Epidemiology and Antimicrobial Resistance of Typhoid Fever in School-Age Children in Ibadan, Oyo State: A Cross-Sectional Study

Typhoid fever caused by Salmonella Typhi remains a significant cause of febrile illness in school-age children in sub-Saharan Africa, with increasing concerns about antimicrobial resistance complicating treatment. This cross-sectional epidemiological study investigated the prevalence, risk factors, and antimicrobial resistance profiles of typhoid fever in children aged 5 to 15 years in Ibadan, Oyo State, South West Nigeria. A total of 350 febrile school-age children from five primary and secondary schools were enrolled over six months. Blood cultures and Widal test were performed on all participants, with culture-positive cases subjected to antimicrobial susceptibility testing by Kirby-Bauer method and E-test for minimum inhibitory concentration determination. A structured epidemiological questionnaire collected data on water sources, sanitation facilities, hygiene practices, and food consumption patterns. Culture-confirmed typhoid prevalence was 14.3 percent. Risk factors significantly associated with typhoid included consumption of street food (OR: 3.4), lack of household toilet facility (OR: 2.8), and drinking unchlorinated water (OR: 2.1). Multidrug resistance to classical first-line agents was detected in 44 percent of isolates. Fluoroquinolone non-susceptibility was 28.6 percent. The Widal test demonstrated low positive predictive value (56.3%), confirming its inadequacy as a standalone diagnostic tool. These findings characterize the epidemiological and resistance landscape of pediatric typhoid in Ibadan and support investment in typhoid conjugate vaccination, sanitation improvements, and fluoroquinolone-sparing treatment protocols. Keywords: Salmonella Typhi, typhoid fever, school children, antimicrobial resistance, Ibadan.