Widal Agglutination Research Articles

Incidence of Typhoid Fever Infection among Febrile Patients attending FUDMA Clinic

Typhoid fever remains a public health concern in Nigeria, with its incidence poising substantial challenges to health care systems. Widal agglutination test is largely the only used diagnostic test method for the laboratory diagnosis of Typhoid infection which has been proven to be neither sensitive nor specific. This paper delves into the incidence, contributory factors as well as sensitivity and specificity of commonly used diagnostic tests of typhoid fever infection among febrile patients attending the FUDMA Clinic. A total of 55 Blood and stool samples were analyzed using standard procedures for slide agglutination test (Widal) and stool culture, before culturing, the samples were first inoculated in an enrichment medium (Selenite-F broth). After 4 hours of pre-enrichment, the samples were inoculated into Salmonella Shigella Agar and Mackonkey agar, while catalase, TSI, citrate utilization test, Indole test, and urease tests served to identify the organism biochemically. Socio-demographic data revealed that 55 Participants, 52.8% were males, 72.7% were students and 80% were singles. Slide agglutination test recorded a 90.9% incidence rate, stool culture had an incidence rate of 18.18%. Among the age groups that enrolled in this study, a 44.1% incidence rate was recorded among the age Group 20-26 years. Stool culture was to found have performed better diagnostically with a sensitivity of 60% as well as a specificity of 40%. Conclusively, A high Incidence of typhoid fever was observed in this study. This Therefore suggests that there is an urgent need for improved personal hygiene and more accessibility to potable drinking water.

COMPREHENSIVE ANALYSIS OF SALMONELLA ANTIBODY PREVALENCE IN PATIENTS USING WIDAL TITER AT A TERTIARY CARE INSTITUTION IN NORTHEAST DELHI

Introduction: Enteric fever continues to pose a significant public health challenge in India. The detection of enteric fever through laboratory diagnosis relies predominantly on serological tests. Among these tests, the widal test stands out as a cost-effective, readily accessible, and widely employed method for serologically diagnosing enteric fever. Objective: This study aimed for comprehensive analysis of Salmonella antibody prevalence in patients using widal titer at a tertiary care institution in north-east Delhi. Method: This is a cross-sectional observational study, that employed the widal tube agglutination test to 9,665 blood samples over a period of eighteen months (January 2022 to July 2023) for the serodiagnosis of enteric fever. Results: In a year and a half study, 11% of the population exhibited significant agglutination titre of ≥1:128, indicating exposure to infection. The estimated prevalence of enteric fever by Salmonella Typhi, paratyphi A and B detected by the widal test was 10.98%, 0.54%, and 0.052%, respectively. Notably, two distinct surges in enteric cases were observed during the late winter to early spring and during monsoon. Enteric predominantly affected females (55.7%) compared to males (44.2%). The age group most affected was 11 to 30 years, with a prevalence of 51.9%, followed by young children aged between 1-10 years (30.5%). Conclusion: Enteric fever remains a significant healthcare concern in India, particularly among the younger demographic. The diagnosis of enteric fever still predominantly relies on serological testing, such as the widal test, in developing nations.

Comparative analysis of widal agglutination and typhoid humoral response assays in febrile patients at Kebbi State, Nigeria

Comparative analysis of widal agglutination and typhoid humoral response assays in febrile patients at Kebbi State, Nigeria

Malaria and Typhoid Fever Coinfection among Febrile Patients Attending Kafin-Maiyaki Primary Health Centre

Study’s Novelty/Excerpt This study investigates the burden and co-existence of malaria and typhoid fever among febrile patients, providing a rare examination of these symptomatically similar but aetiologically distinct diseases in a single patient cohort. The novelty of the research lies in its detailed analysis of co-infection rates across different age groups and genders, highlighting significant age-related disparities and suggesting the higher vulnerability of older patients. These findings underscore the importance of concurrent screening for malaria and typhoid fever in febrile patients, offering critical insights for improving diagnostic and treatment strategies in the study area. Full Abstract Malaria and typhoid fever are two symptomatically similar but aetiologically dissimilar diseases: mala ria is caused by parasitic agents from Plasmodium species; ty phoid fever, on the other hand, is caused by Salmonella typhi. They both have no gender distinction in terms of their effect, but malaria appears to be more severe among children. The study aimed to determine the burden of these two diseases among febrile patients in the study area by collecting four (4) mL of blood from each participant, 2 mL of which were dispensed into EDTA bottles for use to detect microscopic parasites. The harvested serum from the remainder was used for the Widal agglutination test to detect the presence of antibodies to Salmonella species. Based on the results, malaria and typhoid fever co-existence was found to be 20.9%. The findings with respect to age group revealed that patients >60 years had a higher coinfection rate of 75% while the 1-12 years age group had the least coinfection (10.6%). There was a significant association between coinfection and age groups (p = 0.019). With respect to gender, females were more prone to be co-infected (53.6%) compared to their male counterparts (46.4%) out of the total positive cases (28) obtained, but the observed difference was not statistically significant (p = 0.016). We therefore recommend concurrent screening of these diseases in all febrile cases in the study area.

Malaria and Typhoid Co-Infection among Children under 5 Years of Age at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Anambra State, Nigeria

This study sheds light on the prevalence of malaria and typhoid in children below the age of five in a hospital in Nigeria. This study aimed to determine the presence of malaria, typhoid and malaria-typhoid co-infection in children less than five years of age. In this community-based descriptive, quantitative and cross-sectional hospital-based survey, the blood samples of 125 children between 0 to less than 5 years (68 males and 57 females) were examined for the presence of malaria parasites and typhoid infection. Blood samples were collected using venepuncture. The malaria parasitaemia was detected using malaria microscopy on a thick blood film. Typhoid fever infection was detected using the Widal Agglutination Test. The chi-square test was used to compare the prevalence of malaria, typhoid fever and malaria/typhoid co-infections between male and female infected and uninfected participants and between children below 1 year and those 1 year and above. P-values less than 0.05 were considered significant. A prevalence of 47.2%, 32% and 16% were recorded for malaria, typhoid and malaria/typhoid co-infection respectively. A mean malaria parasite intensity of 56.8475 (±3.30177) was recorded. There was no significant difference between the prevalence of malaria, typhoid and malaria/typhoid co-infection between the genders and age groups. Also, there was no significant difference between the mean PCV of the infected (33.1610 (±0.80748) and uninfected (34.6667 (0.48441) (P> 0.05). These results underscore the importance of continued efforts to combat these diseases and improve the health and well-being of children in the region.

Epidemiology and Performances of Typhidot Immunoassay and Widal Slide Agglutination in the Diagnosis of Typhoid Fever in Febrile Patients in Bafoussam City, Cameroon: A Cross-Sectional Comparative Study.

Enteric fever is a great public health problem associated with significant illness and death in many endemic countries, and its clinical diagnosis is still daunting. The aim of this study was to determine the prevalence and risk factors of S. Typhi among febrile patients in Bafoussam and to evaluate the diagnostic performances of Widal and Typhidot tests. This was a cross-sectional study among 336 participants visiting three hospitals in Bafoussam from August 1, 2021, to November 31, 2021. Widal test, Typhidot assay, and stool culture were used to screen for salmonellosis with the help of a structured questionnaire. The prevalence of S. Typhi and S. Paratyphi was found to be 62.85% and 37.14%, respectively. The overall prevalence of typhoid fever using stool culture was 20.86%. The significant risk factors associated with enteric fever were lack or insufficient knowledge of typhoid fever, poor hand hygiene, and anorexia. Typhidot immunoassay was more sensitive (100%) and specific (82.3%) than the Widal test. Both were analytically inferior to stool culture. High prevalence of typhoid fever (20.86%) was observed which was largely associated with lack or insufficient knowledge of typhoid fever, poor hygiene measure, and anorexia as risk factors. The performances of the Widal and Typhidot test against a stool culture were inferior but with Typhidot better than the Widal slide agglutination.

Health facility-based prevalence of typhoid fever, typhus and malaria among individuals suspected of acute febrile illnesses in Southwest Region, Ethiopia.

Acute febrile illnesses such as typhoid fever, typhus, and malaria are still major causes of hospital admission in many parts of Ethiopia. However, there are substantial gaps in the monitoring systems, which result in a lack of knowledge about the geographic distribution and role of common pathogens, particularly in rural areas. Thus, this study was aimed at assessing the seroprevalence of typhoid fever, typhus, and malaria among suspected acute febrile patients at the MTU Teaching Hospital and Mizan-Aman Health Center, Southwest region of Ethiopia. A health facility-based cross-sectional study was carried out from July to October 2022. Blood samples were collected from a total of 384 individuals. Widal and Weilfelix direct card agglutination and tube agglutination test methods were used for the Salmonella enterica serotype Typhi (S. typhi) and Rickettsia infections. The diagnosis of malaria was made using thick and thin blood smears. Questionnaires given by interviewers were used to gather information on risk factors and other sociodemographic factors. The data was analyzed using STATA/SE 14.0. A total of 371 patients were tested for S. Typhi and Rickettsia infections using direct card agglutination and tube agglutination methods. Using the screening test, 20.5% (76/371) patients were reactive either for O or H antigens or both, of which 55.3% (42/76) were reactive by the titration test at the cutoff value ≥ 1:80. About 17.5% (65/371) were reactive to OX19 antigen by card agglutination test, and of which 58.5% (38/65) were reactive by the titration test at the cutoff value ≥ 1:80. The overall seroprevalence of S. Typhi and Rickettsia infections using combined direct card and tube agglutination techniques was 11.3% (42/371) and 10.2% (38/371), respectively. Out of 384 suspected malaria patients, 43 (11.2%) were found positive either for P. falciparum, 27 (7.03%), or P. vivax, 16 (4.2%). In this study, typhoid fever, typhus, and malaria were found among symptomatic acute febrile patients. To increase disease awareness, it is necessary to provide sustainable health education about risk factor behaviors, disease transmission, and prevention strategies. In addition, improving laboratory diagnosis services and early treatment may also lower the likelihood of potentially fatal consequences.

Rapid stool antigenic test for typhoid fever among suspected cases, Northeast, Ethiopia

Typhoid fever continued to be the key cause of morbidity and mortality in developing countries with poor hygienic practices and limited access to safe drinking water. The Widal card agglutination test is the main diagnostic tool in Ethiopia, which is limited in differentiating the overlapping symptoms with other acute febrile illnesses such as malaria and viral enteritis. This eventually leds to unnecessary antibiotic use and eventual drug resistance. Therefore this study wants to assess the burden and associated potential risk factors of typhoid fever among suspected cases using the typhoid rapid stool antigen test in Northeast Ethiopia. A hospital-based cross-sectional study was conducted at Gaint and Meket Shediho primary hospitals from May to July 2021. A total of 255 patients clinically suspected of typhoid fever, and willing to grant informed consent were included systematically. The demographic and hygiene-related variables were collected using a pre-tested structured questionnaire. The rapid stool antigenic test and xylose-lysine-deoxycholate agar (XLD) stool culture were evaluated for the level of agreement. The present study indicated that the prevalence of typhoid fever was 15.3%. This displayed that the human-restricted infectious disease, typhoid fever remained a challenge to Ethiopians. Washing hands with soap, history of typhoid fever, having previous history of hospitalization, and chronic underlying disease was the significant potential factor for typhoid fever. The higher agreement of the rapid stool antigenic test with the stool culture can indicate the factual burden of typhoid fever in the suspected population. This could minimize empiric treatment and the possible emergence of drug resistance. Thus, resource-poor settings may need to look for a rapid and reliable stool antigenic test.

Early Diagnosis of Typhoid Fever: Uses of Clinical Profile, Blood Culture and IGM Antibody: A Prospective Study from a Tertiary Care Centre in Western Uttar Pradesh

Objective:• To study clinical profile of typhoid in children.• To study Comparison of clinical profile and its correlation with blood culture and IgM antibody detection testfor early diagnosis of fever.• To study blood culture and widal at tertiary care centre in western UP.Methods: The study was carried out in Department of Pediatrics, Saraswathi Institute of Medical Sciences, Hapur,UP. All the children presenting with fever, aged from 6 months to 18 years, visited in the pediatric OPD(outpatientdepartment) and IPD(in patient department) of Saraswathi Institute of Medical Sciences from November 2020 toOctober 2022 were included in the study.Results: IgM antibody test was found positive in total 167 cases and negative in 63 cases. Also, blood culture wasreported positive in 157 cases and negative in 73 cases. Out of total positive IgM antibody, 138 showed positivefor blood culture and 29 were reported negative in blood culture. Out of total negative IgM antibody, 19 showedpositive for blood culture and 44 were reported negative in blood culture.Conclusion: Present study shows that typhoid IgM procedure is more sensitive than the established Widalagglutination assay and results can be obtained within 15 minutes while widal agglutination test can be doneafter 1 week. Typhi IgM test can be done after 72 hours of illness as IgM antibody becomes positive after 3 days ofinfection with Salmonella typhi. It is cost effective and can be done bed side.

Prevalence of typhoid fever among patients attending Murtala Muhammad Specialist Hospital Kano

Typhoid fever poses a serious public health problem in Nigeria and is largely diagnosed based on the Widal agglutination test which has been proven to be neither sensitive nor specific. This study determined the prevalence of typhoid fever using both Widal agglutination test and blood culture using automated microbiology systems (BD BACTEC). The study was carried out among 90 patients attending Murtala Muhammad Specialist Hospital in Kano. Out of the 90 cases recruited for the study, none of the cases (0, 0.0%) had S. Typhi isolated using blood culture. However, 18 cases (20%) had other bacteria which are not S. Typhi isolated using blood culture while 72 cases (80%) were negative. For the Widal test, 63 cases (70%) were positive for anti S. Typhi O antigen while 27 cases (30%) were negative. Similarly, 42 cases (46.7%) were positive for anti S. Typhi H antigen, while 48 cases (53.3%) were negative. Type of toilet system was found to be significantly associated with non S. Typhi bacteraemia (P=0.021). The studyrecommends the use of other diagnostic test such as molecular techniques to determine the sensitivity and specificity of both Widal and cultural methods.

Malaria And Typhoid Co – Infection Among Patients Attending Some Selected Healthcare Facilities In Kawo Metropolis, Kaduna State, Nigeria

Malaria and typhoid fever are two leading infections of poverty with serious health and socioeconomic impacts, and due to their geographical overlap, co-infections are very common. Their mimicking symptomatology often present with gross misdiagnosis and mistreatment. This study was carried out to determine the incidence of malaria and typhoid co-infections among adult population attending some selected healthcare facilities in Kawo Metropolis, Kaduna, Kaduna State. A cross-sectional study was conducted on Two hundred and seventy six (276) patients. Venous blood samples were collected for Widal and Malaria tests, respectively. The Widal agglutination test was performed by the rapid slide titration method using commercial antigen suspension while the Malaria diagnosis was carried out using antigen based- Rapid Diagnostic Test (RDT). Out of the 276 blood samples analyzed, 184 (66.67%) were positive for malaria, 143 (51.81%) were positive for Salmonella typhi, while 132 (47.83%) were positive for both typhoid and malaria co – infection. However, the prevalence of malaria parasite was statistically significant in relation to sex (p<0.05), as males had 75 (40.76%) prevalence and females, 109 (59.24%). The highest prevalence of typhoid fever was recorded in males 87 (60.84%) while females had the lowest prevalence of typhoid fever 56 (39.16%). Both malaria and typhoid were prevalent among the studied population with high rate of co-infection. Co-infection was higher in females than males and use of herbal medicine for treatment was common. Efforts should be made to improve on the living conditions of the people of Kawo and also, there should be public enlightenment on the preventive and control measures of the two diseases. Since both diseases have similar symptomatology, treatment should be based on adequate laboratory diagnosis. Also, personal hygiene is hereby encouraged among the populace.

Prevalence and Antibiotic Susceptibility Pattern of Salmonella enterica Isolated from Apparently Healthy Students Screened for Salmonella Agglutinins

Infections caused by Salmonella enterica remains a major public health concern worldwide, contributing to the economic burden of both industrialized and underdeveloped countries through the costs associated with surveillance, prevention and treatment of disease. This was a cross-sectional study conducted between October – December, 2021 in which the detection of Salmonella enterica by stool culture was carried out on sixty (60) apparently healthy students screened for Salmonella agglutinin by widal agglutination test. The susceptibility of the Salmonella isolates to commonly used antibiotics was carried out by disc diffusion method. The result showed that 52 (82.7%) subjects were found to be widal positive with at least one of the tested antigens. From these, 26 (86.7%) each were recorded among male and female students respectively. The most common Salmonella agglutinin detected in both male and female belong to the Paratyphi serovar. However, the percentage of the positive titres, 1:320 and 1:160 in both males (p=0.139). and females (p =0.382) were not significantly different. Salmonella enterica was isolated in 11(42.3%) males and 7(26.9%) females, with a combined prevalence of 18(34.6%). For male subjects, Salmonella enterica was more susceptible to ciprofloxacin (81.8%) and ofloxacin (81.8%) and least to nalidixic acid (45.5%). For female gender, Salmonella enterica enterica exhibits multidrug resistance phenotype, accounting for the prevalence of 64.7%. From these, the MDR phenotype was more in female than male but with no statistical difference (P=0.569). The findings of this study established that Salmonella agglutinins are common among apparently healthy. It also shows the limitations of widal agglutination test, since Salmonella species could not be isolated in all the subjects whose sera were widal positive.

Evidence of hepatitis B infection and co-infection with enteric fever among febrile patients in a primary health facility in Kogi State, Nigeria

ABSTRACT Hepatitis B and enteric fever remain infectious diseases of major health concern and the etiologic agents share overlapping regions of high endemicity worldwide. This study determined the seroprevalence of hepatitis B and enteric fever among febrile patients in Ejule metropolis, North-central Nigeria. In a cross-sectional study, blood samples obtained from 200 consenting patients were screened for hepatitis B and enteric fever with standard diagnostics ABON hepatitis B surface antigen (HBsAg) and Widal agglutination tests, respectively. A structured questionnaire was used to collect socio-demographic and risk factor information. Of the 200 sera tested, 20 (10%) had HBV alone, 35 (17.5%) enteric fever while 6 (3%) had both HBV/enteric fever. Males recorded more HBV (12% vs 6.7%), enteric fever (20% vs 13.3%), and co-infection (3.2% vs 2.7%) than their counterpart females. Ages 18–30 years were more predisposed to single and dual infections compared to older categories. Although sex, ages as well as the participants’ occupation were not significantly linked to both infections (p > .05). The prevalence of enteric fever differed significantly with being married (p = .01). The illiterate had a higher prevalence of HBV, enteric fever, and dual infection (16.7%, 25%, and 8.3%) compared to higher educational levels. The study confirms the endemicity of hepatitis B and enteric fever in the area. Their concurrent rate highlights the need for clinicians to always consider the laboratory diagnosis of both diseases among febrile patients in endemic regions for proper management in events of co-morbidity. The high prevalence of both infections in connection with illiteracy shows the need to further intensify education of masses on the predisposing risk factors.

Traditional Widal Agglutination Test Versus Rapid Immunochromatographic Test in the Diagnosis of Enteric Fever: A Prospective Study From South India.

IntroductionEarly diagnosis and treatment are crucial to reducing the morbidity of patients with enteric fever/typhoid fever. Among the available diagnostic tests, the blood culture is considered a gold standard. However, in most of the developing and resource-limited settings, the diagnosis is made utilizing the traditional Widal test and rapid immunochromatographic test (ICT). This study was aimed to compare the diagnostic value and efficacy of ICT and traditional Widal test in the diagnosis of typhoid fever.MethodsA prospective study was conducted, and 40 patients were included in the study. The Widal test and Salmonella enterica serovar Typhi IgM/IgG immunochromatographic test were performed for all the patients. The Widal is a tube agglutination test, and the rapid ICT utilizes the principle of enzyme-linked immunosorbent assay (ELISA). All the samples were also tested for the presence of antibodies (IgG and IgM) against the S. enterica serovar Typhi and the titers against ‘O’ and ‘H’ antigens of S. enterica serovar Typhi. An antibody titer of 1:80 or more against the ‘O’ and ‘H’ antigen was considered positive.ResultsIn the ICT, 24 samples (60%) tested positive for the IgM antibodies, and only 15 samples tested positive and for IgG antibodies. In the Widal test, 27 samples (67.6%) returned positive for antibodies against the S. enterica serovar Typhi ‘O’ antigen. The sensitivity (90% vs 72.73%), specificity (81.25% vs 64%), and accuracy (82.12% vs 64.87%) for the Widal test were found to be more when compared to the ICT.ConclusionThe results indicate that the traditional Widal agglutination test is superior to the rapid ICT in the diagnosis of enteric fever. However, both these tests cannot be considered as gold standards for the diagnosis owing to their low positive predictive values.

Extensively Drug Resistant Salmonella Enterica Serovar Typhi Misdiagnosis In Pakistan: A Matter Of Serious Concern

There have been several outbreaks of antimicrobial resistant (AMR) strains of Salmonella enterica serovar Typhi that cause extensively drug resistant (XDR) typhoid fever in Pakistan. It has been observed that many clinicians use serological diagnostic tests such as Widal agglutination, and TyphiDOT that detects IgM and IgG antibodies against the outer membrane protein of S. Typhi. However, it has been confirmed by many scientists that these test may lead to misdiagnosis against XDR S. Typhi. Due to lack of implementation strategies health authorities are unable to hamper Widal or TyphiDOT tests which are still practiced in many rural and urban areas.

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.

Background The diagnosis of typhoid fever based on the Widal slide agglutination test remains a major hurdle in developing countries due to varied perceptions of the value of the Widal test in determining clinical decision-making. We undertook a study to evaluate the diagnostic performance of the Widal test and the Typhidot immunoassay in patients suspected of having typhoid fever in the Menoua division, West Region of Cameroon. Methods Blood and stool samples were collected from 558 consenting febrile patients on the basis of suspicion of typhoid fever. These patients attended three district health services of the Menoua division between April 2018 and September 2019. These patients had clinical symptoms suggestive of typhoid fever as determined by their consultant. Serum was used for the Widal slide agglutination test and for the Typhidot rapid immunoassay test based on manufacturer's guidelines. A composite reference of fever plus positive coproculture for Salmonella typhi and Salmonella paratyphi was used as the reference. The sensitivity, specificity, and predictive values of the positive and negative tests were calculated as well as Cohen's kappa for agreement between the two tests. Results Of 558 patients, 12.90% tested positive for the reference method, 57.17% tested positive for the Widal slide agglutination test, while 15.59% were positive for Typhidot-IgM. The overall sensitivity, specificity, and predictive values of the positive and negative tests were 80.56%, 94.03%, 66.6%, and 97.03% for Typhidot-IgM and 94.44%, 48.35%, 21.32%, and 98.33% for the Widal slide agglutination test, respectively. Cohen's kappa estimates were 0.1660 (0.121–0.211) and 0.386 (0.312–0.460) for the Widal test and Typhidot immunoassay for 53.6% and 76.16% agreements of all observations, respectively. Conclusion The Widal test was found to have a lower predictive value for the diagnosis of typhoid fever in our setting. However, the Typhidot test, although better, was not ideal. Diagnosis of typhoid fever should therefore rely on adequate clinical suspicion and a positive Typhidot test to improve the clinical management of typhoid fever in our setting.

A comparative evaluation of Typhidot and Widal tests for the detection of agglutinins against typhoid and paratyphoid bacilli in patients’ sera

Background: The term enteric fever includes typhoid fever caused by Salmonella typhi and paratyphoid fever caused by Salmonella paratyphi A, B, and C. Typhoid fever has been virtually eliminated in the developed countries during the past several decades, mainly as a result of improvement in water supply and sanitation, but it continues to be endemic in the resource-limited nations of the world. The control of paratyphoid fever has not been so successful. Bacteriological diagnosis of enteric fever consists of isolation of the bacilli from the patients and the demonstration of antibodies in their sera. Widal testing is cost-effective and gives reports quickly. The Typhidot test is based on the method of immunochromatography test. It is easy to perform, and the results can be preserved for a long time. This study aims to compare the sensitivity and specificity of the Widal test and Typhidot test for the diagnosis of enteric fever. Materials and Methods: This prospective study was carried out at the Department of Microbiology, N.C. Medical College and Hospital, Panipat, Haryana, India, over 6 months from September 2020 to February 2021. In our study, a total of 150 clinically suspected patients were included. First of all, the area for blood collection was cleaned with spirit-soaked cotton and 10 mL of blood was collected with a sterile disposable needle and syringe from a median cubital vein (antecubital vein) of each patient after obtaining informed consent from the patient (from parents in case of age below 18 years). Seven milliliters of blood was immediately transferred to a blood culture bottle by cleaning the cap of the bottle for isolation and identification of causative organisms and 3 mL was transferred to a sterile plain vial for serum separation. Then the qualitative Widal slide agglutination test and Typhidot test were performed on each sample. Results: In the present study, out of the 150 clinically suspected enteric fever cases, maximum positivity 53 (35.33%) was given by the Typhidot test, followed by 36 (24%) given by the qualitative Widal slide agglutination test and 44 (29.33%) given by blood culture for S. typhi and S. paratyphi. Conclusion: Our study highlights the use of Typhidot for early diagnosis of enteric fever and also cross-checks with Widal test and blood culture for the diagnosis of enteric fever. Typhidot tests are easy to perform and less-trained personnel can also perform the test; they have been designed to detect IgM and IgG antibodies to lipopolysaccharide or outer membrane protein antigens of S. typhi and S. paratyphi. It can be useful in the early diagnosis of infection in the initial weeks of primary infection when a single serum sample is available, with a sensitivity and specificity of 90% and 80%, respectively, considering blood culture as a gold standard.

Investigation of Typhoid Fever and their Associated Risk Factors in Children Attending “Deo Gratias” Hospital in Douala, Littoral, Cameroon

Typhoid fever is a communicable disease transmitted by the bacteria Salmonella typhi, related to serotype paratyphi A, B and C. The disease is a significant health concern in most developing countries especially Cameroon. Objectives: The study aimed at assessing the risk factors associated to typhoid fever in children (0-18 years) attending the “Deo Gratias” hospital in Douala. Method: A hospital based cross sectional study from August to September 2018 was carried out in children aged 0-18 years suffering from typhoid fever at the Deo gratias Catholic hospital. Widal slide agglutination and stool culture were the diagnostic test used. Positive confirmed cases were administered questionnaires to evaluate the level of knowledge, attitude and practice toward the disease. Data obtained from respondents was analyzed by descriptive statistics. One-way ANOVA and means comparison using Tukey’s test (α = 0.05) was performed to check whether the population of respondents differed significantly across risk factor practices. Results were finally presented on bar charts, tables and pie chart. Results: Out of 64 patients tested for typhoid, 44 (68.75 %) were confirmed positive. Typhoid fever was more prevalent in females (52.3 %) than in males (47.7 %), with a high proportion in the ages 5-9 years (38.6 %). A significant difference was observed in population of respondents across risk factor practices. Conclusion: Water quality have a great impact on the burden of typhoid fever among children. The identification of risk factors associated to the disease is of great importance in the development of rational control strategies of the disease.

Comparison of rapid serological diagnostic test in diagnosing typhoid fever in a tertiary care centre in western Uttar Pradesh

: In the study we compare the sensitivity and specificity of two commonly used rapid serological test, Widal test and Typhidot, in the diagnosing of Typhoid fever. Serum samples coming to the microbiology laboratory for routine testing over the period from September 2019 to November 2020 were analysed for the comparison for the presence of the Salmonella antibodies by carrying out the Typhidot and Widal tube agglutination test in tertiary care centre.: Out of 580 blood specimen, 49.3% cases were positive by Typhidot and 38.6% cases were positive by Widal method.Typhidot is a rapid and more sensitive test for early diagnosis of typhoid fever. It is now commercially available for the diagnosis of typhoid fever in areas with limited resources. Widal test showed the sensitivity and specificity of 37% & 62.4% respectively. Typhi dot test showed sensitivity of 41.4% and specificity of 56.5%.

A comparative evaluation of rapid card and widal slide agglutination tests for rapid diagnosis of typhoid fever

Background: Typhoid fever is a serious public health problem. It causes severe systemic infection in lesser developed areas of the world. Although blood culture is regarded as the gold standard for diagnosis, it is a time taking procedure. An early and accurate diagnosis is necessary for an effective treatment. Aims: The present study was done to comparatively evaluate rapid card and Widal slide agglutination tests for rapid diagnosis of typhoid cases. Settings and Design: The study design was a cross-sectional descriptive study done over a period of 6 months from January to June 2018. Materials and Methods: A total of 265 patients suspected of typhoid fever who gave their consent were included in the study whose blood samples were tested by both rapid card and Widal slide agglutination tests. Statistical Analysis Used: The collected data were analyzed using SPSS Data Editor Software version 20. Percentage of variables was calculated. Results: Of 265 patients, 97 patients were positive by the Widal slide test, whereas 113 patients were positive by the rapid card test, with 96.9% sensitivity and 88.7% specificity. Of 113 positives, 83 cases were positive for immunoglobulin M (IgM) only, whereas 30 cases were positive for both IgM and IgG. Conclusion: Rapid card test is a simple and easy to perform the diagnostic test for rapid detection of typhoid cases with an additional advantage of separate determination of IgM and IgG antibody, thereby aiding in identification of current infection and previous exposure so that appropriate and timely treatment could be given to the patients.