COMPARATIVE STUDIES OF THREE DIAGNOSTIC METHODS FOR TYPHOID FEVER

Author: Ozor Patricia Ginika
Department: Applied Microbiology
Affiliation: Nnamdi Azikiwe University Awka

Efficacy of widal test in the diagnosis of typhoid fever was compared with stool and blood cultures on patient that attended National Orthopedic Hospital Enugu within the months of January to June 2014. 120 (50 males, 70 females, 4 children and 116 adults) samples were tested with two different widal kits (cromatest and spine react) by slide and tube agglutination. 52 tested positive. Stool and blood samples were collected from the positive 52 widal test candidate. Stool was first inoculated into Selenite F and subcultured on Salmonella Shigella Agar (SSA) and Desoxycholate Citrate Agar (DCA) after overnight incubation at 370c. Blood culture was done using brain heart infusion broth and incubated at 370c for 24 hours. 36 (30%), and 16 (13.3%) were positives for stool and blood cultures respectively. Sensitivity of the three methods was compared. Widal test had sensitivity of 90%. Stool cultures had 83% and blood cultures had 44%. Specificity of the methods assessed showed that stool culture had 98% which is greater than widal test and blood culture with 80% and 97% thus justifying stool culture as the best method of diagnosis of typhoid fever. However, from widal test, gender and sex result revealed 48 cases in adults with greatest number occurring between 41-50 years and 4 cases in children which fell between 1-10 years. Females and males had 32 and 20 cases respectively with peak number which also occurred within the range of 41-50 years. In stool culture, 34 isolates were made from adults and 2 from children, 26 from females, 10 from males. Predominance was also observed in males, females and adults within the age range of 31 -40. Blood culture had 12 females, 4 males, 16 adults and none from children. Statistical significance (P<0.05) existed in gender in all the three methods (widal, stool, blood) used while none existed in sex analysis. The Polymerase Chain Reaction (PCR) analysis confirmed the presence of 16 Samonella typhi out of the 18 cultural and biochemically identified Salmonella typhi.

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