Comparative study of Typhidot-M with Widal and blood culture in diagnosis of enteric fever
Journal Title: Indian Journal of Child Health - Year 2017, Vol 4, Issue 1
Abstract
Objective: To evaluate the diagnostic utility of Typhidot-M and Widal test in the early diagnosis of enteric fever (EF) in terms of sensitivity and specificity. Methods: The study included 270 children in the age group of 1-18 years admitted to the Department of Pediatrics from November 2012 to February 2014, with fever of 5 days or more and with clinical symptoms and signs suggestive of typhoid fever. Detailed history and clinical examination findings were recorded on a standard pro forma. Complete hemogram (hemoglobin, platelet count, and total and differential leukocyte count), Typhidot-M test, Widal tube test, and blood culture were done on day 1 of admission. For Widal test, a titer of 1 in 160 or more for “O” agglutinins and a titer of 1 in 320 or more for “H” agglutinins were considered as positive results. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results: Of 270 children included in the study, Salmonella typhi was isolated from 82 samples (30.4%) and the remaining 188 (69.6%) were blood culture negative. Widal test was positive in 107 children (39.6%) and Typhidot-M was positive in 136 (50.4%). The sensitivity was 78%, specificity was 79.3%, PPV was 59.8%, and NPV was 91.4% for Widal test. Typhidot-M test had a sensitivity of 81.7%, specificity of 84.6%, PPV of 69.8%, and NPV of 91.4%. Conclusion: Prompt diagnosis of EF is essential for appropriate management and it is, therefore, important to have a satisfactory test to replace conventional tests used for diagnosis. The present study compares newer test (Typhidot-M) against conventional tests such as Widal test and blood culture, and it appears to be a practical alternative to Widal test in the early detection of EF even in the resource-poor laboratories as it neither requires much laboratory equipment nor laboratory expertise to conduct the test. This test can be done within 7 days of illness, but whenever feasible confirmation with blood culture is strongly recommended, especially with the well-documented presence of multidrug-resistant strains of salmonella typhi worldwide. However, both Widal and Typhidot-M appear to correlate less satisfactorily with blood culture, and thus, there is a need for developing a test which allows accurate and early diagnosis of EF to manage a child effectively and limit its morbidity and mortality.
Authors and Affiliations
S Udayakumar, K Pushpalatha, H M Naveen Sagar, P M Swathi, Raksha Yoganand2, C Sushma
Keywords
Related Articles
- EP ID EP454124
- DOI -
- Views 98
- Downloads 0
Risk factors for complicated appendicitis among pediatric population
Context: Appendicitis is the most common surgical emergency in children. In children, it is difficult to diagnose appendicitis due to atypical presentation. Various risk factors have been mentioned in literature leading...
Study of prenatal, natal, and neonatal risk factors associated with autism
Introduction: Autism spectrum disorder is one of the common developmental disabilities. Underlying autism etiology is most likely polygenic but environmental factors may also contribute. Obstetrical and neonatal risk fac...
Clinical profile and outcome of scorpion sting envenomation in children at a tertiary care centre in South India
Background: Clinical manifestations from scorpion sting envenomation ranges from mild local pain to systemic manifestation involving multiple systems. With recent protocol guided management the mortality has reduced to a...
Scimitar syndrome - A rare cause of recurrent pneumonia
Scimitar syndrome is a congenital anomaly characterized by anomalous drainage of the right lung into inferior vena cava. This may be associated with other anomalies in the form of pulmonary hypoplasia, systemic arterial...
To study the incidence of retinopathy of prematurity in high-risk neonates and the risk factors associated with the disease
Background: Retinopathy of prematurity (ROP) is a complex disease of the developing retinal vasculature in premature infant. The challenge in India is that a large number of neonatal intensive care units (NICUs) don’t ha...