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Related Experiment Videos

Diagnostic value of the Widal test

G Abraham, B Teklu, M Gedebu

    Tropical and Geographical Medicine
    |December 1, 1981
    PubMed
    Summary

    The Widal test is useful for diagnosing typhoid fever in Ethiopia, especially the H titre, when combined with clinical symptoms. A single test with high titres strongly suggests typhoid, though clinical evaluation remains crucial.

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    Area of Science:

    • Medical Microbiology
    • Infectious Diseases
    • Clinical Diagnostics

    Background:

    • Typhoid fever remains a significant public health concern in Ethiopia.
    • Accurate and timely diagnosis is essential for effective treatment and control.
    • The Widal test is a commonly used serological method for typhoid diagnosis.

    Purpose of the Study:

    • To evaluate the diagnostic utility of a single Widal test for typhoid fever in the Ethiopian context.
    • To compare the performance of Salmonella typhi H and O titres.
    • To assess the impact of clinical presentation and patient groups on test results.

    Main Methods:

    • Retrospective and prospective investigation of three groups: blood culture-proven typhoid patients, non-typhoid patients, and healthy individuals.
    • Analysis of Widal test titres (H and O antigens) in relation to blood culture results.
    • Evaluation of titre levels in different stages of illness and in relation to antibiotic treatment.

    Main Results:

    • Widal titres ≥1:160 for H and O antigens were observed in 82% and 58% of typhoid fever patients, respectively.
    • Low titres (≥1:80) were found in only 4% of healthy individuals and 8% of non-typhoid patients.
    • The H titre elevates earlier and more frequently than the O titre, peaking in the second week of illness; antibiotic treatment did not impact titre rise.

    Conclusions:

    • A single Widal test with titres ≥1:160 (H and/or O) in unvaccinated Ethiopian patients with typhoid-like symptoms is highly suggestive of typhoid fever.
    • The H titre appears more diagnostically useful than the O titre.
    • While the Widal test shows more false positives than false negatives, the clinical picture remains the decisive factor for diagnosis.

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