Diagnosis of typhoid fever using a string capsule device

Area of Science:

• Infectious Diseases
• Microbiology
• Gastroenterology

Background:

• Typhoid fever, caused by Salmonella typhi, remains a significant global health concern.
• Accurate and timely diagnosis is crucial for effective treatment and control of typhoid fever.

Purpose of the Study:

• To evaluate the diagnostic sensitivity of duodenal content cultures compared to blood, bone marrow, and stool cultures for Salmonella typhi.
• To assess the influence of illness duration and prior antibiotic therapy on duodenal culture sensitivity.
• To determine the utility of duodenal cultures for Salmonella typhi recovery during antimicrobial treatment.

Main Methods:

• Blood, bone marrow, stool, and duodenal contents were cultured from 36 patients with bacteriologically confirmed typhoid fever.
• Duodenal contents were obtained using a string capsule method.
• Culture results were analyzed for sensitivity and effectiveness in isolating Salmonella typhi.

Main Results:

• Duodenal content cultures demonstrated high diagnostic sensitivity (86%), comparable to bone marrow (75%) and superior to blood (42%) and stool (26%) cultures.
• The sensitivity of duodenal cultures was unaffected by illness duration or previous antibacterial treatment.
• Salmonella typhi was recovered from duodenal contents in 8 of 17 patients on day 7 of chloramphenicol treatment, versus only 2 from stool cultures.

Conclusions:

• Duodenal content culture using string capsules is a sensitive and effective method for diagnosing typhoid fever.
• The procedure is simple, economical, and requires minimal facilities, making it suitable for widespread use.
• This diagnostic approach facilitates bacteriological recovery for antibiotic sensitivity testing, aiding in typhoid fever control efforts.