COMPARISON OF WIDAL AND TYPHOID IMMUNOGLOBULIN M AND IMMUNOGLOBULIN G IN RAPID AND EARLY DIAGNOSIS OF ENTERIC FEVER

Sharanya K; Vinod K; Lakshmi K

doi:10.22159/ajpcr.2016.v9s3.14648

Authors

Sharanya K
Vinod K
Lakshmi K

DOI:

https://doi.org/10.22159/ajpcr.2016.v9s3.14648

Abstract

ABSTRACT
Objective: Typhoid fever is one of the major public health problems in developing countries including India. A simple, reliable, rapid, and early
diagnostic test has been one of the important needs of the clinicians. The present study was carried out to compare the Widal test and typhoid
immunoglobulin 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 were
compared.
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 only
58 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 first
week 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.

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References

Crump JA, Mintz ED. Global trends in typhoid and paratyphoid fever. Clin Infect Dis 2010;50(2):241-6.

Kothari A, Pruthi A, Chugh TD. The burden of enteric fever. J Infect Dev Ctries 2008;2(4):253-9.

Bhutta ZA. Impact of age and drug resistance on mortality in typhoid fever. Arch Dis Child 1996;75(3):214-7.

Parker MT. Enteric infections: Typhoid and paratyphoid fever. In: Collies L, Balows A, Suusman M, editors. Topley and Wilsonâ€™s Microbiology and Microbial Infections. 8th ed., Vol. 3. London: Arnold; 1990. p. 423-46.

Gasem MH, Dolmans WM, Isbandrio BB, Wahyono H, Keuter M, Djokomoeljanto R. Culture of Salmonella typhi and Salmonellaparatyphi from blood and bone marrow in suspected typhoid fever. Trop Geogr Med 1995;47(4):164-7.

Pang T, Puthucheary SD. Significance and value of the Widal test in the diagnosis of typhoid fever in an endemic area. J Clin Pathol 1983;36(4):471-5.

Haque A, Ahmed J, Qureshi JA. Early detection of typhoid by polymerase chain reaction. Ann Saudi Med 1999;19(4):337-40.

Bhutta ZA, Mansurali N. Rapid serologic diagnosis of paediatric typhoid fever in an endemic area: A prospective comparative evaluation of two dot enzyme immunoassays and the Widal test. Am J Trop Med Hyg 1999;61(4):654-7.

Butler T, Scheld WM. In: Goldman L, Ausiello D, editors. Typhoid Fever in Cecil Text Book of Medicine. 22nd ed., Vol. 2. Philadelphia, PA, Pennsylvania: Saunders, An Imprint of Elsevier; 2004. p. 1847-52.

Forbes BA, Sahm DF, Weissfeld AS. Blood Stream Infection in Bailey & Scottâ€™s, Diagnostic Microbiology. 11th ed. St. Louis, Missouri, USA: Mosby, Inc.; 2002. p. 871-83.

Escamilla J, Santiago LT, Uylangco CV, Cross JH. Evaluation of sodium polyanethanol sulfonate as a blood culture additive for recovery of Salmonella typhi and Salmonella paratyphi A. J Clin Microbiol 1983;18(2):380-3.

Mathew R, Jobin SR. A comparative study on methods for diagnosis of enteric fever. Int J Curr Res Rev 2013;5(14):88-95.

Schroeder SA. Interpretation of serologic tests for typhoid fever. JAMA 1968;206(4):839-40.

Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ. Typhoid fever. N Engl J Med 2002;347(22):1770-82.

Simanjuntak CH, Hoffman SL, Darmowigoto R, Lesmana M, Soeprawoto, Edman DC. Streptokinase clot culture compared with whole blood culture for isolation of Salmonella typhi and S. paratyphi A from patients with enteric fever. Trans R Soc Trop Med Hyg 1988;82(2):340-1.

Mantur BG, Bidari LH, Akki AS, Mulimani MS, Tikare NV. Diagnostic yield of blood clot culture in the accurate diagnosis of enteric fever and human brucellosis. Clin Lab 2007;53(1-2):57-61.

Conanan EC, Dayrit MM, Flores BB, Roa RR, Obenza J, Faraon AO, et al. Typhoid fever pseudo epidemic in Oroquieta city: Lessons in the inappropriate use of the Widal test. Field Epidemiol Train Program 1989;65:205-9.

Saha MR, Dutta P, Palit A, Dutta D, Bhattacharya MK, Mitra U, et al. A note on incidence of typhoid fever in diverse age groups in Kolkata, India. Jpn J Infect Dis 2003;56(3):121-2.

Hossain MS. Comparitive Study of Widal Test and DOT Enzyme Immunoassay for Early Seri Diagnosis Typhoid Fever. (Thesis) Bangabandhu Sheikh Mujib. Bangladesh: Medical University Dhaka; 2001.

Jesudason MV, Sivakumar S. Prospective evaluation of a rapid diagnostic test typhidotÂ® for typhoid fever. Indian J Med Res 2006;123:513-6.

Mohanty SK, Ramana KV. Single and unpaired sera tube Widal agglutination test in enteric fever. Saudi J Gastroenterol 2007;13(4):213.

Shukala S, Patel B, Chitinnis DS. 100 years of Widal test and its re appraisal in an endemic area. Indian J Med Res 1997;105:53-7.

Senewiratne B, Senewiratne K. Reassessment of the Widal test in the diagnosis of typhoid. Gastroenterology 1977;73(2):233-6.

Saha SK, Ruhulamin M, Hanif M, Islam M, Khan WA. Interpretation of the Widal test in the diagnosis of typhoid fever in Bangladeshi children. Ann Trop Paediatr 1996;16(1):75-8.

Noorbakhsh S, Rimaz S, Rahbarimanesh AA, Mamishi S. Interpretation of the Widal test in infected children. Iran J Public Health 2003;32(1):35-7.

Malik AS, Malik RH. Typhoid fever in Malaysian children. Med J Malaysia 2001;56(4):478-90.

Duthie R, French GL. Comparison of methods for the diagnosis of typhoid fever. J Clin Pathol 1990;43(10):863-5.

Handojo I, Edijanto SP, Retnowati E, Salim SY. The Widal slide agglutination test (SAT) using antigen from locally prevalent Salmonella typhi as a diagnostic tool for typhoid fever. Folia Med Indones 2003;39(1):29-35.

Pang T, Pothocheary SD. False-positive Widal test in nontyphoid Salmonella infections. Southeast Asian J Trop Med Public Health 1989;20(1):163-4.

Sherwal BL, Dhamija RK, Randhawa VS, Jais M, Kaintura A, Kumar M. A comparative study of typhidot and Widal test in patients of typhoid fever. JIACM 2004;5(3):244-6.

Choo KE, Oppenheimer SJ, Ismail AB, Ong KH. Rapid serodiagnosis of typhoid fever by dot enzyme immunoassay in an endemic area. Clin Infect Dis 1994;19(1):172-6.

Gopalakrishnan V, Sekhar WY, Soo EH, Vinsent RA, Devi S. Typhoid fever in Kuala Lumpur and a comparative evaluation of two commercial diagnostic kits for the detection of antibodies to Salmonella typhi. Singapore Med J 2002;43(1):354-8.