TMSS Medical College Journal

Background: The enteric fever, caused by Salmonella typhi, is endemic in the sub-continent. The disease can occur in all age group with highest incidence among children. It is transmitted usually by close person to person contact with infected individuals or chronic carriers and rarely from person to person through faeco-oral route. Objective: To compare between blood culture and widal test for lab diagnosis of enteric fever. Materials & Methods: A comparative study was carried out Department of Medicine in Shaheed Ziaur Rahman Medical College Hospital, Bogura during July 2017 to December 2017. Hospitalized 100 patients with acute febrile illness were included in this study and fever for other causes of febrile illness or known disease and those who took antibiotic for the fever 1 week before admission were excluded from this study. Results: Widel test positive was found 61(61.0%) and negative 39(39.0%). Regarding blood culture 72(72.0%) patients was found culture positive and their organisms were salmonella typhi. Regarding bacteria of blood culture, it was observed that S.thphi was found 41(41.0%), S.paratyphi was 19(19.0%), non typoidal salmonella 8(8.0%), other 4(4.0%) and negative blood culture 28(28.0%). The sensitivity (81.9%), specificity (92.9%), accuracy (85.0%), positive predictive value (96.7%), and negative predictive value (66.7%) of widal tests for diagnosis of enteric fever from febrile patients respectively. Conclusion: Widal test has a low sensitivity, specificity and positive predictive value, but it has good negative predictive value which indicates that negative widal test result have a good indication for the absence of the disease.

The enteric fever, caused by Salmonella typhi, is endemic in the sub-continent. The disease can occur in all age group with highest incidence among children." Typhoid fever causes significant morbidity and mortality in developing countries. Disease burden assessment is limited by lack of a high degree of sensitivity and specificity by many current rapid diagnostic tests.” Widal agglutination test which is the main laboratory procedure for diagnosis of typhoid fever in our rural and urban settings has received cautious acceptability and often outright rejection in other places.’ Widal test is routinely used as diagnostic tool to rule out the disease. The diagnostic ability of Widal test is debatable as the test method has a low sensitivity, specificity and positive predictive value (PPV). Therefore, reviewing articles across the world regarding the diagnostic value of Widal test is necessary.® This study was carried out to compare the value of a single acute phase widal test result by blood culture for the diagnosis of enteric fever and to assess how much the widal test is diagnostic for enteric fever where blood culture facilities is not available.