The utility of diagnostic tests for enteric fever in endemic locations

Parry, Christopher M.; Wijedoru, Lalith; Arjyal, Amit; Baker, Stephen

doi:10.1586/eri.11.47

Cited by 166 publications

(194 citation statements)

References 151 publications

(117 reference statements)

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“…5,8 Positivity rate of blood culture was considered low. In contrast to a previous study which stated that the best period for blood culture is day <7 of disease, [14][15][16] the highest rate was noted on day 7. Low positivity rates of blood culture, which was also reported in a previous study, may as well be results from prior antibiotic use.…”

Section: Discussioncontrasting

confidence: 92%

“…High sensitivity and low specificity of the test were also reported in the childrenpopulated study performed by Narayanappa, et al 11 This retrospective study was a hospitalbased study where most patients had previously visited the primary health care. Children with 1-14 days of fever were included because the best period of blood culture are the first few days of disease [14][15][16] and the best period of IgM anti S. typhi serologic test is the second week of disease. 5,8 The facts that antibiotics were widely used prior to the admission of patients could make the number of study subjects even lower and impossible to conduct this study; thus, children with prior antibiotic use were not excluded.…”

Section: Discussionmentioning

confidence: 99%

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Validity of Immunoglobulin M Anti Salmonella typhi Serologic Test in Childhood Typhoid Fever

Marsela¹,

Setiabudi²,

Indrati³

2017

amj

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Background: Typhoid fever, which mostly affects children, remains a major health problem in developing countries. Early diagnosis will help the management and thus, reduce morbidity and mortality. However, a rapid diagnostic test that detects the presence of immunoglobulin M (IgM) directed towards Salmonella typhi (S. typhi) antigen remains controversial despite its popularity. This study was aimed to assess the validity of IgM anti S. typhi serologic test in childhood typhoid fever. Methods: This retrospective diagnostic test, used blood culture as gold standard. Forty-one typhoid fever children with fever of 1-14 days admitted to Dr. Hasan Sadikin General Hospital Bandung from 2013 to 2015 were recruited. Diagnosis of typhoid fever is made clinically. Data were analyzed by Receiver Operating Characteristic (ROC) curve and diagnostic test. Results: Forty one children diagnosed with typhoid fever, 37 were positive for IgM anti S. typhi, but only 18 were positive for S. typhi in blood culture. IgM anti S. typhi (cut-off ≥4) test had an Area Under the Curve (AUC) of 59%, sensitivity of 100% and specificity of 17.39%. IgM anti S. typhi with cut-off >8 showed the highest AUC with sensitivity of 55.56% and specificity of 73.68%. Conclusions: IgM anti S. typhi test of cut-off >8 performs better than cut-off ≥4 in terms of AUC..

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Section: Discussioncontrasting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Validity of Immunoglobulin M Anti Salmonella typhi Serologic Test in Childhood Typhoid Fever

Marsela¹,

Setiabudi²,

Indrati³

2017

amj

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“…However, it has been proved by many studies that the Widal agglutination test is still of signifi cant diagnostic value, particularly in an area where there is a reasonably high suspicion (prior probability) of enteric fever, provided judicious interpretation of the test is made. [11,12] At the same time, it is also true that if going for the slide agglutination test instead of the standard tube Widal test, it should always be interpreted with reference to the results of the tube agglutination test and clinical data available. [13] …”

Section: Discussionmentioning

confidence: 99%

Diagnostic efficacy of Widal slide agglutination test against Widal tube agglutination test in enteric fever

Gaikwad

Rajurkar

2014

Int J Med Public Health

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Introduction: Enteric fever is an endemic disease in India and warrants rapid and affordable diagnosis. The Widal slide agglutination test is a commonly used rapid screening test for this purpose. The literature available on its diagnostic ability in comparison to the tube agglutination test is however scanty. Hence, this study aims to evaluate the effi cacy of the Widal slide agglutination test and the tube agglutination test for the diagnosis of enteric fever. Materials and Methods: A total of 1470 sera were collected during the study period of one year from patients having pyrexia of unknown origin. 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 signifi cant titer for the diagnosis of enteric fever. The results of the slide agglutination test were compared with the tube agglutination test and analyzed using Fisher's exact test. The sensitivity, specifi city, positive and negative predictive values of slide agglutination were calculated using the tube agglutination method as a standard for comparison. Results: Of the 294 slide positive samples, 209 (71.1%) samples tested negative by the tube agglutination test. The sensitivity, specifi city, positive and negative predictive values for the slide agglutination test were observed to be 100 % (CI 95.75-100%), 84.91% (CI 82.93-86.73%), 28.91% (CI 23.84-34.45%) and 100% (CI 99.69-100%) respectively. Conclusion: Serological diagnosis of enteric fever should always be confi rmed by the tube agglutination test rather than depending solely upon the rapid slide agglutination test results.

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“…A positive IgM or IgG either alone or in combination, was regarded as a positive ICT in this study. Detected IgM antibody is suggestive of recent infection and IgG indicates a current or previous infection (Parry et al, 2011). The reason for considering IgG as positive for ICT is that when typhoid infection occurs the immune response mechanism produces both IgM and IgG as well.…”

Section: Discussionmentioning

confidence: 99%

Detection of anti-salmonella antibodies by Immunochromatographic assay at Rajshahi Medical College, Bangladesh

Hasan¹

2013

J. Microbiol. Antimicrob.

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The public health burden of typhoid fever can be substantially reduced by early diagnosis and appropriate antibiotic therapy. This study was conducted in an attempt to assess the reliability of immunochromatographic test (ICT) for the early diagnosis of typhoid fever. Immunochromatographic test to detect IgM, IgG or combined IgM/IgG in serum in 1st week of fever was done for the diagnosis of typhoid fever. Blood samples were taken for culture and Widal test of 100 clinically suspected cases of typhoid fever in 1st week of illness of patients at Outpatient Department of Rajshahi Medical College Hospital (RMCH), Bangladesh. Forty (40) controls of comparable age and sex were also taken including 20 febrile (non-typhoidal) and 20 healthy persons. Blood culture positive cases (16) and Widal test positive cases (15) were considered as typhoid fever patients and the total number was 31. ICT was performed for 31 typhoid fever patients and 40 controls. In this study, out of 31 cases, ICT was found positive in 28 (90.32%) typhoid fever patient, while 03 (15.00%) of the controls also showed ICT positivity indicating its specificity of 92.50%. It is evident from this study that ICT as a reliable diagnostic tool for early diagnosis of typhoid fever was found highly sensitive, rapid and easy to perform. It can be a versatile test for the screening of clinically suspected case of typhoid fever. therefore, ICT have been found to be encouraging in this study.

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The utility of diagnostic tests for enteric fever in endemic locations

Cited by 166 publications

References 151 publications

Validity of Immunoglobulin M Anti Salmonella typhi Serologic Test in Childhood Typhoid Fever

Validity of Immunoglobulin M Anti Salmonella typhi Serologic Test in Childhood Typhoid Fever

Diagnostic efficacy of Widal slide agglutination test against Widal tube agglutination test in enteric fever

Detection of anti-salmonella antibodies by Immunochromatographic assay at Rajshahi Medical College, Bangladesh

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