarrhea is 37%,
and Dengue Hemorragic Fever is 17%

Table 2. Data of patient's interview

The result of interview with patient.

Patient How Signs and syptoms

Cause
Long

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Name: Ariko Saputra 12 days Caused by a dirty  Headache
Place of Birth: environment that has  Weakness and
Palembang, South been infected by fatigue
Sumatera Salmonella thypii  Muscle ache
Date of Birth: 11th bacteria through the  Diarrhea
July 1980 consumption of
Age: 38 years contaminated food
Address: Mutiara 4 or drink.
street number 67,
Palembang, South
Sumatera.

From the interview we have done, it can be seen that Mr. Ariko Saputra
experienced this disease due to his dirty living environment. This causes a lot of
germs and bacteria to spread to contaminate the food and drinks eaten by him. The
bacteria that causes this disease is called Salmonella thypii. The symptoms that are
risky are because of this disease, among others headache, weakness and fatigue,
muscle ache, diarrhea. He suffered from this disease for 12 days and required him
to stay at 7 Ulu Palembang Health Center.

Table 3. Data of nurse's interview

The result of interview with nurse.

Nurse Cause Diagnose Treat

Name: Feni  Dirty living  Based on the  Drink plenty of
Kurnia environment symptoms and fluids to prevent
Profession: Nurse which causes a patient’s medical dehydration due
at 7 Ulu lot of germs and history. to fever and
Palembang Health bacteria.  With widal ongoing

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Center  Less clean food check-up which diarrhea.
or drink that has can show  Provide
been Salmonella nutritious food
contaminated by thypii  Bed rest
Salmonella contamination in  Always keep the
thypii bacteria. patients. environment
clean

From the data above, it can be seen that typhoid is caused by our dirty
living environment. This can allow the growth of various germs and bacteria. One
of them is Salmonella thypii bacteria which is the cause of typhoid fever. This
disease can be diagnosed through sign and symptoms experienced by patients and
also on widal check-up that allow for contamination of Salmonella thypii bacteria
in our bodies. For this reason, patients need to take a total complete rest. Besides
that the patient must keep the environment clean, drink plenty of fluids to prevent
dehydration due to fever and ongoing diarrhea and provide nutritious food.

DISCUSSION
What Is Typhoid Fever?

Based on the results of interviews, typhoid is an acute disease of the small

intestine caused by Salmonella thypii. This was also stated by dr. Tania Savitri
(2018) that typhoid fever is an acute disease accompanied by fever, which is
caused by Salmonella thyphii or Salmonella paratyphi bacteria. These bacteria are
found in water or contaminated food and are spread by other people in the same
area.

How Common Is Typhoid Fever?

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 Typhoid fever is common in developing countries, especially in children.
This condition is more common in children, but can occur in patients of any age.
Typhoid can be treated by reducing risk factors.

Signs & Symptoms

Typhoid disease can cause some symptoms that will be felt by the patient.
sign and symptoms that can be experienced by patients include headache,
weakness and fatigue, muscle ache, and diarrhea. this is also explained by dr.
Tania Savitri (2018) that the signs and symptoms of typhoid fever are:

 Low fever but increases every day, reaching up to 40.5 degrees Celsius
 Headache
 Weakness and fatigue
 Muscle ache
 Sweating
 Dry cough
 Loss of appetite and weight
 Stomach ache
 Diarrhea or constipation
 Rash
 A very swollen stomach.

Cause of Typhoid Fever

Typhoid can occur due to salmonella thypii bacterial contamination in the

food and drinks we consume. This bacterial growth occurs because of our
unhealthy environment.

Typhoid is an infectious disease that occurs in the small intestine caused by

Salmonella thypii, which is transmitted through food, mouth or drinks
contaminated with bacteria Salmonella thypii (Hidayat, 2006).

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 dr. Tania Savitri (2018) has explained that the cause of this disease is
Salmonella typhi bacterial infection. Bacteria are transmitted through food that is
infected or contains bacterial germs. When a person consumes these ingredients
and the body's resistance is low, the bacteria will attack the person's intestine.
Furthermore, bacteria enter the bloodstream and the occurrence of typhoid
disease. Salmonella typhi infection from consuming contaminated food or water is
the main cause of typhoid fever.

What Increases My Risk For Typhus (Typhoid Fever)

Some things that can increase your risk of typhoid fever are:

 Work or travel to endemic areas of typhoid fever.

 Work as a clinical microbiologist who conducts research on Salmonella
typhi bacteria.
 Make direct contact with someone infected with typhoid fever.
 Eating foods and beverages that have been contaminated with
Salmonella typhi bacteria.
 Have close contact with someone who is infected or has just been
infected with typhus

How To Diagnose Typhoid Fever?

From the interviews we have done, it can be seen that typhoid disease can
be diagnosed by looking at the symptoms experienced by the patient. In addition,
patients can also undergo a widal check-up to find out if their body is
contaminated with Salmonella thypii bacteria.

According to dr. Tania Savitri, typhoid fever has several ways to diagnose
typhoid those are:

 Typhoid can be diagnosed based on your symptoms and medical history

and your journey.

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  To confirm your condition, identification of S. typhi in blood cultures
or body fluids or other tissues is needed.
 An antibody test to check typhoid DNA in your blood.

How To Treat Typhoid Fever?

Based on the data, treatment that can be done is drink plenty of fluids to
prevent dehydration due to fever and ongoing diarrhea, provide nutritious food,
and bed rest.

According to dr. Tania Savitri has several ways to treat typhoid fever. The
only effective way to treat typhus is by antibiotic therapy, such as:

 Ciprofoxacin (Cipro) if you are not pregnant.

 Ceftriaxone (Rocephin) for children.

There are several other treatments for typhoid fever, namely:

 Drink plenty of fluids to prevent dehydration due to fever and ongoing

diarrhea.
 Surgery to repair if the intestine is hollow.

Treatment At Home

 Washing hands
 Avoid drinking water that is not processed
 Avoid drinking with ice cubes whose origin is unclear
 Avoid raw fruits and vegetables

Prevention

Prevention of typhoid fever is by improving sanitation, career treatment and

vaccination. Sanitation measures must be taken for prevent contamination of food
and water by rodents or other animals which secretes Salmonella. Livestock,
infected meat and eggs must be cooked until cooked. Carriers may not be allowed
to work as food holders and they must take hygienic precautions strict ones.

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CONCLUSION

Typoid is a type of disease associated with fever because there is a

bacterial infection that spreads throughout the body and affects many organs
called bacteriaella typhi.Typoid fever occurs when Salmonella Typhi bacteria
enters the body, especially the intestine.

There is no imbalance between environmental, host and agent that can

cause the occurrence of a disease, the community is expected to always maintain a
balance between the three elements. The effort that can be done is to prevent
Salmonella Typhi bacterial infection is to maintain the health and cleanliness of
the environment and drink boiled water

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REFERENCES
Savitri,T. (2016), “Apa Itu Demam Tifoid(Tifus)”,Retrieved From :
https://hellosehat.com/penyakit/tifus-demam-tifoid/

Savitri,T. (2017), “Demam Tifoid(Tifus)”,Retrieved From

https://hellosehat.com/hidup-sehat/pertolongan-pertama/demam-tifoid-
tifus/

Savitri,T. (2018),”Tipes”, Retrieved From : https://hellosehat.com/penyakit/tipes/

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