Serology of Typhoid Fever in an Area of Endemicity and Its Relevance to Diagnosis

House, Deborah; Wain, John; Hó, Vô Anh; Diep, To Song; Chinh, Nguyen Tran; Bay, Phan Van Be; Vinh, Ha; Duc, Minh; Parry, Christopher M.; Dougan, Gordon; White, Nicholas J.; Hien, Tran Tinh; Farrar, Jeremy

doi:10.1128/jcm.39.3.1002-1007.2001

Cited by 125 publications

(99 citation statements)

References 28 publications

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“…The clinical utility of the dipstick assay was recently also demonstrated in a study performed in Vietnam. 38 A sensitivity of 77% and a specificity of 95% was calculated for the dipstick assay in that study.…”

Section: Discussionmentioning

confidence: 99%

Simple dipstick assay for the detection of Salmonella typhi-specific IgM antibodies and the evolution of the immune response in patients with typhoid fever.

Hatta

Goris²,

Heerkens³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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Abstract. Application of a dipstick assay for the detection of Salmonella typhi-specific IgM antibodies on samples collected from S. typhi or S. paratyphi culture-positive patients at the day of admission to the hospital revealed the presence of specific IgM antibodies in 43.5%, 92.9%, and 100% for samples collected 4-6 days, 6-9 days, and > 9 days after the onset of fever, respectively. The mean sensitivity for samples collected an average of 6.6 days after the onset of fever was 65.3%. Culture was positive in 65.9% of the cases with a final clinical diagnosis of typhoid fever. Testing of paired serum samples from culture negative patients with a final clinical diagnosis of typhoid fever resulted in staining of the dipstick in 4.3% of the samples collected at the day of admission to the hospital and in 76.6% of the samples collected one week later, thereby provided strong supporting evidence of typhoid fever by demonstrating seroconversion in a large proportion of the patients. The dipstick assay may thus also be useful for the serodiagnosis of culture-negative patients with clinical signs and symptoms consistent with typhoid fever. The advantages of the dipstick assay are that the result can be obtained on the same day allowing a prompt treatment, that only a small volume of serum is needed, and that no special laboratory equipment is needed to perform the assay. The stability of the reagents of the dipstick and the simplicity of the assay allows its use in places that lack laboratory facilities.

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Section: Discussionmentioning

confidence: 99%

Simple dipstick assay for the detection of Salmonella typhi-specific IgM antibodies and the evolution of the immune response in patients with typhoid fever.

Hatta

Goris²,

Heerkens³

et al. 2002

The American Journal of Tropical Medicine and Hygiene

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“…We found out that if O antibody titres were high (>1:160) irrespective of culture results, a presumptive diagnosis of typhoid would still be made, and this would be confirmed by considering clinical manifestations of the patient. In addition, a clinician needs to consider other differential diagnoses that would manifest serologically with raised O antibody titres, including schistosomiasis, malaria, rheumatoid arthritis, nephrotic syndrome and ulcerative colitis, nontyphoidal salmonellae, and chronic liver disease [14,15,16].…”

Section: Challenges Of Diagnosis Of Typhoid Fever In Sub-saharan Africamentioning

confidence: 99%

Typhoid fever in sub-Saharan Africa: Challenges of diagnosis and management of infections

Kariuki

2008

J Infect Dev Ctries

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Typhoid fever, caused by Salmonella enterica serovar Typhi (S. Typhi), is a disease transmitted by the faecal-oral route. It continues to be a public health problem in many developing countries in sub-Saharan Africa. School-age children, especially those from resource-poor settings with inadequate water and sanitation systems, are disproportionately affected. It is estimated that a total of 400,000 cases occur annually in Africa, an incidence of 50 per 100,000 persons per year. Lack of effective diagnosis often leads to inappropriate treatment and management of these infections. Additionally, the emergence and spread of S. Typhi strains having multiple resistance to nearly all commonly available drugs in most developing countries has been a major challenge to health care systems, reducing the effective treatment options for the disease, increasing treatment costs and increasing the risk of complications and death. Although not much data from sub-Saharan Africa has been published, it seems clear that typhoid is common in Nigeria, Mali, Ethiopia and Kenya. Given the importance of information on disease incidence for targeting control measures, including improved sanitation and water supply, vaccination and assessing impact, priority should be given to strengthening surveillance systems for typhoid fever.

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“…Blood culture is the 'gold standard' for diagnosis and also gives information about antibiotic sensitivity of the isolate. 3,4 However, prior oral antibiotics use and the cost of cultures, limits its use in the diagnostic approach. The Widal test is very commonly used in our set up but has very variable sensitivity and specificity and problems in interpretation.…”

Section: Introductionmentioning

confidence: 99%

Clinical profile of enteric fever in tertiary care hospital of Kashmir

Mushtaq

Bhat

Rather

et al. 2017

Int J Contemp Pediatr

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Background: Enteric fever is common cause of pyrexia in children and its diagnosis poses several problems, the diagnosis most often remains either as an unsubstantiated clinical impression or a serological diagnosis and occasionally confirmed by blood culture. Typhoid fever is a commonly encountered systemic disease caused by the gram-negative bacteria Salmonella enterica serovar typhi. It is a major public health problem in India. The incidence of enteric fever can be regarded as an index of sanitary measure practiced in our country. Aim of our study was to know the clinical profile, hematological features of clinically and serologically suspected typhoid cases, antibiotic pattern in use, the time to defervescence with the treatment received and over all hospital stay days. Methods: This was a retrospective record file review of all admitted children for pyrexia under evaluation who were clinically suspected as cases of enteric fever and serologically proven by significant titres of O and H antigen and few were culture proven cases of enteric fever carried out at a tertiary care children hospital in Kashmir valley over the period January 2012 to January 2016. Results: During this period, a total of 129 children with typhoid fever were admitted to Pediatric ward. Of the 129 children, 69 (53.5%) were boys and 60 (46.5%) were girls. The age range of the study population was 1 year to 15 years. The predominant symptoms of typhoid fever were fever 123 (95.3%), anorexia/weakness 58 (45.0%), abdominal pain 53 (41.1%), pallor 47 (36.4%), coated tongue 42 (32.6%), headache 30 (23.3%) and gastrointestinal symptoms/ dysentry 9 (7.0%). Diarrhea 25 (19.4%) was more common than constipation 5 (3.9%) in this study. Hepatomegaly 26 (20.2%) and splenomegaly 67 (51.9%), lymphadenopathy 24 (19.4%) and seizure in 5 cases (3.9%) were other major physical findings. Typhoid complications were seen in the form of jaundice (deranged LFTs) 25 (19.4%), abdominal distention 20 (15.5%) and tenderness 14 (10.9%), encephalopathy 5 (3.9%), shock 3 (2.3%) and UTI 4 (3.1%). Blood culture was positive in 36 (27.9%), 20 (15.5%) percent of the isolates were Salmonella typhi, while 16 (12.4%) were Salmonella paratyphi A. low yield was attributed to oral antibiotics received outside hospital setting. Ceftriaxone was used to treat all the patients diagnosed with enteric fever. Oral Azithromycin was added to treatment regime in those patients who were persistently febrile after 6 days. Those patients who were discharged before 14 days, therapy was completed with oral cefixime. The mean duration of hospital stay was 9.6 days for uncomplicated cases. Leukopenia was seen in majority of the patients with mean cell count of 6492.7cubic/mm. The mean time to defervescence in patients who received prior antibiotics was 4 days while that in those who did not receive prior antibiotics was 5 days. Conclusions: Atypical presentations are seen in typhoid fever patients so we need to be cautious about it, clinical symptoms and signs can vary with different ...

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Serology of Typhoid Fever in an Area of Endemicity and Its Relevance to Diagnosis

Abstract: Currently, the laboratory diagnosis of typhoid fever is dependent upon either the isolation of

Cited by 125 publications

References 28 publications

Simple dipstick assay for the detection of Salmonella typhi-specific IgM antibodies and the evolution of the immune response in patients with typhoid fever.

Simple dipstick assay for the detection of Salmonella typhi-specific IgM antibodies and the evolution of the immune response in patients with typhoid fever.

Typhoid fever in sub-Saharan Africa: Challenges of diagnosis and management of infections

Clinical profile of enteric fever in tertiary care hospital of Kashmir

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