scholarly journals COMPARISON OF WIDAL AND TYPHOID IMMUNOGLOBULIN M AND IMMUNOGLOBULIN G IN RAPID AND EARLY DIAGNOSIS OF ENTERIC FEVER

2016 ◽  
Vol 9 (9) ◽  
pp. 243
Author(s):  
Sharanya K ◽  
Vinod K ◽  
Lakshmi K
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Immunoglobulin G ◽  
Rapid Test ◽  
High Sensitivity ◽  
Salmonella Typhi ◽  
Clinical Suspicion ◽  
Immunoglobulin M ◽  
Widal Test ◽  
Sensitivity Specificity

ABSTRACTObjective: Typhoid fever is one of the major public health problems in developing countries including India. A simple, reliable, rapid, and earlydiagnostic test has been one of the important needs of the clinicians. The present study was carried out to compare the Widal test and typhoidimmunoglobulin M (IgM) and immunoglobulin G (IgG) rapid test in diagnosing of Salmonella typhi infection.Methods: A total of 100 cases having clinical suspicion of typhoid fever and 40 controls (20 healthy persons and 20 non-typhoidal febrile patients)were studied. Participants were investigated by blood culture, clot culture, Widal test, and typhoid IgM and IgG rapid test, and the results werecompared.Results: Typhoid IgM and IgG test was positive for IgM in 70 cases and IgG for 6 cases of typhoid fever compared to Widal test which showed only58 positive cases. The sensitivity, specificity, positive, and negative predictive value of typhoid IgM was found as 70%, 90%, 94.59%, and 54.55%,respectively. On the other hand, corresponding values for Widal test were 58%, 85%, 90.63%, and 44.74%, respectively.Conclusion: In the present study, the typhoid IgM and IgG yielded remarkable high sensitivity and specificity to diagnose typhoid fever in the firstweek of illness, so it is recommended to use the test in small and less equipped laboratories as a complementary test to Widal.Keywords: Widal, Typhoid immunoglobulin M/immunoglobulin G, Typhoid fever, Blood culture.

scholarly journals Utility of A Single Widal Test in The Diagnosis of Typhoid Fever

2012 ◽  
Vol 35 (2) ◽  
pp. 53-58 ◽  
Author(s):  
ABM Shahidul Alam ◽  
Fahim Ahmed Rupam ◽  
Farhana Chaiti
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Predictive Value ◽  
Salmonella Typhi ◽  
Definitive Diagnosis ◽  
Blood Cultures ◽  
Widal Test ◽  
Female Ratio ◽  
The Mean ◽  
Agglutinin Titer

Background & objectives: The clinical diagnosis of typhoid fever is difficult, as the presenting symptoms are often diverse and similar to those observed with other febrile illnesses. The definitive diagnosis of typhoid fever requires the isolation of Salmonella typhi or paratyphi from the patient concerned. Since patients often receive antibiotics prior to a confirmatory diagnosis, there is uncertainty that bacteria can be isolated from the blood cultures. Besides this, the facilities for blood culture are not always available or feasible. All these limitations have made Widal test the most utilized diagnostic test for typhoid fever. Many studies have produced data which had cast serious doubts on the value of the Widal Test and thus reappraisal of the role of a single Widal test is needed.Methods & materials: This study was carried out to determine the changes in clinical pattern of enteric fever. A total of 153 children, aged 0 to 14 years, diagnosed as typhoid fever (either positive blood culture for Salmonella typhi or paratyphi) were induced in the study. Of them, 86 children were with a definitive diagnosis of typhoid or paratyphoid fever as indicated by the isolation of S. typhi or S. paratyphi from the blood and 17 had negative blood culture but were clinically suspected of having typhoid fever. The control group was comprised of 50 children with non-typhoidal fevers The Widal test was carried out using rapid slide agglutination method and its accuracy was assessed by comparing the findings with that obtained through blood culture.Result: The mean age of the patients was 5.2 ± 2.8 years and the youngest and oldest patients were 0.7 and 14 years respectively and male to female ratio was roughly 1:1. Nearly one-quarter (24.6%) of the patients had been suffering from the disease for >10 days and the mean duration of illness was 8.2 ± 3.3 days. Widal Test result showed that an ‘O’ agglutinin titer of cut-off value e”1:40 gave a sensitivity of 87.2%, a specificity of 47.1%, a positive predictive value (PPV) of 89.2% and a negative predictive value (NPV) of 42.1%. The sensitivity and NPV decreased with the increase in titer levels and were 56.9% and 31.5% at cut-off value of e” 1:320, while the specificity and PPV increased with the increase in titer levels from 47.1% and 89.2% respectively at a titer of e”1:40 to 100% at a titer of e” 1:320. The ‘titer behaved in the same way as did the ‘O’ agglutinin titer. Similarly when H’ agglutinin was used the sensitivity and NPV decreased from 65% and 31.7% at a titer of e”1:40 to only 25% and 20% respectively at a titer of > 1:320, while specificity and PPV increased from 76.4% and 81.1% at >1:40 to 94.1% and 95.6% respectively at e” 1:320. When either ‘O’ or ‘H’ antibody titer of e”1:160 was used, a good sensitivity (71%), specificity (70.6%) and PPV (92.4%) resulted, though NPV decreased to 32.4%.Conclusion: The Widal test can be of diagnostic value when blood cultures are not available nor practically feasible.DOI: http://dx.doi.org/10.3329/bjch.v35i2.10377  Bangladesh J Child Health 2011; Vol 35 (2): 53-58

scholarly journals Comparison of results obtained by widal agglutination test & polymerase chain reaction among clinically suspected typhoid fever cases

2015 ◽  
Vol 30 (2) ◽  
pp. 46-50
Author(s):  
Shafinaz Khan ◽  
Md Ruhul Amin Miah ◽  
Shammin Haque ◽  
Chowdhury Rafia Naheen
Keyword(s):  
Polymerase Chain Reaction ◽  
Blood Culture ◽  
Typhoid Fever ◽  
False Negative ◽  
Salmonella Typhi ◽  
Widal Test ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Positive Results ◽  
Prior Antibiotic Treatment

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 Bangladesh J Physiol Pharmacol 2014; 30(2): 46-50

scholarly journals Antimicrobial sensitivity pattern of Salmonella typhi isolated from blood culture in a referral hospital

2011 ◽  
Vol 5 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Bulbul Hasan ◽  
Sabera Gul Nahar ◽  
Laila Akter ◽  
Ahmed Abu Saleh
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Antimicrobial Susceptibility ◽  
Salmonella Typhi ◽  
Susceptibility Pattern ◽  
Widal Test ◽  
College Hospital ◽  
Medical College ◽  
Antimicrobial Susceptibility Pattern ◽  
Sensitivity Pattern

The present study has been carried out in an attempt to evaluate antimicrobial susceptibility patterns with special reference to susceptibility of Salmonella Typhi to ciprofloxacin isolated from blood culture. The study is also designed to find out the MIC of Ciprofloxacin by E- test. Blood samples were taken for culture sensitivity, Widal test and ICT from 100 clinically suspected cases of typhoid fever in 1st week of illness who attended at out patient department of Rajshahi Medical College Hospital (RMCH).The study was done in Microbiology Department of Rajshahi Medical College and Shishu Hospital, Dhaka. Diagnosis of patients was based on history of fever, blood culture, Widal test and ICT. The antimicrobial susceptibility pattern of isolates from blood culture was recorded. Further more, the minimum inhibitory concentration of Ciprofloxacin was determined by E-test for the isolates resistance to Ciprofloxacin. Out of 100 suspected cases of typhoid fever, blood culture positive for S. Typhi were 16 (16%). Antimicrobial susceptibility pattern of 16 isolates of S. Typhi showed that no isolate was resistant to Ceftriaxone and Ceftazidime, only 03(18.75%) were resistant to Ciprofloxacin and Azithromycin whereas 10(62.5%) were MDR showing resistance to Ampicillin, Co-trimoxazole and Chloramphenicol which are first-line antityphoidal drugs. On the other hand, all (100%) the isolates were resistant to Nalidixic acid. The study revealed that Ceftriaxone and Ceftazidime are the most effective drugs in the treatment of typhoid fever. Moreover, E-test has been found to be helpful to determine appropriate therapeutic dose of Ciprofloxacin especially in case of drug resistance and pediatric population.DOI: http://dx.doi.org/10.3329/bjmm.v5i1.15816 Bangladesh J Med Microbiol 2011; 05 (01): 16-20

Relying on Widal test alone could lead to over diagnosis of typhoid fever: Findings from a records review of febrile patients at Damphu Hospital, Bhutan, 2011-2012

2018 ◽  
Vol 4 (1) ◽  
pp. 50-54
Author(s):  
Tej Nath Nepal ◽  
Tshering Dorji ◽  
Tsheten Tsheten ◽  
Karma Tenzin ◽  
Dorji Pelzom ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Scrub Typhus ◽  
Correct Diagnosis ◽  
High Sensitivity ◽  
Salmonella Typhi ◽  
Clinical Judgement ◽  
Test Results ◽  
Widal Test ◽  
Duration Of Illness ◽  
The Right

Introduction: The Widal test is widely used in hospitals in Bhutan for diagnosis of typhoid fever. The right test with high sensitivity and specificity supplements clinical judgement and contributes to correct diagnosis of disease. This study focuses on the contribution of the Widal test in the diagnosis of typhoid fever. Methods: Data was collected from records of patients who presented to Damphu hospital from March 2011 to June 2012 with clinical suspicion of typhoid fever. Blood samples were collected from patients and tested at Damphu Hospital, Tsirang and the Royal Centre for Disease Control, Thimphu. Seventy records were used for the study. Results: There was no growth of Salmonella typhi on blood cultures from patients who had tested positive in the Widal test. There were 20 (28.57%) samples which tested positive for scrub typhus; among these Widal test was positive in 10 (50%) samples. Thirty four out of 36 (94.44%) patients had duration of illness less than seven days and among them 26 (74.47%) had positive Widal test results. Conclusion: None of the samples that tested positive by Widal test gave a definite diagnosis of typhoid fever with blood culture. Clinical judgement may be more challenging because patients with other febrile illnesses like Scrub typhus also have positive Widal test result. We conclude that it is best not to rely on the Widal test alone for the diagnosis of typhoid fever and this test should be replaced by more accurate ones.

scholarly journals Evaluation of Typhidot (IgM) for Early Diagnosis of Typhoid Fever

2009 ◽  
Vol 3 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Zohra Begum ◽  
Md Akram Hossain ◽  
AKM Shamsuzzaman ◽  
Md Monjurul Ahsan ◽  
AKM Musa ◽  
...  
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Predictive Value ◽  
Serological Test ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Major Public Health Problem ◽  
Medical College ◽  
Sensitivity Specificity ◽  
Culture Positive

Typhoid fever still continues to be a major public health problem, particularly in many developing countries. A simple, reliable, affordable and rapid diagnostic test has been a long-felt need of the clinicians. We, therefore, prospectively evaluated the sensitivity and specificity of Typhidot (IgM), a serological test to identify IgM antibodies against Salmonella typhi. The study was carried out in the department of Microbiology, Mymensingh Medical College, Mymensingh between June, 2006 and July, 2007, on a total of 100 samples from clinically suspected patients to have typhoid fever. Blood culture as well as Typhidot test were performed for each of the cases. Out of 100 clinically diagnosed typhoid fever, 14 were blood culture positive for S. typhi and 73 were Typhidot (IgM) positive. Among 14 culture positive cases, 13 (92.85%) were Typhidot (IgM) positive. The test was also positive in 04 (20%) out of 20 febrile controls. None of the healthy controls was positive by Typhidot (IgM). The sensitivity, specificity, positive predictive value and negative predictive value of the test using blood culture as gold standard were 92.85%, 90.00%, 76.47% and 97.29% respectively for typhoid fever. Typhidot (IgM) test is rapid, easy to perform and reliable test for diagnosing typhoid fever, and useful for small, less equipped laboratories as well as for the laboratories with better facilities. Key words: Typhoid fever, Salmonella typhi, Typhidot (IgM) test   doi: 10.3329/bjmm.v3i1.2964 Bangladesh J Med Microbiol 2009; 03 (01): 10-13

scholarly journals Value of the single Widal test in the Diagnosis of Typhoid fever

2013 ◽  
Vol 2 (1) ◽  
pp. 34-38
Author(s):  
Zohra Begum ◽  
Md Monjurul Ahsan ◽  
Ambia Begum ◽  
Abdul Baten ◽  
Md Murshed Alam ◽  
...  
Keyword(s):  
Medical Journal ◽  
Blood Culture ◽  
Typhoid Fever ◽  
Positive Blood Culture ◽  
Predictive Value ◽  
Widal Test ◽  
Community Based ◽  
Presumptive Diagnosis ◽  
Medical College ◽  
Sensitivity Specificity

The value of a single Widal test was evaluated on 100 clinically suspected typhoid fever cases and 40 age-sex matched controls, in the Department of Microbiology, Mymensingh Medical College during the period from July 2006 to June 2007. Blood culture and Widal test with rising titre were performed in all patients. Among 100 clinically suspected of typhoid fever cases, 35 were subsequently confirmed on the basis of positive blood culture for S. typhi and/or significant rising titre of Widal test. The sensitivity, specificity, positive and negative predictive value of a single Widal test was found as 42.85%, 85.00%, 71.42% and 62.96% respectively. Thus, an elevated levels of agglutinating O and H antibodies as measured in a single Widal test might be helpful in making a presumptive diagnosis of typhoid fever if interpreted with care. DOI: http://dx.doi.org/10.3329/cbmj.v2i1.14180 Community Based Medical Journal Vol.2(1) 2013 34-38

scholarly journals TYPHOID FEVER

2011 ◽  
Vol 18 (02) ◽  
pp. 259-264
Author(s):  
ATIF SITWAT HAYAT ◽  
NAILA SHAIKH ◽  
SYED IQBAL AHMED SHAH
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Serological Test ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Major Public Health Problem ◽  
Healthy Controls ◽  
Predictive Values ◽  
Laboratory Services ◽  
Sensitivity Specificity

Background: Typhoid fever is widely recognized as a major public health problem in developing countries. A simple, reliable and rapid diagnostic test is needed for clinicians especially in areas where laboratory services are limited. Objective: To evaluate sensitivity and specificity of typhidot (IgM), a serological test to identify IgM antibodies against salmonella typhi. Study Design: This was a prospective study. Setting: Northern Institute of Medical Sciences (NIMS) and Ayub Teaching Hospital Abbottabad. Period: 1st November 2009 to 31st August 2010. Methods: A total of 100 patients with clinically suspected typhoid fever were studied and divided into three main groups as A, B and C, with definite typhoid fever, typhoid suspects plus non-typhoidal illnesses and healthy controls respectively. Blood culture and typhidot (IgM) tests were conducted for all subjects included in the study. The validity of typhidot (IgM) test has been evaluated by determining the sensitivity, specificity, positive and negative predictive values. Results: In our study, majority (75%) were males and (25%) females with M to F ratio of 3:1. The mean age of study group was 26.31±11.8 (SD) years. Among 100 clinically diagnosed typhoid fever patients, 19 had positive blood culture for S.typhi and 71 were typhidot (IgM) positive. Out of 19 culture positive patients, 18 (94.73%) were true typhidot (IgM) positive, which was also falsely positive in 05 (20.83%) among 24 non- typhoidal febrile controls. None of the healthy controls was positive for typhoid (IgM) test. The sensitivity, specificity, negative and positive predictive values of typhidot (IgM) test using blood culture as gold standard were 94.73%, 90%, 97.72% and 78.26% respectively for patients having typhoid fever. Conclusions: Typhidot (IgM) test is a simple, reliable, rapid and valid diagnostic tool for typhoid fever especially in areas where laboratory services are limited.  

scholarly journals Stool shedding of Salmonella Typhi in children with blood culture-confirmed typhoid fever

2020 ◽  
Vol 101 ◽  
pp. 123
Author(s):  
M. Srinivasan ◽  
S. Giri ◽  
S. Kulandaipalayam Natarajan ◽  
N. Kumar ◽  
V.R. Mohan ◽  
...  
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Salmonella Typhi

scholarly journals A Patient with Typhoid Hepatitis

2021 ◽  
Vol 22 (2) ◽  
pp. 154-158
Author(s):  
M Vitanata Arfijanto ◽  
Isty Rindryastuti
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Hemorrhagic Fever ◽  
Liver Function Tests ◽  
Salmonella Typhi ◽  
Abnormal Liver Function ◽  
Grade Ii ◽  
Ig G

Typhoid hepatitis is typhoid fever accompanied by symptoms of jaundice, hepatomegaly and abnormal liver function tests. The incidence varies between 0.4% -26% of typhoid fever patients. We report a case of a 34-year-old male, presented with fever, epistaxis, gastrointestinal symptoms, thrombocytopenia and elevated AST/ ALT, thus the patient was first diagnosed as dengue hemorrhagic fever grade II. On day 9th the signs and symptoms were persisted, Ig M and Ig G Dengue was negative. Then we evaluated the virus marker for hepatitis and blood culture. The results were negative for HBsAg, anti HCV and Ig M anti HAV, but Salmonella typhi detected on blood culture. The patient was treated with ceftriaxone 1000mg bid iv and get better then discharged from hospital.

scholarly journals A SYSTEMATIC EVALUATION OF RAPID DOT-EIA, BLOOD CULTURE AND WIDAL TEST IN THE DIAGNOSIS OF TYPHOID FEVER

2013 ◽  
Vol 03 (01) ◽  
pp. 21-24 ◽  
Author(s):  
H. Sanjeev ◽  
Sweetha Nayak ◽  
Pai Asha K. B. ◽  
Rai Rekha ◽  
Vimal Karnaker ◽  
...  
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Gold Standard ◽  
Salmonella Enterica ◽  
Diagnostic Yield ◽  
Far East ◽  
Health Care Facilities ◽  
Systematic Evaluation ◽  
Widal Test ◽  
South Central

Abstract Background: Typhoid fever, caused by Salmonella enterica serotype Typhi, is endemic in the Indian sub-continent including Bangladesh, South-east and Far-east Asia, Africa and South Central America. The disease can occur in all age group with highest incidence among children. Blood culture is regarded as the gold standard for diagnosis and carry 70-75% diagnostic yield in the first week of illness. However, this requires laboratory equipment and technical training that are beyond the means of most primary health care facilities in the developing world. Typhidot is a rapid dot-enzyme immune assay (EIA), which detects IgG and IgM antibodies to a specific 50 kD outer membrane protein (OMP) antigen of Salmonella enterica serotype Typhi. Typhidot becomes positive as early as in the first week of fever. The results can be visually interpreted and is available within one hour. Materials and method: Fifty blood samples, collected aseptically from patients clinically diagnosed of Typhoid fever, were evaluated by blood culture, Widal test and Typhidot. Results: Of the 50 patients, 33 (66%) were positive by blood culture. Widal test was positive in 33(66%) patients which included 26 in blood culture positive patients and 7 in blood culture negative patients. Typhidot was positive in 37 (74%) patients. Thus, in comparison to the gold standard test i:e blood culture, Typhidot and Widal test had sensitivity and specificity of 100% & 76% and 78.78% & 58.82% respectively. Conclusion: Typhidot is found to have high sensitivity and good specificity and could be applied as a good alternate in resource poor nation. Further, it is simple to perform, reliable when compared to Widal test, and rapid, with results being available in one hour when compared to 48 hours for blood culture and 18 hours for Widal test.

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