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Retrospective audit of the widal test for diagnosis of typhoid Fever in pediatric patients in an endemic region.
[typhoid]
Although
typhoid
fever
is
confirmed
by
culture
of
Salmonella
Typhi
,
Widal
test
is
widely
used
in
India
but
little
information
exists
about
its
reliability
.
We
examined
the
performance
of
Widal
test
in
our
hospital
for
diagnosis
of
typhoid
fever
in
children
.
Hundred
consecutive
pediatric
in
-patients
for
whom
,
the
Widal
test
was
requested
were
grouped
into
four
categories
:
widal
positive
and
clinically
consistent
with
typhoid
fever
(
Group
1
;
n
=
42
)
,
widal
negative
but
clinically
consistent
(
Group
2
,
n
=
12
)
,
widal
positive
but
not
clinically
consistent
(
Group
3
,
n
=
12
)
and
widal
negative
and
also
not
clinically
consistent
(
Group
4
,
n
=
34
)
.
The
results
were
analyzed
by
the
test
performance
criteria
,
namely
,
sensitivity
,
specificity
,
positive
predictive
value
(
PPV
)
,
and
negative
predictive
value
(
NPV
)
using
culture-confirmed
typhoid
fever
cases
as
the
"
true
positives
"
.
We
found
that
7
/
100
patients
had
culture-proven
typhoid
fever
.
Using
a
cut
off
≥
50
for
O
agglutinins
or
≥
100
for
H
agglutinins
,
the
Widal
test
gave
a
sensitivity
of
71
.
43
%
,
specificity
of
47
.
31
%
,
and
a
positive
predictive
value
of
09
.
25
%
and
a
negative
predictive
value
of
95
.
65
%
.
The
Widal
test
is
an
easy
,
inexpensive
and
relatively
non-invasive
but
is
not
reliable
in
our
set
up
because
of
a
low
PPV
.
There
is
a
need
for
a
more
efficient
rapid
diagnostic
test
for
typhoid
fever
.
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"efficient rapid diagnostic test"
symptom
typhoid
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