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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
.
Diseases
Validation
Diseases presenting
"positive predictive value"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
carcinoma of the gallbladder
cholangiocarcinoma
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
heparin-induced thrombocytopenia
hodgkin lymphoma, classical
phenylketonuria
thoracic outlet syndrome
typhoid
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