Title: Comparative study of Dot enzyme immune assay and Widal test in the diagnosis of Typhoid fever in a tertiary care hospital in south Kerala
Authors: Sahira Haneefa, Sumayya K S, Biju Rani V R
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.30
Abstract
Typhoid fever is acute and often life-threatening febrile illnesses caused by systemic infection with the bacteria Salmonella enterica serotype Typhi. The disease is endemic in the Indian subcontinent including Bangladesh, South-East and the Middle East Africa, Central and South America1 . The signs and symptoms of typhoid fever are non specific. So diagnosis relies not only on the clinical features of the disease, but also on investigative methods like culture and sensitivity, detection of agglutinating antibodies to Salmonella typhi by the Widal test. Serologic diagnostic tests for typhoid fever by immunochromatographic test (ICT) are good alternatives2 .
Aim: Comparison of immuno dot and widal test for the detection of typhoid fever among the febrile patients of Medical college, Thiruvananthapuram.
Materials and Methods: A cross sectional study was conducted among febrile patients attended in Govt. Medical college Trivandrum for a period of 6months, from March to September 2015.
Result: Out of 433 cases 26 (6%) were positive and 407 ( 94%) were negative by Widal test, whereas 21 (4.85%) were positive and 413 ( 95.15%) were negative by immunochromatography. Sensitivity and specificity of immunochromatographic method was 80.8% and 100% respectively considering widal as the standard test.
Conclusion: Widal test has been used extensively used as a laboratory tool for diagnosis of typhoid fever in most laboratories, but it is laborious, time consuming and may not be positive in early stages and is to be interpreted judiciously3. ICT is a simple and sensitive test for early diagnosis of typhoid fever. The results can be visually interpreted and is available within one hour.
References
1. Jenkins, C and Gillespie, SH, Salmonella Infections in Gordon, C, Cook and Zumla, AIeditors, in Manson.s Tropical Diseases, 22nd edition, China, Saunders, Elsevier ,2009, pp. 931-952.
2. Bhutta, ZA and Mansurali, Rapid serologic diagnosis of paediatric typhoid fever in an endemic area: a prospective comparative evaluation of two dot-enzyme immunoassays and the Widal test, American Journal of Tropical Medicine and Hygiene1999, vol. 61, pp. 654-657.
3. Dr.Wiseman Pinto M Jose1, Rodrigues Savio, Evaluation of Enterocheck WB - a rapid test for diagnosis of typhoid fever ,IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 11, Issue 6 (Nov.- Dec. 2013), PP 48-51
4. Ananthanarayan, R and Panikar,in Textbook of Microbiology, Chennai, Orient Longman, CKJ 1999, pp. 244-249.
5. Gasem, MH, Dolmans, WM, Isbandrio, BB, Wahyono, Keuter, HM, Djokomoeljanto, R et al., Culture of Salmonella typhi and Salmonella paratyphi from blood and bone marrow in suspected typhoid fever, Tropical Geographical Medicine1995, vol. 47, 164-167.
6. Gautam, V, Gupta, NK, Choudhary, U, Arora, Sensitivity pattern of Salmonella serotypes in Northern India, The Brazilian Journal of Infectious Diseases2002, vol. 6, pp. 281-287.
7. Pearson, RD and Guerrant, Enteric fever and other causes of abdominal symptoms with fever, in Principles Practices of Infectious Diseases, Mandell, GL, Bennet, JE, Dolin, R editors, Churchill Livingstone, New York, London. RL 1995, pp. 998-1012.
8. R. Shyamala, Prevalence of Widal positivity in a tertiary care hospital in South India Der Pharmacia Lettre, 2012, 4 (5):1486-1489.
9. Indu Sharma , T. L Devi1 and S.S Sen, significance of widal test in the diagnosis of typhoid fever in Assam ,India, world journal of pharmacy and pharmaceutical science, Volume 3, Issue 3, 1719-1724
10. Vallab Ganesh Bharadwaj B, Vazhavandal G, Uma A, Chitra Rajalakshmi P. Prevalence of Enteric fever in patients with Pyrexia of Unknown origin. Asian Journal of Biomedical and Pharmaceutical Sciences; 04 (28); 2014; 39-42.
11. House, D, Chinh, NT, Diep, TS, Parry, CM, Wain, J, Dougan, G et al. , Use of paired serum samples for serodiagnosis of typhoid fever. Journal of Clinical Microbiology, vol. 43,pp. 4889-4890.
12. Hatta, M, Goris, MG, Heerkens, E, Gooskens, J and Smits, Simple dipstick assay for the detection of Salmonella typhi-specific IgM antibodies and the evolution of the immune response in patients with typhoid fever, American Journal of Tropical Medicine and Hygiene, HL 2002, vol. 66, pp. 416-421.
13. Wain, J and Hosoglu, the laboratory diagnosis of enteric fever, Journal of Infectious Developing Countries, S 2008, vol. 2, no. 6, pp. 421-425.
14. Jindal N, Bansal R, Grover P, Malhotra rapid diagnosis of typhoid fever, Interna-tional Journal of Bioassays,ISSN: 2278-778.
15. K.Mary Sushi, K.Sivasangeetha, A.Suresh Kumar, Pandi Shastri, A.Ganesan, D.Anitha1,G.Thatchinamoorthy, S.Mini Jacob, Seroprevalence of Leptospirosis, Enteric fever and Dengue in patients with acute febrile illness in Tamil Nadu, India. Indian Journal of Basic and Applied Medical Research; March 2014: Vol.-3, Issue- 2, P.615-623.
16. Tina M. Parker, Clinton K. Murray, Allen L. Richards, Ahmed Samir, Tharwat Ismail, Moustafa Abdel Fadeel,Ju Jiang, Momtaz O. Wasfy, and Guillermo Pimentel, Concurrent Infections in Acute Febrile Illness Patients in Egypt,m. J. Trop. Med. Hyg.,77(2), 2007, pp. 390–39.