Comparison of Widal test and polymerase chain reaction for early and rapid diagnosis of typhoid fever (original) (raw)
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Bangladesh Journal of Physiology and Pharmacology, 2015
The diagnosis of typhoid fever currently depends on isolation of Salmonella Typhi from blood. The sensitivity of blood culture is very low due to prior antibiotic treatment which is a common practice in Bangladesh. The sensitivity of blood culture also decreases at later stage of the disease. Widal test is the most utilized test in Bangladesh next to blood culture because it is inexpensive, less invasive. But the result of the test is controversial due to false negative & false positive results in some cases. In this study, a recently introduced polymerase chain reaction-based technique (which has 100% specificity for S. Typhi) was compared with widal test among 80 clinically suspected typhoid fever cases. Among 80 cases, the respective figures of positivity for PCR & widal test were 70% & 43.75% respectively. It can be concluded that PCR based technique is more sensitive & much superior to widal for diagnosis of typhoid fever. DOI: http://dx.doi.org/10.3329/bjpp.v30i2.22683 Bang...
Central European Journal of Medicine, 2008
Typhoid fever caused by Salmonella typhi, paratyphi A and B, is an important cause of morbidity and mortality in many developing countries. A rapid and sensitive method for the detection of S. typhi is essential for early diagnosis of typhoid fever and effective therapy. In this study 45 febrile patients who were suspected to have enteric fever were enrolled, and the results of blood cultures, widal agglutination tests and Polymerase Chain Reaction in these cases were evaluated. Group I consisted of 11 patients with diseases other than salmonella infections, group II represented 6 patients with positive cultures, and group III represented 28 patients with negative blood cultures negative but who were clinically suspected cases that had a medical history of using variable antimicrobial agents. Two positive PCR results were present; one of them was in culture positive group (16,6%) and the other was in culture negative group (3,5%). In our study widal agglutination tests and cultures were found not to be helpful in differential dignosis. Although PCR based detection of S. typhi is reported to be a sensitive and specific test for the diagnosis of enteric fever, in our study the benefit of this method in the diagnosis of especially patients who were treated with antimicrobial therapy was not clearly determined. Other methods to increase sensitiviy and specificity to levels such as those of real time PCR should be developed and large-scaled studies should be done in endemic and non-epidemic regions.
Acta Scientifica Malaysia
Typhoid fever is a major dilemma in developing nations, despite the antibiotic use and new antibiotics discovery. Blood culture and serological tests (especially Widal test) that are regularly performed in Pakistan for diagnosis provide objectionable levels of false negative and false positive results, respectively. The present study was carried out at Kohat University of science and technology, Kohat, Pakistan from January 2013 to December 2013. A polymerase chain reaction (PCR) assay was compared with Widal test and blood culture for blood samples of 96 patients. In this study, blood from 25 healthy individuals was collected as a negative control. The detection rate of PCR was maximum (64.5%) followed by Widal test (26%) and blood culture (14.5%). Among the 82 (85.4%) samples that were found negative with blood culture, 48 (58.5%) were successfully detected by PCR and 11 (13.4%) were positive for the Widal test. Findings of this study showed that PCR is a fast and reliable technique for diagnosis of typhoid fever in suspected cases, as compared to frequently used conventional techniques like blood culture and Widal test.
Rapid Diagnosis of Typhoid Fever-A Comparative Study of Typhidot and Widal Test
International Journal of Bioassays, 2014
Typhoid fever is a major public health problem in Asia Pacific region. It is endemic in Indian subcontinent. Conventional methods for its diagnosis are blood culture and Widal test. Typhidot is a new rapid serological test which is now commercially available and reliable in diagnosis of typhoid fever even with limited resources. The study included 100 patients of all age groups who presented with fever in the outpatient departments (OPD). Blood culture, widal test and typhidot test were performed in all the patients. Typhidot test is an immunodot ELISA which detects outer membrane protein specific for Salmonella typhi within an hour. It separately identifies IgM and IgG antibodies. Typhidot and widal tests results were then compared in clinically suspected cases of typhoid fever (62 Group-1) and non typhoidal fever (38 Group-2). Seven (11.29%) patients of Group-1 were blood culture positive, 45(72.58%) were widal test positive and 52 (83.8%) were positive in typhidot test. All patie...
South Asian research journal of engineering and technology, 2020
The "gold standard" for diagnosis of typhoid fever is the isolation of Salmonella typhi from appropriate samples including blood, stool and urine. The study was aimed to compare Widal test against stool culture for diagnosis of typhoid fever cases in Kano, Northern Nigeria. A completely randomized design is used. A total of 125 subjects (male, n= 57 and female, n=68) presenting febrile conditions in 4 different health care centers within Kumbotso Local Government Kano State were used for the study. About 5ml of blood was obtained from each study participant for Widal test and freshly passed faeces were collected for stool culture. The result showed that 22 (17.6%) tested positive for Salmonella typhi by Widal test, whereas 17 (13.6%) tested positive by stool culture. From the result, patients within the age category 21-40 years has the highest incidence 9 (7.2%) and 7 (5.6%) for Widal test and stool culture respectively while male has the highest prevalence with 12 and 10 individuals (9.6% and 8%) while 10 and 7 individual positive samples were female accounted for 8% and 5.6% for widal test and stool microcopy respectively. In relation to stool culture, Widal test has high sensitivity (78.3%), specificity (93.6%), positive predictive value (68.2%) and negative predictive value (98.1%). There is no significant difference on the prevalence of the infection on the basis of gender, age category and diagnostic methods at p<0.05. It is concluded that Widal test can be used as a diagnostic method for detection of Salmonella typhi.
Comparative clinical utility of Widal and Typhidot in the diagnosis of typhoid fever
International Journal of Biosciences (IJB), 2016
Timely and accurate diagnosis of typhoid fever is considered as the key factor to stop its alarming morbidity and mortality rates in our country. Typhoid fever is usually diagnosed by Widal and Typhidot, while from comparative diagnostic point of view blood culture is considered as gold standard of diagnosis. Current Study correlates Widal and Typhidot results with blood culture to evaluate reliability, sensitivity and specificity of these techniques. Blood samples from 91 patients were collected by aseptic technique and blood culture, Typhidot and Widal tests were performed for detection of Salmonella typhi. In group I about 76 patients were suspected for typhoid, while in group II, 15 controls (non-typhoidal) patients were included. Out of 76 samples 44 (58%) were positive for blood culture, 51 (67%) positive for Typhidot and 33 (43%) were Widal positive. From group II all 15 cases showed no growth on blood culture. About 2 (13%) cases were Typhidot reactive while only 4 (27%) cases were Widal positive. Amongst 44 culture positive cases from group I, 41 patients were positive for Typhidot and 31 were reactive against Widal, showing sensitivity of 93 % and specificity of 87% while, Widal sensitivity was 70% and specificity was 73%. The results of this study showed that blood culture is a standard diagnostic test for early diagnosis of Salmonella typhi. Typhidot is still sensitive, specific, safe and simple method for the diagnosis of typhoid fever in the underdeveloped areas of the world.
Mağallaẗ Tikrīt li-l-ʻulūm al-ṣirfaẗ, 2023
The aim of this study was to investigate the accuracy of widal test by compared with enzyme linked immunosorbent assay (ELISA) as standard method and for this purpose 150 blood samples were pulled from patients suspected infected with typhoid fever coming to Azadi Teaching Hospital and Children's Hospital in Kirkuk Governorate from 1-09-2016 to 1-11-2016, and 20 sample of blood were pulled from healthy people considered as a control group. The sample tested by tube titration method of Widal test and also by using ELISA test (antibodies IgM and IgG). The results showed that the percentage of infection in patients with typhoid fever were 74% (111:150) when diagnosed by widal test, and IgM antibodies increasing in ratio 32.6% (49:150) Which indicate as acute phase. IgG antibody recorded increasing with ratio 2.7% (4:150) this indicate as chronic phase. Both types of Ab (IgM and IgG) increasing in ratio 12% (18:150). the accuracy of widal test showed that the Positive and negative predictive value were 49.45%, 87.17% respectively, While the percentage of sensitivity and specificity were 92.95% and 43.03% respectively. We conclude from this study that widal test have high sensitivity for diagnosis typhoid fever but its haven't good Specificity and it must be replace with more accurate testing such as ELISA .
Usefulness of the Widal test in diagnosing childhood typhoid fever in endemic areas
Journal of Paediatrics and Child Health, 1993
Data are presented for 2382 children investigated for fever in a Malaysian hospital between 1984 and 1987 when Widal tests and blood cultures were a routine part of every fever screen. There were 145 children who were culture positive (TYP-CP) for Salmonella typhi, while 166 were culture negative but were diagnosed as having typhoid (TYP-CN). Analyses of the sensitivity and specificity of combinations of initial Widal titres in predicting a positive S. typhi culture in a febrile child (culture positive vs the rest) showed the best model to be an 0and/or H-titre of 2 1 in 40 (sensitivity 89%; specificity 89Oh). While the negative predictive value of the model was high (99.2%) the positive predictive value remained below 50% even for very high titres of 0 and H (>1 in 640), at which point the specificity was 98.5%, supporting the clinical view that a high proportion of the TYP-CN patients really were typhoid but were missed by culture. The TYP-CN patients showed a very similar clinical and age profile to TYP-CP patients. The length of history of fever did not affect the initial Widal titre in culture positive cases. The Widal test in children remains a sensitive and specific 'fever screen' for typhoid although it will not identify all cases. In children, lower cut-off points for 0and H-titres should be used than are generally recommended.
Different Diagnostic Procedure of Typhoid Fever: A Review Update
Journal of Current and Advance Medical Research, 2014
Typhoid fever is diagnosed by using a combination of the clinical presentation, the isolation of Salmonella typhi from body fluids and by Widal test. In the first week of illness, the diagnosis may be more difficult because in this invasive stage with bacteraemia; the symptoms are those of generalized infections without localizing feature. Cultures of stool, urine, rose spots, bone marrow, gastric and intestinal secretions can all be useful for diagnosis. The efficacy of culture varies with the specimen being tested. In addition, the prehospital antibiotic therapy frequently used in developing countries complicates the isolation of infectious agents from clinical specimens especially from blood. Bone marrow appears to be the most suitable specimen because bone marrow culture has a higher sensitivity than blood culture. The methods of bacterial isolation are inherently slow and take more than 48 hours. That is why, serologic analysis becomes more important. The Widal test has got lim...