Enteric Fever in a Cross-section of Patients in Karachi: Current Correlation of Positive Blood Cultures with the Widal Agglutination and the Typhidot Immunoassay Tests

Authors

  • Farhan Essa Abdullah Department of Pathology, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
  • Amna Shaikh Liaquat Medical and Dental College, Karachi, Pakistan.
  • Maria Abid Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
  • Abu Talib Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.

Keywords:

Enteric fever, Widal, Typhidot, Blood Cultures, Salmonella

Abstract

Objectives: A lab-based scrutiny to assess the correlation of current blood culture Salmonella isolates as the gold standard with matched Widal agglutinin titers and the EIA-based Typhidot immunoassay antibodies.
Methods: 2,704 blood specimens were drawn for culture and Widal test in a private clinical lab in Karachi City from subjects presenting with clinical signs of Enteric fever during April 2012 and March 2013. Of these, 1,497 yielded Salmonella isolates; sera of these patients that were not accompanied with requests for Typhidot were also subjected to dot immunoassay with informed consent solicited at the time of bleeding. All sera were stored at 40C until screened.
Results: Blood from 802 males (53.6%) and 695 females (46.4%) yielded 61.85% S typhi (n=926), 31.26% S. paratyphi-A (n=468) and 6.88% S. paratyphi-B (n=103) isolates. Widal agglutinins were detected in 473 (31.5%) of the sera of these subjects. ‘H’ titers of 1:80 (n=264: 17.6%) without detectable ‘O’ antibodies were seen more frequently in children’s sera (n=112; 7.4%). Widal ‘H’ with ‘O’ agglutinins were recorded in 209 (13.9%) of corresponding positive blood cultures, of which 104 (6.9%) yielded titers of 1:320 or more. A total of 1,024 sera (58.4%) lacked detectable Widal antibodies. The Typhidot immunoglobulin dots, negative in 856 sera (57.1%), were detected in 641 specimens (42.8%).

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References

Crump JA, Mintz ED. Global trends in typhoid and paratyphoid fever. Clin Inf Dis 2010;50:241-6.

Mubeena RS, Saleem AK, Ameena RS, Prevalence of enteric fever in Karachi. Inf Dis J Pak 2006;15:103-5.

Durrani AB, Rab SM. Changing spectrum of Typhoid. J Pak Med Assoc 1996;46:52-2.

Ochiai RL, Camilo JA, Dong B, Sujit KB, Magdarina DA et al. A study of typhoid fever in five Asian countries: disease burden and implications for controls. Bull World Health Organ 2008;86:260-8.

Mweu E, English, M. Typhoid fever in children in Africa. Trop Med Int Hlth 2008;13:532-40.

Siddiqui FJ, Rabbani F, Hasan R, Nizami SQ, Bhutta ZA. Typhoid fever in children: some epidemiological considerations from Karachi, Pakistan. Int J Infect Dis 2006;10:215-22.

Luby SP, Faizan MK, Fisher-Hoch SP, Syed A, Mintz ED, Bhutta ZA, et al. Risk factors for typhoid fever in an endemic setting, Karachi, Pakistan. Epidemiol Infect 1998;120:129-38.

Anjum P, Qureshi AH, Parvez MS, Haq MZU, Hamid M. Increasing prevalence of multidrug resistant Salmonella enterica serotype paratyphi-A in patients with enteric fever. Pak J Med Res 2004;43:56-9.

Butt T, Ahmad RN, Salman M, Kazmi SY. Changing trends in drug resistance among typhoid Salmonellae in Rawalpindi, Pakistan. East Mediterr Health J 2005;11:1038-44.

Hasan R, Zafar A, Abbas Z, Mehraj V, Malik F, Zaidi A. Antibiotic resistance among Salmonella enterica serovar typhi and Paratyphi A in Pakistan (2001-2006). J Infect Dev Ctries 2008;2:289-94.

Chau TT, Campbell JI, Galindo CM, Minh Hoang NV, Diep TS, Nga TT et al. Antimicrobial drug resistance of Salmonella enterica serovar typhi in Asia and molecular mechanism of reduced susceptibility to the fluoroquinolones. Antimicrob Agents Chemother

;51:4315-23.

Parry CM, Hoa NT, Diep TS, Wain J, Chinh NT, Vinh H et al. Value of a Single-Tube Widal Test in Diagnosis

of Typhoid fever in Vietnam. J Clin Microbiol 1999;37: 2882-86.

Choo KE, Razif AR, Oppenheimer SJ, Ariffin WA, Lau J, Abraham T. Usefulness of the Widal test in diagnosing childhood typhoid fever in endemic areas, J Paediatr Child Health. 1993; 29:36-9.

Ilker D, Koray E, Ates K, Hasan T, Inci Y, Ali B. The comparison of cultures, Widal agglutination test and polymerase chain reaction as a diagnostic tool in typhoid fever. Central European J Med 2008; 3:470-4.

Willke A, Ergonul O, Bayar B. Widal test in Diagnosis of Typhoid Fever in Turkey. Clin Diagn Lab Immunol.

; 9: 938–41.

Chew SK,ÊCruz MS,ÊLim YS,ÊMonteiro EH. Diagnostic value of the Widal test for typhoid fever in Singapore. J Trop Med Hyg. 1992;95:288-91.

Taiwo SS, Fadiora SO, Oparinde DP, Olowe OA. Widal agglutination titers in the diagnosis of typhoid fever.

West Afr J Med. 2007;26:97-101.

Saha SK, Ruhulamin M, Hanif M, Islam M, Khan WA. Interpretation of the Widal test in the diagnosis of typhoid fever in Bangladeshi children. Ann Trop Paediatr 1996;16:75-8.

Wain J, Hosoglu S. The laboratory diagnosis of enteric fever. J infect Dev Ctries 2008; 2: 421– 5.

Willke A, Ergonul O, Bayar B. Widal test in diagnosis of typhoid fever in Turkey. Clin Diagn Lab Immunol.

; 9: 938–41.

Mohanty SK, Ramana KV. Single and unpaired sera tube Widal agglutination test in enteric fever. Saudi J Gastroenterol. 2007; 9: 213.

Ismail A, Kader ZS, Hai OK. Dot Enzyme

Immunosorbent Assay for the serological diagnosis of Typhoid. South East Asian J Trop Med Public Health 1991;22:563-66.

Karamat KA, Usman J, Ahmed TA, Abbasi SA. Detection of serum IgM against Salmonella typhi: A rapid diagnostic technique. J College Phys Surg Pakistan 1998;8:170-3.

Chart H, Cheasty T, De Pinna E, Siorvanes L, Wain J, Alam D et al. Serodiagnosis of Salmonella enterica serovar Typhi and S. enterica serovars Paratyphi A, B and C human infections. J Med Microbiol 2007; 56:1161–6.

Abdullah FE, Haider F, Fatima K, Irfan S, Iqbal MS. Enteric fever in Karachi: Current antibiotic susceptibility of Salmonellae isolates. J Coll Phys Surg Pak 2012;22:147-50.

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Published

2013-12-28

How to Cite

Essa Abdullah, F. ., Shaikh, A. ., Abid, M., & Talib, A. (2013). Enteric Fever in a Cross-section of Patients in Karachi: Current Correlation of Positive Blood Cultures with the Widal Agglutination and the Typhidot Immunoassay Tests. Journal of the Dow University of Health Sciences (JDUHS), 7(3), 89–93. Retrieved from https://jduhs.jduhs.duhs.edu.pk/index.php/jduhs/article/view/1536

Issue

Vol. 7 No. 3

Section

Original Articles

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Copyright (c) 2021 Farhan Essa Abdullah, Amna Shaikh, Maria Abid, Abu Talib

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