| Typhoid fever, also known as enteric fever, is a potentially fatal multi systemic illness caused primarily by Salmonella enterica serotype Typhi (S. Typhi). The classic presentation of the disease includes fever, malaise, diffuse abdominal pain, and constipation. Untreated, typhoid fever may progress to severe condition like delirium, intestinal hemorrhage, bowel perforation, and death. The disease remains a critical public health problem in developing countries. In 2000, it was estimated that over 2,16 million of typhoid occurrences worldwide, resulting in 216,000 deaths, and that more than 90% of this morbidity and mortality occurred in Asia [1]. A report from World Health Organization in 2008 on typhoid fever in five Asian countries showed the annual typhoid incidence (per 100,000 person years) among 5-15 years age group varied from 24.2 and 29.3 in Vietnam and China, to 180.3 in Indonesia; and to 412.9 and 493.5 in Pakistan and India, respectively; multidrug resistant S. Typhi were 23% (96/413) [2]. Further, unlike S. Typhi originated from Pakistan, Vietnam and India, those from Indonesia collected in North Jakarta, were all susceptible to antibiotic tested, i.e. Chloramphenicol, Ampicillin, Trimethoprim-Sulfamethoxazole; none of multidrug resistance were found. Nalidixic acid resistance was rather high in Pakistan, India and Vietnam, but none was found in Indonesia [2]. |