Laboratory Diagnosis of Typhoid Fever using Widal and Blood culture Methods in Aba, Southeastern Nigeria

Abstract

The emergence of multidrug resistance strains of Salmonella typhi poses a big challenge to the eradication of typhoid fever. Typhoid fever shares similar transmission factors with malaria, and require careful and accurate laboratory diagnosis for effective treatments of patients. Increased request for Widal test as a quick diagnosis of typhoid fever has produced exaggerated results since typhoid fever and malaria often show mimicking symptoms even in laboratory diagnosis. The main objective of this study is to investigate the rate of infection of typhoid fever in Aba, southeastern Nigeria, using Widal test and blood culture methods. Widal and blood culture were carried out on all the samples. Out of 400 blood samples examined, comprising of 126 (31.5%) males and 274 (68.5%) females, 98 (24.5%) were tested positive for Salmonella typhi using the Widal test while the blood culture method only recorded 37 (9.3%). On age-related prevalence, the age bracket 31-40 years showed the highest prevalence rate for both methods with 23 (32.4%) for Widal test and 9 (12.7%) for blood culture method. Sex-related prevalence also showed that more males (34.9% and 11.1%) were infected with Salmonella typhi than females (19.7% and 8.4%) for Widal and blood culture methods respectively. The result of this study shows a significant mean difference (t-value = 2.95, p-value = 0.026) between Widal and Blood culture at 5% level of significance. The blood culture test was found to be more sensitive than the widal test. It is therefore recommended that the assumingly high incidence of the disease using Widal test will be greatly reduced if blood culture technique is routinely adopted as a baseline for the diagnosis of typhoid fever.