scholarly journals A Cross-Sectional Comparative Study of the Performance of the Widal Test and the Typhidot Immunoassay for Typhoid Fever Diagnosis in the West Region of Cameroon

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Karimo Ousenu ◽  
Innocent Mbulli Ali ◽  
Leonard Fonkeng Sama ◽  
Marcel Nsangou Ndam ◽  
Thibau Florant Tchouangueu ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Agglutination Test ◽  
Widal Test ◽  
Cohen’S Kappa ◽  
Predictive Values ◽  
Slide Agglutination ◽  
West Region ◽  
Cohen's Kappa ◽  
Slide Agglutination Test ◽  
Sensitivity Specificity

Background. The diagnosis of typhoid fever based on the Widal slide agglutination test remains a major hurdle in developing countries due to varied perceptions of the value of the Widal test in determining clinical decision-making. We undertook a study to evaluate the diagnostic performance of the Widal test and the Typhidot immunoassay in patients suspected of having typhoid fever in the Menoua division, West Region of Cameroon. Methods. Blood and stool samples were collected from 558 consenting febrile patients on the basis of suspicion of typhoid fever. These patients attended three district health services of the Menoua division between April 2018 and September 2019. These patients had clinical symptoms suggestive of typhoid fever as determined by their consultant. Serum was used for the Widal slide agglutination test and for the Typhidot rapid immunoassay test based on manufacturer’s guidelines. A composite reference of fever plus positive coproculture for Salmonella typhi and Salmonella paratyphi was used as the reference. The sensitivity, specificity, and predictive values of the positive and negative tests were calculated as well as Cohen’s kappa for agreement between the two tests. Results. Of 558 patients, 12.90% tested positive for the reference method, 57.17% tested positive for the Widal slide agglutination test, while 15.59% were positive for Typhidot-IgM. The overall sensitivity, specificity, and predictive values of the positive and negative tests were 80.56%, 94.03%, 66.6%, and 97.03% for Typhidot-IgM and 94.44%, 48.35%, 21.32%, and 98.33% for the Widal slide agglutination test, respectively. Cohen’s kappa estimates were 0.1660 (0.121–0.211) and 0.386 (0.312–0.460) for the Widal test and Typhidot immunoassay for 53.6% and 76.16% agreements of all observations, respectively. Conclusion. The Widal test was found to have a lower predictive value for the diagnosis of typhoid fever in our setting. However, the Typhidot test, although better, was not ideal. Diagnosis of typhoid fever should therefore rely on adequate clinical suspicion and a positive Typhidot test to improve the clinical management of typhoid fever in our setting.

A comparative study of the performance of the widal slide agglutination test and the typhidot immunoassay for the diagnosis of typhoid fever in the West Region of Cameroon.

2020 ◽  
Author(s):  
Ousenu Karimo ◽  
Innocent Mbulli Ali ◽  
Leonard Fonkeng Sama ◽  
Francois Marcel Nsangou Ndam ◽  
Thibau Florant Tchouangueu ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Agglutination Test ◽  
Widal Test ◽  
Cohen’S Kappa ◽  
Predictive Values ◽  
Slide Agglutination ◽  
West Region ◽  
Cohen's Kappa ◽  
Slide Agglutination Test ◽  
Sensitivity Specificity

Abstract Background: The diagnosis of Typhoid fever, based on the Widal slide agglutination test, remains a major hurdle in developing countries like Cameroon due to varied perceptions of the value of the Widal test in determining clinical decision making. We undertook a study to evaluate the diagnostic performance of the Widal test and the typhidot immunoassay in patients suspected of having typhoid fever in the Menoua division, West Region of Cameroon. Methods: Blood and stool samples were collected from 558 consenting febrile patients on the basis of suspicion of typhoid fever. These patients attended three district health services of the Menoua division between April 2018 and September 2019. These patients had clinical symptoms suggestive of typhoid fever as determined by their consultant. Serum from whole blood was used for the Widal slide agglutination test and for the Typhidot rapid immunoassay test based on manufacturer’s guidelines. A composite reference of fever plus positive coproculture for Salmonella enteric serovars typhi and paratyphi was used as reference. The sensitivity, specificity, predictive values of the positive and negative tests were calculated as well as the Cohen’s Kappa for agreement between the two tests. Results: Of 558 patients, 12.90% tested positive for the reference method, 57.17% tested positive for the Widal slide agglutination test while 15.59% were positive for typhidot-IgM. The overall sensitivity, specificity, predictive values of the positive and negative tests were 80.56%, 94.03%, 66.6% and 97.03% respectively for typhidot-IgM; 94.44%, 48.35%, 21.32% and 98.33% for Widal slide agglutination test. The Cohen’s kappa estimates were 0.1660 (0.121-0.211), 0.386 (0.312-0.460) for Widal test and typhidot immunoassay respectively, with agreements of 53.76% and 76.16% respectively. Conclusion: The Widal test was found to have a lower predictive value for the diagnosis of typhoid fever in our setting. However, the Typhidot test, although better, was not ideal. Diagnosis of typhoid fever should therefore rely on adequate clinical suspicion and a positive Typhidot test to improve the clinical management of Typhoid fever in our setting.

scholarly journals Evaluation of the Performance of Widal Slide Agglutination Test Compared to Blood Culture and Evaluation of Interferon Gamma Response in the Diagnosis of Typhoid Fever

2020 ◽  
pp. 117-122
Author(s):  
Mujahid N.S. ◽  
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Interferon Gamma ◽  
Agglutination Test ◽  
Antibody Detection ◽  
Widal Test ◽  
Blood Samples ◽  
Slide Agglutination ◽  
Slide Agglutination Test ◽  
Interferon Gamma Response

Typhoid fever remains a public health challenge in developing countries including Nigeria. Widal test is widely used for the diagnosis of typhoid fever due to its simplicity and short turnaround time. However, the specificity of this test has been debated. The aim of the study was to evaluate the performance of Widal test compared to blood culture and determine interferon gamma response among the study subjects. Blood samples were collected from 90 patients who complained of fever and other symptoms suggestive of typhoid fever. Widal slide agglutination test, automated blood culture and interferon gamma concentrations were conducted using rapid antibody detection kit, BACTEC and sandwich enzyme linked immunosorbent assay (ELISA) respectively. Of the 90 samples tested, 63 (70.0%) were positive for anti-Typhi O antigen while 42 (46.7%) were positive for anti-Typhi H antigen. Similarly, 18 (20%) of the blood samples were non- S. Typhi culture positive while 72 (80%) had no bacteria isolated. None of the cases had S. Typhi positive culture. With regards to interferon gamma, subjects with lower levels of 15pg/mL had no bacteria isolated from their blood. As the interferon gamma concentration increased, more subjects had non- S. Typhi bacteria isolated from their blood which shows the relationship between interferon gamma and bacteraemia. The study demonstrated that the use of Widal serology test in the diagnosis of typhoid fever may be erroneous as all the samples were found to be negative for S. Typhi using the gold standard culture methods while Interferon gamma concentration was statistically related to the isolation of non- S. Typhi in blood culture as such, could be a good marker for the development of an alternative screening test, possibly an interferon gamma based detection system for typhoid fever. However, further research is recommended to elucidate that. Keywords: Typhoid, Widal test, Blood culture, Interferon gamma

scholarly journals COMPARISON OF PERFORMANCE OF TWO WIDAL TEST TECHNIQUES WITH STOOL CULTURE IN THE DIAGNOSIS OF TYPHOID FEVER AT THE DSCHANG DISTRICT HOSPITAL, WEST CAMEROON

2020 ◽  
pp. 171-174
Author(s):  
CERGE KAMHOUA NATHEU ◽  
BRUNO PHÉLIX TELEFO
Keyword(s):  
Typhoid Fever ◽  
Predictive Value ◽  
District Hospital ◽  
Venous Blood ◽  
Stool Culture ◽  
Agglutination Test ◽  
Widal Test ◽  
Cross Sectional ◽  
Slide Agglutination ◽  
Slide Agglutination Test

Objective: This study is aimed to compare the performance of two Widal test techniques with stool culture in the diagnosis of typhoid fever. Methods: A cross-sectional study was performed at the Dschang District Hospital in patients clinically suspected to have typhoid fever, whose stool was collected for stool culture. Furthermore, venous blood was collected and the serum was tested by both Widal slide agglutination test and Widal tube titration test. Results: The results showed that out of 750 participants include in the study, 325 (43.33%) were positive for Widal slide agglutination test, 174 (23.20%) for Widal tube titration test, and 159 (21.20%) for stool culture. The sensitivity, specificity, positive predictive value, and negative predictive value of Widal slide agglutination test with respect to stool culture were 97.48%, 71.23%, 47.69%, and 99.22%, respectively, but 100%, 97.46%, 91.37%, and 100% for the Widal tube titration test. With the stool culture, Widal slide agglutination test had a moderate agreement (kappa = 0.47), but Widal tube titration test had an absolute agreement (kappa = 0.94). Conclusion: Widal tube titration test should be used in place of Widal slide agglutination test in the diagnosis of typhoid fever in the case of limited access to stool culture test.

scholarly journals A slide agglutination test for the exclusion and diagnosis of typhoid fever

1939 ◽  
Vol 39 (3) ◽  
pp. 294-297 ◽  
Author(s):  
F. M. Berger ◽  
G. Brecher
Keyword(s):  
Typhoid Fever ◽  
Positive Result ◽  
Agglutination Test ◽  
Serological Diagnosis ◽  
Agglutination Reaction ◽  
Negative Test ◽  
Slide Agglutination ◽  
Peculiar Behaviour ◽  
Slide Agglutination Test ◽  
Agglutination Method

A sensitive antigen suspension is described for use with a simple slide agglutination method which makes possible a serological diagnosis or exclusion of typhoid fever without recourse to a laboratory. The method has been tested on 414 sera sent to our laboratory; it detected all cases with a titre of 1: 80 or more, and most of those with a titre of 1: 40. The method was further tested on 130 clinically observed cases, in which it gave satisfactory results. The S. A. method gave a positive result with 98 out of 100 sera from patients with typhoid fever, whereas the classical Widal reaction gave a positive result with 68 of them only.The intensity and rapidity of the slide agglutination reaction provide a rough measure of the titre of a serum. A quick and distinct agglutination indicates a titre of 1: 80 or more and is diagnostic of typhoid fever. A slow and indistinct result is obtained when the titre of the serum is about 1: 40. A negative test indicates with great probablity that a diagnosis of typhoid fever may be excluded.We think the method succeeds because the nature of the suspension employed and the peculiar behaviour of slide agglutinations permit the detection of O agglutinins as well as H agglutinins.

scholarly journals COMPARISON OF QUANTITATIVE TUBE AGGLUTINATION AND SEMIQUANTITATIVE SLIDE AGGLUTINATION TEST FOR DIAGNOSING OF THE SUSPECTED CASES OF ENTERIC FEVER

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Shubhdeep Kaur ◽  
Harsh Yadav ◽  
Umed Singh ◽  
Mona Narain ◽  
Mayank Bhardwaj ◽  
...  
Keyword(s):  
Predictive Value ◽  
Enteric Fever ◽  
Venous Blood ◽  
Laboratory Method ◽  
Agglutination Test ◽  
Major Health Problem ◽  
Slide Agglutination ◽  
Slide Agglutination Test ◽  
Slide Test ◽  
Sensitivity Specificity

Introduction: Enteric fever is the major health problem of developing country like India, with a notable morbidity and mortality. Isolation of Salmonella the causative agent from Blood is the standard laboratory method for diagnosis, but it is not available at PHC level. So, rapid and affordable diagnostic test like Widal tube and slide agglutination test are used. The present study was done to comparatively evaluate the Widal slide agglutination and tube agglutination test in detecting enteric fever. Methods: A total of 500 patients with clinical presentation suggestive of enteric fever were included in the study whose venous blood was collected. All the samples were tested for the presence of anti O and anti H agglutinins against S. typhi and S. paratyphi A by semi quantitative slide and quantitative tube agglutination tests as per standard protocols. The titers of 1:80 (O agglutinins) and 1:160 (H agglutinins) were taken as the significant titer for the diagnosis of enteric fever. Results: Out of 500 collected samples, 183 (36.6%) was positive by slide agglutination test, whereas, only 145 (29%) were positive by tube agglutination method. The slide test had a sensitivity of 97.2%, specificity of 88.1%, positive predictive value of 77% and negative predictive value of 98.7% as compared to Widal tube agglutination test. Conclusions: Due to high false positivity shown by slide test, it is suggested that serological diagnosis should not be made solely on the basis of slide test rather its results should be confirmed by using Widal tube agglutination test. Keywords: Enteric fever, Slide agglutination test, Widal tube agglutination test, Sensitivity, Specificity

THE WIDAL SLIDE AGGLUTINATION TEST, A VALUABLE RAPID DIAGNOSTIC TEST IN TYPHOID FEVER PATIENTS AT THE INFECTIOUS DISEASES HOSPITAL OF JAKARTA

1986 ◽  
Vol 123 (5) ◽  
pp. 869-875 ◽  
Author(s):  
STEPHEN L. HOFFMAN ◽  
TIMOTHY P. FLANIGAN ◽  
DOUGLAS KLAUCKE ◽  
BUDHI LEKSANA ◽  
ROBERT C. ROCKHILL ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Typhoid Fever ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Agglutination Test ◽  
Slide Agglutination ◽  
Slide Agglutination Test

scholarly journals Typhoid fever among febrile Nigerian patients: Prevalence, diagnostic performance of the Widal test and antibiotic multi-drug resistance

2019 ◽  
Vol 31 (3) ◽  
pp. 184-192 ◽  
Author(s):  
Martin E Ohanu
Keyword(s):  
Drug Resistance ◽  
Typhoid Fever ◽  
Predictive Value ◽  
Antibiotic Susceptibility ◽  
Agglutination Test ◽  
Controlled Study ◽  
Multi Drug Resistance ◽  
Widal Test ◽  
Culture Positivity ◽  
Sensitivity Specificity

BackgroundOver-dependence on clinical presentation and/or the Widal agglutination test for the diagnosis of typhoid fever in developing countries can lead to antibiotic abuse. In Nigeria, the antibiotic resistance of typhoid organisms is poorly characterized. In this study, we determined the prevalence of culture positivity among patients suspected of having typhoid fever, evaluated the diagnostic value of the Widal test and the burden created by the multi-drug resistance of typhoid organisms in South-East Nigeria. MethodologyThis was a prospective and case-controlled study carried out between 2013 and 2016. We acquired samples of blood/stool/urine cultures, and data relating to the Widal agglutination test and malaria parasites from 810 febrile patients (suspected of having typhoid) and 288 apparently healthy controls. Individuals with a history of antibiotic use within the previous 14 days were excluded. We then carried out antibiotic susceptibility tests on all isolates. Multi-drug resistance was defined as a resistance to ≥3 of the antibiotics tested. We determined the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Widal test for typhoid laboratory diagnosis compared to bacterial culture which is the gold standard. A P-value <0.05 was considered to be statistically significant. ResultsThe mean age of typhoid suspects was 33.1±6.5 years and 50.7% were women. Of the 810 typhoid suspects tested, 114 (14.1%) had positive cultures for the typhoid organisms Salmonella enterica serovar paratyphi (72) and S. enterica serovar Typhi (42). Sample-specific rates of culture positivity were as follows: stool (72; 8.9%), blood (21; 2.6%) and urine (21; 2.6%), P<0.001. None of the controls had typhoid isolates. The sensitivity, specificity, PPV and NPV of the Widal test were 49.1%, 90.7%, 46.2% and 91.6%, respectively. Malaria parasitaemia was detected in 180 (22.2%) febrile patients, out of whom 115 (63.9%) had a positive Widal test for O/H antigens vs. 1% (6/630) in those with negative malaria parasite test results (P<0.001). The rate of false-positive Widal titres was 48%. Antibiotic multi-drug resistance was detected in 52.6% of patients. The antibiotics with the highest susceptibility were ciprofloxacin, levofloxacin and meropenem (all 100% susceptibility) and ceftriaxone (95.6% susceptibility). ConclusionOur data showed that while typhoid fever is common in Nigeria, malaria is more prevalent. Our analysis showed that the Widal test performed poorly as a diagnostic test and that the burden created by multi-drug resistance was high. Our data indicate that periodic surveillance of antibiotic susceptibility is critical for optimal typhoid therapy.

scholarly journals Diagnostic reliability of Widal slide agglutination test for enteric fever- still a query

2017 ◽  
Vol 5 (10) ◽  
pp. 4407
Author(s):  
Kiran Yadav ◽  
Geeta Parihar ◽  
Suresh Kumar Yadav
Keyword(s):  
Enteric Fever ◽  
Public Health Problem ◽  
Agglutination Test ◽  
Major Public Health Problem ◽  
Widal Test ◽  
Serum Samples ◽  
Cross Sectional ◽  
Diagnostic Reliability ◽  
Slide Agglutination ◽  
Slide Agglutination Test

Background: Typhoid fever is a major public health problem associated with significant morbidity and mortality in many countries. The Widal slide agglutination test is a commonly used test for diagnosing enteric fever. Limited literature is available on its diagnostic ability in comparison to the tube agglutination test. Aim of this study was carried out to evaluate the efficacy of the Widal slide agglutination test for the diagnosis of enteric fever.Methods: This cross-sectional study was done in department of microbiology in Jawahar Lal Nehru medical college and hospital, Ajmer over a period of six months from September 2013 to March 2014. A total of 640 serum samples received in the microbiology department were processed for detecting the presence of anti O and anti H agglutinins against S. typhi, S. Paratyphi A and S. Paratyphi B by slide and tube Widal agglutination tests as per standard protocols. The significant titre for O and H agglutinin, 1:160 was taken as positive.Results: Of the 154 slide Widal positive samples, 115 (18%) samples tested negative by the tube agglutination test whereas only 39 (6%) samples were positive by both slide and tube agglutination.Conclusions: Slide Widal test has high sensitivity and NPV (100%) can be used as a screening tool but due to low specificity (83.93%) any positive sample should be confirmed by tube Widal test.

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