A Comparative Study of Typhidot Test and Widal Test With the Culture-Positive Typhoid Fever in Children

Abstract

BACKGROUNDTyphoid fever in children is a common childhood infection in both urban and rural regions in tropical countries. Clinical presentation is varied and overlaps many other acute febrile illness. MATERIALS AND METHODSStudy was a prospective descriptive study. The study was conducted in Institute of Child Health and Hospital for Children, Egmore, Chennai, Tamilnadu during the period of April 2013 to November 2015. Children aged 3-12 years with fever more than 5 days with no obvious focus of infection. Coated tongue, abdominal distension, toxic look, constipation or loose stools, hepatomegaly, splenomegaly, relative bradycardia was included. Children immunised with typhoid vaccine, children already on antibiotics, and children with documented typhoid fever in the past 8 weeks were excluded. It was aimed to analyse the clinical presentation and to compare the Typhidot test and Widal test with the culture positivity in children with typhoid fever. RESULTS167 children fitted into the inclusion criteria, of which 26 (15.6%) children were culture positive. 52 (31.1%) children were Widal positive, 49 (29.3%) were Typhidot test positive. Fever with anorexia was the common symptoms, and toxic look, coated tongue was the common signs in our study group. CONCLUSIONSBlood culture for typhoid fever is the gold standard, but is time consuming. In our study, we conclude that Typhidot shows high sensitivity and low specificity with higher negative predictive value when compared to Widal test. KEYWORDSTyphoid fever, Typhidot Test, Widal Test. Since the clinical features of the common infections like malaria, dengue, typhoid, leptospirosis and scrub typhus are very similar it is difficult for the treating physician to diagnose typhoid fever based on clinical features. (1,2,3) It is then mandatory to have a very valid diagnostic test with good sensitivity and specificity for an earlier diagnosis in children with acute febrile illness. (4,5) With increasing use of antibiotics, the clinical presentation is nonspecific and difficult to diagnose based on clinical features in children. HOW TO CITE THIS ARTICLE:

Molecular analysis of immunoglobulins related to salmonella typhi in pediatric patients

“…Typhidot IgM positive means early phase of illness while both IgM and IgG are positive in case of middle phase of infection. IgG antibodies are not indicative of acute infection as they persist in serum of the patient for about 2 years of infection [12].…”

“…The usefulness of Typhidot is quite profound in the diagnosis of typhoid fever. It is easy to perform, and results are interpreted quickly [12]. There is no need of an ELISA reader to evaluate the results.…”

“…Form always for its identi ication are blood culture and Widal test. The gold standard for Typhoid fever is blood culture but is time consuming [12]. Also, the results of the blood culture are affected by prior administration of antibiotics.…”

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

“…The Widal test parameters obtained in the present study show some general patterns with some previous studies that are high sensitivity, low predictive value of the positive test, and high predictive value of the negative test. For example, in the study conducted by Muthaiyan [ 24 ] and collaborators, they reported a sensitivity of 88.5% (95% CI: (69.82–97.42)), a specificity of 81.56% (95% CI: (74.16–87.58)), a positive predictive value of 46.94% (95% CI: (32.54–61.720)), and a negative predictive value of 97.46% (95% CI: 92.74–99.44) for the Widal slide agglutination test. In a similar study in India in 2016 [ 24 ], the authors reported a sensitivity of 80.77% (95% CI: (60.64–97.42)), a specificity of 78.01% (95% CI: (70.22–84.54)), a positive predictive value of 40.38% (95% CI: (27.01–54.90)), and a negative predictive value of 95.65% (95% CI: ()90.14–98.56)).…”

“…For example, in the study conducted by Muthaiyan [ 24 ] and collaborators, they reported a sensitivity of 88.5% (95% CI: (69.82–97.42)), a specificity of 81.56% (95% CI: (74.16–87.58)), a positive predictive value of 46.94% (95% CI: (32.54–61.720)), and a negative predictive value of 97.46% (95% CI: 92.74–99.44) for the Widal slide agglutination test. In a similar study in India in 2016 [ 24 ], the authors reported a sensitivity of 80.77% (95% CI: (60.64–97.42)), a specificity of 78.01% (95% CI: (70.22–84.54)), a positive predictive value of 40.38% (95% CI: (27.01–54.90)), and a negative predictive value of 95.65% (95% CI: ()90.14–98.56)). Sherwal et al [ 25 ] also reported a sensitivity of 74%, a specificity of 83%, and a positive predictive value of 87.5%.…”