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Comparative analysis of methods for the diagnosis of typhoid fever

Subbulakshmi R .


Background and Objectives -Typhoid fever continues to be one of the leading causes of morbidity and mortality in our country. Conventional methods of diagnosis are gold standard blood culture and supportive Widal test. This study analyzes Typhoid rapid antibody test, a rapid serological test for the diagnosis of typhoid fever and its usefulness for an early diagnosis, its sensitivity and specificity as compared to Widal test. Materials and Methods-The Typhoid rapid IgM IgG test is a lateral flow immuno-chromatographic test specific for Salmonella typhi and separately identifies IgM and IgG antibodies. This study included 81 patients who presented with fever. Clot culture, Widal test and Typhoid rapid antibody test were performed in all patients. Typhoid rapid antibody test and Widal tests were compared for sensitivity and specificity. Results-57 patients out of 81 were clinically suspected to be cases of typhoid fever (Gp-I), while 24 patients were non-typhoidal febrile illness (Gp-II). 10 patients (18 percentage) of the Gp-I were positive for clot culture, 32 (56 percentage) were Widal positive, and 44(77 percentage) were positive for Typhoid rapid antibody test. Gp-II had all patients sterile on clot culture, 5 (21 percentage) were Widal positive, while 4 (17 percentage) tested positive for Typhoid rapid antibody test. Amongst 10 culture positive cases in Gp-I, Typhoid rapid test was positive in 9 patients, while Widal was positive in 6 patients, giving sensitivity of 90 percentage and specificity of 83 percentage as compared to Widal which had sensitivity of 60 percentage and specificity of 79 percentage.Conclusion-Typhoid rapid antibody test is an equally reliable, simple test that gives rapid diagnosis and can be helpful in diagnosis and early institution of therapy.

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