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 ◽  
...  

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

2011 ◽  
Vol 18 (02) ◽  
pp. 259-264
Author(s):  
ATIF SITWAT HAYAT ◽  
NAILA SHAIKH ◽  
SYED IQBAL AHMED SHAH

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.  


2020 ◽  
Vol 7 (8) ◽  
pp. 1677
Author(s):  
Mohammad Ashfaque Ansari ◽  
Amit Kumar Thakur ◽  
Atindra Mishra ◽  
Md Jaffer Rain

Background: Typhoid fever still continues to be a major public health problem in Nepal. A clinical spectrum of typhoid varies widely. It causes significant complication as well as mortality. A simple, reliable, affordable and rapid diagnostic test has been a long felt need of the clinicians to prescribe specific medication, adopt prevention of the emergence of antibiotics resistance and overall reduce the disease burden in the community.Methods: The prospective descriptive study was performed in 125 children between 2 years to 15 years of age admitted to the Pediatrics Department from September 2017 to September 2018. Blood culture, Typhidot rapid IgM were performed. MEDCALC software was used to calculate 95% confidence interval for sensitivity, specificity, predictive value positive, predictive value negative and accuracy. Kappa test was used to determine the agreement between Typhidot IgM and blood culture methods.Results: The study consisted of 125 children with acute febrile illness for more than 3 days with clinical symptomatology, consistent with typhoid fever. The reliability of Typhidot IgM in relation with blood culture and the study lighten that sensitivity 92.3% (95% CI: 63.9, 99.8), specificity 49.1% (95% CI: 39.5, 58.7), PPV 17.4% (95% CI: 14.2, 21.1), NPV 98.2% (95% CI: 89.2, 99.7) and accuracy 53.6% (95% CI: 44.5, 62.6). The two methods i.e. Typhoid IgM and blood culture shows significant agreement with p value 0.004.Conclusions: The present study demonstrates that Typhidot IgM has all the attributes of an ideal screening test.


Author(s):  
Sougata Mitra ◽  
Masuma Khanam ◽  
M. Iqbal Hossain ◽  
Rukhsana Quadir

Background: Typhoid fever is a severe debilitating and potentially life threating illness. In Bangladesh, typhoid fever is a round the year problem which sometimes take epidemic proportions. The reasons behind such occurrences are unsafe water supply, defective sewage system and unhygienic food handling practice. This study aimed to compare the efficacy of ceftriaxone and azithromycin in the treatment of uncomplicated enteric fever.Methods: An observational study was conducted at the department of pharmacology in Dhaka medical college, Dhaka, Bangladesh. Data were collected from blood culture positive patients for Salmonella typhi and Salmonella paratyphi, who admitted in the Dhaka medical college and hospital, Dhaka during the period of July 2015 to June 2016. Data was collected by using a structured questioner, face to face interview, physical examination and investigation reports. Patients were hospitalized during the entire treatment period and at admission evaluation was made by history and physical examination in a structured format. Subjects ware asked regarding changes in symptoms and possible adverse effects of the study drugs. All patients were asked to return two weeks after completion of treatment for follow up. Blood culture of Salmonella typhi or Salmonella paratyphi were done in all cases. Total 91 patients were culture positive for either S. typhi or S. paratyphi which were finally studied.Results: During the study period out of 91 patients, 51 were receiving ceftriaxone and 40 were receiving azithromycin. Clinical cure was achieved in 46 patients (90%) of ceftriaxone group and in 31 patients (78%) in the azithromycin group. There were no significant differences of clinical cure between both treatment groups (p>0.05). Mean fever clearance time in ceftriaxone group was 3±1.4 days and was 4±1.6 days for azithromycin group. Difference in fever clearance time was statistically significant (p<0.05). No clinical relapses were detected in any study subject. No major side effects of both drugs occurred in any subject.Conclusions: These results indicated that both ceftriaxone and azithromycin were effective against enteric fever caused by sensitive organisms and multi drug resistant S. typhi and S. paratyphi. It is concluded that ceftriaxone is more effective and can be a convenient alternative for the treatment of enteric fever, especially in developing countries like us where medical resources are scarce.


2013 ◽  
Vol 2 (1) ◽  
pp. 34-38
Author(s):  
Zohra Begum ◽  
Md Monjurul Ahsan ◽  
Ambia Begum ◽  
Abdul Baten ◽  
Md Murshed Alam ◽  
...  

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


2012 ◽  
Vol 35 (2) ◽  
pp. 53-58 ◽  
Author(s):  
ABM Shahidul Alam ◽  
Fahim Ahmed Rupam ◽  
Farhana Chaiti

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


Author(s):  
Sharanya K ◽  
Vinod K ◽  
Lakshmi K

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.


2011 ◽  
Vol 5 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Bulbul Hasan ◽  
Sabera Gul Nahar ◽  
Laila Akter ◽  
Ahmed Abu Saleh

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


Author(s):  
Samiksha Sharma ◽  
Girijanand Jha ◽  
Binod Kr Singh ◽  
Saroj Kumar

India has a very high disease burden (214.2 per 1,00,000 individuals/year), primarily affecting children 5 to 15 years. Recently, there have been concerns of increasing proportion of infections in very young children, rising paratyphoid infections, and emerging drug resistance. Also, there are challenges in diagnosis and management of enteric fever due to lack of laboratory-based investigations. While blood culture remains the gold standard of diagnosis, the mainstays in developing countries are serological tests, which are suboptimal due to lack of standardization and uniformity. Hence based on above condition the present study was planned for Assessment of Clinical and Laboratory Parameters in Typhoid Fever in Pediatric Cases Admitted to NMCH, Patna. The present study was planned in Department of Pediatrics, Nalanda Medical College and Hospital, Patna, Bihar, India. The study was planned from January 2018 to November 2018. In the present study 50 childrens of age up to 18 years having fever more than 7 days were enrolled. These cases were enrolled based on the Widal positive or positive culture were enrolled in the present study. The data generated from present study concludes that Typhoid fever manifestations are diverse. The most common symptoms apart from fever were anorexia, vomiting, pain abdomen, diarrhoea followed by headache and cough. Also the Serum parameters are also seen changed in the Thyphoid affected patients. Typhoid fever remains a major public health problem in the developing countries predominantly seen in school going children among pediatric age group. Keywords: Clinical, Laboratory Parameters, Typhoid Fever, Pediatric Cases, etc.


2003 ◽  
Vol 42 (146) ◽  
pp. 65-70 ◽  
Author(s):  
Kun Young Sohn ◽  
S Shrestha ◽  
A Khagi ◽  
S S Malla ◽  
B M Pokharel ◽  
...  

ABSTRACTTuberculosis has remained to be a major public health problem in Nepal. The risk of spread of infection andemergence of drug-resistant strain has created the need for a rapid, sensitive and specific diagnostic test.In addition, clinically suspicious cases that do not give positive result in conventional laboratory test needmore sensitive test for diagnosis.In order to evaluate the possibility of incorporation of Polymerase Chain Reaction (PCR) in the diagnosis oftuberculosis, we performed a comparative study of PCR to detect Mycobacterium tuberculosis in sputumspecimens, against Ziehl-Neelsen (Z-N) stain and culture as a standard method.A total of 103 specimens were subjected to Z-N staining, culture and PCR for detecting Mycobacteriumtuberculosis. Of these, 19 were positive by Z-N stain, 26 by PCR and 25 by culture. Four stain negativespecimens showed positive result in both culture and PCR. Two specimens of stain and culture positive werePCR negative. Five specimens showed positive result only with PCR. Two culture positive specimens gavenegative results by both Z-N stain and PCR. Sensitivity, specificity, positive predictive value and negativepredictive value of PCR which were 84%, 93.5%, 80.8% and 94.9% respectively.This study showed that there is no need for PCR test for the smear positive cases. However, PCR could be apossible diagnostic tool for the confirmation of the smear negative cases that show clinical symptoms of TB.Key Words: Mycobacterium tuberculosis, Z-N stain, PCR, sensitivity, specificity.


2009 ◽  
Vol 4 (02) ◽  
pp. 070-073 ◽  
Author(s):  
Kavita Nagshetty ◽  
Shivannavar T. Channappa ◽  
Subhashchandra M. Gaddad

Background: Typhoid fever continues to remain a major public health problem, especially in regions such as Gulbarga, due to poor sanitation and personal hygiene. Gulbarga region is often prone to enteric fever outbreaks and is an endemic region of typhoid fever. Enteric fever caused by Salmonella Typhi has not been adequately explored in this region. Methodology: A total of 95 isolates of S. Typhi collected from different clinical and environmental sources were tested for antimicrobial susceptibility according to the CLSI guidelines. MIC of resistant isolates to various antibiotics was performed by agar dilution method. Results: Of the total isolates studied, 10% were found to be multidrug resistant (MDR) (defined as resistance to ampicillin, chloramphenicol and co-trimoxazole). There was a decrease in the susceptibility to ciprofloxacin of S. Typhi with MIC showing an upward trend (0.125-4µg/mL). Concurrently, there has been an increase in the number of isolates sensitive to all antibiotics except nalidixic acid. Conclusion: MDR S. Typhi continues to be an important public health issue in Gulbarga. Presence of quinolone resistance and associated low-level ciprofloxacin resistance is a concern and requires further study.


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