Retrospective Audit of the Widal Test for Diagnosis of Typhoid Fever in Pediatric Patients in an Endemic Region

摘要

>Introduction: Although typhoid fever is confirmed by culture of Salmonella Typhi, Widal test is widely used in India but little information exists about its reliability.>Materials and Methods: We examined the performance of Widal test in our hospital for diagnosis of typhoid fever in children. Hundred consecutive pediatric in-patients for whom, the Widal test was requested were grouped into four categories: widal positive and clinically consistent with typhoid fever (Group 1; n=42), widal negative but clinically consistent (Group 2, n=12), widal positive but not clinically consistent (Group 3, n=12) and widal negative and also not clinically consistent (Group 4, n=34). The results were analyzed by the test performance criteria, namely, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) using culture-confirmed typhoid fever cases as the “true positives”.>Results: We found that 7/100 patients had culture-proven typhoid fever. Using a cut off ≥ 50 for O agglutinins or ≥100 for H agglutinins, the Widal test gave a sensitivity of 71.43%, specificity of 47.31%, and a positive predictive value of 09.25% and a negative predictive value of 95.65%.>Conclusion: The Widal test is an easy, inexpensive and relatively non-invasive but is not reliable in our set up because of a low PPV. There is a need for a more efficient rapid diagnostic test for typhoid fever.