Comparative clinical utility of Widal and Typhidot in the diagnosis of typhoid fever

Paper Details

Research Paper 01/08/2016
Views (397) Download (8)
current_issue_feature_image
publication_file

Comparative clinical utility of Widal and Typhidot in the diagnosis of typhoid fever

Naeem Bukhari, Afshan Saleem, Muhammad Adeeb khan, Sadiq Noor Khan, Abdul Jabbar, Bilal Ahmad, Azhar Khan
Int. J. Biosci.9( 2), 92-96, August 2016.
Certificate: IJB 2016 [Generate Certificate]

Abstract

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.

VIEWS 23

Ananthanarayan and Paniker. 2013. Text book of Microbiology 9, 290-302.

Aziah I, Ravichandran M and Ismail A. 2007. Amplification of ST50 gene using dry-reagent based PCR for the detection of S. typhi. Diagnosis and Microbiology of Infectious Diseases 59, 373-377.

Bhan MK, Bahl R and Bhatnagar S. 2005. Typhoid and paratyphoid fever. Lancet 366, 749-762.

Butta ZA and Mansurali N. 1999. Rapid serological diagnosis of pediatric typhoid fever in an endemic area: a prospective comparative evaluation of two dot-enzyme immunoassays and the Widal test. American Journal of Tropical Medicine and Hygiene 61, 645-7.

Choo KE, Davis T M and Ismail A. 1999. Rapid and reliable serological diagnosis of enteric fever, comparative sensitivity and specificity of typhi dot and typhi dot M in febrile Malaysian children. Acta Tropica 72, 175-83.

Crump JA, Luby SP, Mintz ED. 2004. The global burden of typhoid fever. Bull World Health Organization 82, 346-353.

Dutta S, Sur D, Manna B, Sen B, Deb AK and Deen JL, 2006. Evaluation of new generation serologic tests for the diagnosis of typoid fever: data from a community bases surveillance in Calcutta, India. Diagnostic Microbiology and Infectious Disease 56(4), 359-65.

Glory TG. Salmonella. In: Feigin, Cherry, Demmler, Kaplan editors. Textbook of Pediatric Infectious Diseases. Philadelphia, W B Saunders 1473-1486.

Gopalakrishan V, Sekhar WY, Sooand EH. 2002. Typhoid fever in Kuala Lumpur and a comparative evaluation of two commercially available diagnostic kits for detection of antibodies to S. typhi 2002. Singapore Medical Journal 43(10), 495.

Grimont PAD, Grimont F, Bouvet P. 2000. Taxonomy of the genus Salmonella sp.

Ismail A, Hai, OK and Kader ZA. 1991. Demonstration of an antigenic protein specific for S. Typhi. Biochemical Biophysical Research Communication 181, 301-305.

Jesudasson M, Esther E and Mathai E. 2002. Typhidot test to detect IgG and IgM antibodies in typhoid fever. Indian Journal of Medical Research 116, 70-2.

Karkey A, Aryjal A, Basnyat B and Baker S. 2008. Still an enteric fever capital of the world. Journal of Infection in Developing Countries 2, 461-465.

Khan M, Coovadia YM, Connoly C, Sturm AW. 1998. The early diagnosis of typhoid fever prior to the Widal test and bacteriological culture results. Acta Tropica 69, 165-173.

Lin FY, VO AH, Phan VB, Nguyen TT, Bryla D, Tran CT and Ha Bk. 2000. The epidemiology of typhoid fever in the Dong Thap Province, Mekong Delta region of Vietnam. American Journal of Tropical Medicine and Hygiene 62, 644-648.

Narayanappa D, Sripathi R, Jagdishkumar K, Rajani HS. 2010. Comparative study of Dot enzyme immunoassay (Typhidot M) and Widal test in the diagnosis of typhoid fever, Indian Paediatrics 47, 331-333.

Old DC. 1996. Salmonella infection. In Collee JG, Fraster AG, Marmion BP, Simons a, eds. Mackie and McCartney practical medical microbiology 14 th ed. New York: Churchil Livingstone 385-402.

Olsen SJ, Pruckler J, Bibb W, Thanh NTM, Trinh TM and Minh NT. 2004. Evaluation of rapid diagnostic tests for typhoid fever. Journal of Clinical Microbiology 42(5), 1885-9.

Otegbayo JA, Daramola OO, Onyegbutulem HC, Balogun WF, Oguntoye OO. 2003. Retrospective analysis of typhoid fever in a tropical tertiary health facility. Tropical Gastroenterology 23, 9-12.

Pang T, Puthucheary SD. 1983. Significance and value of the Widal test in the diagnosis of typhoid fever in an endemic area. Journal of Clinical Pathology 36, 471-475.

Park K. 2005. Park’s text book of preventive and social medicine 18th ed. Jabalpur: M/S Banarsidas Bhanot 195-8.

Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ. 2002. Typhoid fever. New England Journal of Medicine 347, 1770-1782.

Postoor R, Hatta, M, Abdoel TH, Smits H. 2008. Simple, rapid and affordable point of care test for the scrodiagnosis of typhoid fever. Diagnostic Microbiology and Infectious Disease 61, 129-34.

Rao S. 2009. Salmonella entricaspecies Typhi: Enyeric (typhoid) fever. Applied Microbiology Cases.

Shah SM, Yousafzai M, Lakhani NB, Chotani RA, Nowshad G. 2003. Prevalence and correlates of diarrhea. Indian Journal of Pediatrics 70, 207-211.

Sherwal BL, Dhamija RK, Randhawa VS, Jais M, Kaintura A and Kumar M. 2004. A comparative study of Typhidot and Widal test in patients of typhoid fever. Journal Indian Acadmy of Clinical Medicine 5(3), 244-6.

Siddiqui FJ, Rabbani F, Hasan R, Nizami SQ, Bhutta ZA. 2006. Typhoid fever in children: some epidemiological considerations from Karachi, Pakistan. International Journal of Infectious Diseases 10(3), 215-222.

Tohme A, Abboud J, El-Murr T, Ghayad E. 2002. Typhoid fever. Retrospective study of 52 cases in Lebanon. Lebanese Medical journal 31, 1257-1262.

Wongsawat J, Pancharoen C Thisyakorn U. 2002. Typhoid fever in children: experience in King Chulalongkorn Memorial Hospital. Journal of the Medical Association Thailand 85, 247-1250.