期刊论文详细信息
BMC Research Notes
A comparative study of Widal test with blood culture in the diagnosis of typhoid fever in febrile patients
Haile Alemayehu2  Adane Mihret1  Solomon Gebre-Selassie1  Nigatu Kebede2  Tamrat Abebe1  Gizachew Andualem3 
[1] Department of Microbiology, Immunology and Parasitology, School of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia;Department of Medical Laboratory Sciences, College of Medical Sciences, Haramaya University, Harar, Ethiopia
关键词: Negative predictive value;    Positive predictive value;    Specificity;    Sensitivity;    Blood culture;    Widal test;   
Others  :  1129382
DOI  :  10.1186/1756-0500-7-653
 received in 2014-01-09, accepted in 2014-09-11,  发布年份 2014
PDF
【 摘 要 】

Background

Typhoid fever is a major health problem in developing countries and its diagnosis on clinical ground is difficult. Diagnosis in developing countries including Ethiopia is mostly done by Widal test. However, the value of the test has been debated. Hence, evaluating the result of this test is necessary for correct interpretation of the result. The main aim of this study was to compare the result of Widal test and blood culture in the diagnosis of typhoid fever in febrile patients.

Methods

Blood samples were collected from 270 febrile patients with symptoms clinically similar to typhoid fever and visiting St. Paul’s General Specialized Hospitals from mid December 2010 to March 2011. Blood culture was used to isolate S.typhi and S.paratyphi. Slide agglutination test and tube agglutination tests were used for the determination of antibody titer. An antibody titer of ≥1:80 for anti TO and ≥1:160 for anti TH were taken as a cut of value to indicate recent infection of typhoid fever.

Results

One hundred and eighty six (68.9%) participants were females and eighty four (31.1%) were males. 7 (2.6%) cases of S. typhi and 4 (1.5%) cases of S. paratyphi were identified with the total prevalence of typhoid fever 4.1%. The total number of patients who have indicative of recent infection by either of O and H antigens Widal test is 88 (32.6%). The sensitivity, specificity, Positive predictive Value and Negative predictive Value of Widal test were 71.4%, 68.44%, 5.7% and 98.9% respectively.

Conclusions

Widal test has a low sensitivity, specificity and PPV, but it has good NPV which indicates that negative Widal test result have a good indication for the absence of the disease.

【 授权许可】

   
2014 Andualem et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150226040624822.pdf 268KB PDF download
Figure 1. 18KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Willke A, Ergonul O, Bayar B: Widal test in diagnosis of typhoid fever in turkey. Clin Diagn Lab Immunol 2002, 9(4):938-941.
  • [2]Crump JA, Luby SP, Mintz ED: The global burden of typhoid fever. Bull World Health Organ 2004, 82(5):346-353.
  • [3]Gopalakrishnan V, Sekhar WY, Soo EH, Vinsent RA, Devi S: Typhoid fever in Kuala Lumpur and a comparative evaluation of two commercial diagnostic kits for the detection of antibodies to salmonella typhi. Singapore Med J 2002, 43(7):354-358.
  • [4]Nsutebu EF, Martins P, Adiogo D: Prevalence of typhoid fever in febrile patients with symptoms clinically compatible with typhoid fever in Cameroon. Trop Med Int Health 2003, 8(6):575-578.
  • [5]Onyekewere CA: Typhoid fever: misdiagnosis or over diagnosis. Niger Med Pract 2007, 51(4):76-79.
  • [6]Wain J, Hosoglu S: The laboratory diagnosis of enteric fever. J Infect Dev Ctries 2008, 2(6):421-425.
  • [7]Parry CM, Tuyet HNT, Diep TS, Wain J, Chinh NT, Vinh H, Hien TT, White NJ, Farrar JJ: Value of a single-tube widal test in diagnosis of typhoid fever in Vietnam. J Clin Microbiol 1999, 37(9):2882-2886.
  • [8]Wain J, Diep TS, Be Bay PV, Walsh AL, Vinh H, Duong NM, Ho VA, Hien TT, Farrar J, White NJ, Parry CM, Day NPJ: Specimens and culture media for the laboratory diagnosis of typhoid fever. J Infect Dev Ctries 2008, 2(6):469-474.
  • [9]Ley B, Mtove G, Thriemer K, Thriemer K, Amos B, Seidlein LV, Hendriksen I, Mwambuli A, Shoo A, Malahiyo R, Ame SM, Kim DR, Ochiai LR, Clemens JD, Reyburn H, Wilfing H, Magesa S, Deen JL: Evaluation of the Widal tube agglutination test for the diagnosis of typhoid fever among children admitted to a rural hospital in Tanzania and a comparison with previous studies. BMC Infect Dis 2010, 10:180. BioMed Central Full Text
  • [10]Beyene G, Asrat D, Mengistu Y, Aseffa A, Wain J: Typhoid fever in Ethiopia. J Infect Dev Ctries 2008, 2(6):448-453.
  • [11]Olopoenia LA, King AL: Widal agglutination test - 100 years later: still plagued by controversy. Postgrad Med J 2000, 76:80-84.
  • [12]Bhutta ZA: Current concepts in the diagnosis and treatment of typhoid fever. BMJ 2006, 333:78-82.
  • [13]Khoharo HK, Ansari S, Qureshi F: Evaluating single acute-phase widal test for the diagnosis of typhoid fever. Med Channel 2010, 16(1):42-44.
  • [14]Olsen SJ, Pruckler J, Bibb W, Thanh NT, Trinh TM, Minh NT, Sivapalasingam S, Gupta A, Phuong PT, Chinh NT, Chau NV, Cam PD, Mintz ED: Evaluation of rapid diagnostic tests for typhoid fever. J Clin Microbiol 2004, 42(5):1885-1889.
  • [15]Omuse G, Kohli R, Revathi G: Diagnostic utility of a single widal test in the diagnosis of typhoid fever at Aga khan university hospital (AKUH), Nairobi. Kenya Trop Doct 2010, 40(1):43-44.
  • [16]Youssef FG, Daba AS, Kabeil SS, Parker TM: A comparative study of blood culture and antibody response with the duration of illness in diagnosis of typhoid fever. Aust J Basic Appl Sci 2010, 4(4):609-614.
  • [17]Udeze AO, Abdulrahaman F, Okonko IO, Anibijuwon II: Seroprevalence of S.typhi among the first year students of university of Ilorin, Ilorin, Nigeria. Middle East J Sci Res 2010, 6(3):257-262.
  • [18]Nsutebu EF, Ndumbe PM, Koulla S: The increase in occurrence of typhoid fever in Cameroon; over diagnosis due to misuse of the Widal test. Trans R Soc Trop Med Hyg 2002, 96(1):64-67.
  • [19]Mamo Y, Belachew T, Abebe W, Gebre-Selassie S, Jira C: Pattern of widal agglutination reaction in apparently healthy population of Jimma town, southwest Ethiopia. Ethiop Med J 2007, 45(1):69-77.
  • [20]Feasey NA, Archer BN, Heyderman RS, Sooka A, Dennis B, Gordon MA, Keddy KH: Typhoid fever and invasive nontyphoid Salmonellosis, Malawi and South Africa. Emerg Infect Dis 2010. In press article
  • [21]Aftab R, Khurshid R: Widal agglutination titre: a rapid serological diagnosis of typhoid fever in developing countries. Pak J Physiol 2009, 5(1):65-67.
  文献评价指标  
  下载次数:11次 浏览次数:28次