THE STUDY OF PERFORMANCE AND DIAGNOSTIC EFFICACY OF WIDAL TEST AND STOOL CULTURE IN THE DIAGNOSIS OF TYPHOID FEVER AMONG SUSPECTED PATIENTS IN LOW INCOME COUNTRIES : A COMPREHENSIVE SYSTEMATIC REVIEW
DOI:
https://doi.org/10.61841/zpd73041Keywords:
Typhoid, LMIC, widal test, stool, diagnosticAbstract
Background: Typhoid fever is a significant health challenge in low- and middle-income countries (LMIC) due to inadequate access to clean water and sanitation infrastructure. The prevalence of typhoid fever, as determined by the Widal test, has quadrupled between 2014 and 2018, with sub-Saharan Africa having the highest infection load. Inadequate diagnosis and treatment are crucial to prevent complications. Rapid serological tests, lack of standard laboratory practices, and limited disease surveillance systems contribute to the uncertainty in disease burden.
Methods: Following PRISMA 2020 guidelines, this systematic review concentrated on full-text English literature published between 2014 and 2024. Editorials and review articles that appeared in the same journal as the submission were not accepted without a DOI. The literature was assembled using a variety of online databases, including ScienceDirect, PubMed, and SagePub.
Result: Utilizing reliable resources including Science Direct, SagePub, and PubMed, the study examined around 800 papers. After seven pieces were determined to be relevant for methodical investigation, a more thorough examination of the complete material was conducted.
Conclusion: Diagnostics for typhoid fever, a common illness in low- and middle-income countries, mostly depend on the Widal test. On the other hand, variables such as malaria parasitemia, antigen standardization, and patient population affect how accurate the test is. The suggested diagnostic strategy identifies Salmonella from blood, stool, and bone marrow cultures; this calls for significant upgrades to laboratory resources as well as continuous training.
References
Akinyemi, K. O., Oyefolu, A. O. B., Mutiu, W. B., Iwalokun, B. A., Ayeni, E. S., Ajose, S. O., & Obaro, S. K. (2018). Typhoid fever: Tracking the trend in Nigeria. American Journal of Tropical Medicine and Hygiene, 99(3), 41–47. https://doi.org/10.4269/ajtmh.18-0045.
Britto, C. D., Wong, V. K., Dougan, G., & Pollard, A. J. (2018). A systematic review of antimicrobial resistance in Salmonella enterica serovar Typhi, the etiological agent of typhoid. PLoS Neglected Tropical Diseases, 12(10), 1–15. https://doi.org/10.1371/journal.pntd.0006779.
Sur, Di., Barkume, C., Mukhopadhyay, B., Date, K., Ganguly, N. K., & Garrett, D. (2018). A Retrospective Review of Hospital-Based Data on Enteric Fever in India, 2014-2015. Journal of Infectious Diseases, 218(Suppl 4), S206–S213. https://doi.org/10.1093/infdis/jiy502
Stanaway, J. D., Reiner, R. C., Blacker, B. F., Goldberg, E. M., Khalil, I. A., Troeger, C. E., Andrews, J. R., Bhutta, Z. A., Crump, J. A., Im, J., Marks, F., Mintz, E., Park, S. E., Zaidi, A. K. M., Abebe, Z., Abejie, A. N., Adedeji, I. A., Ali, B. A., Amare, A. T., … Hay, S. I. (2019). The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet Infectious Diseases, 19(4), 369–381. https://doi.org/10.1016/S1473-3099(18)30685-6
Marchello, C. S., Hong, C. Y., & Crump, J. A. (2019). Global typhoid fever incidence: A systematic review and meta-analysis. Clinical Infectious Diseases, 68(Suppl 2), S105–S116. https://doi.org/10.1093/cid/ciy1094
Mahmoud, A., Oluyemisi, A., Uwishema, O., Sun, J., Jobran, A. W., David, S., Wireko, A. A., Adanur, I., Dost, B., & Onyeaka, H. (2023). Recent advances in the diagnosis and management of typhoid fever in Africa: A review. International Journal of Health Planning and Management, 38(2), 317–329. https://doi.org/10.1002/hpm.3599
Marks, F., von Kalckreuth, V., Aaby, P., Adu-Sarkodie, Y., El Tayeb, M. A., Ali, M., Aseffa, A., Baker, S., Biggs, H. M., Bjerregaard-Andersen, M., Breiman, R. F., Campbell, J. I., Cosmas, L., Crump, J. A., Espinoza, L. M. C., Deerin, J. F., Dekker, D. M., Fields, B. S., Gasmelseed, N., … Wierzba, T. F. (2017). Incidence of invasive salmonella disease in sub-Saharan Africa: a multicentre population-based surveillance study. The Lancet Global Health, 5(3), e310–e323. https://doi.org/10.1016/S2214-109X(17)30022-0
Antillón, M., Warren, J. L., Crawford, F. W., Weinberger, D. M., Kürüm, E., Pak, G. D., Marks, F., & Pitzer, V. E. (2017). The burden of typhoid fever in low- and middle-income countries: A meta-regression approach. PLoS Neglected Tropical Diseases, 11(2), 1–21. https://doi.org/10.1371/journal.pntd.0005376
Lemi, B. W. (2019). Typhoid Fever in an Ethiopian Health Center. Journal of Microbiology and Infectious Diseases, 9(July), 150–154. https://doi.org/10.5799/jmid.657883
Habte, L., Tadesse, E., Ferede, G., & Amsalu, A. (2018). Typhoid fever: Clinical presentation and associated factors in febrile patients visiting Shashemene Referral Hospital, southern Ethiopia. BMC Research Notes, 11(1), 1–6. https://doi.org/10.1186/s13104-018-3713-y
Garedew, L., Solomon, S., Worku, Y., Worku, H., Gemeda, D., Lelissa, G., Mamuye, Y., Abubeker, R., Mihret, A., Fentaw, S., Worku, A., Bahiru, M., & Erenso, G. (2018). Diagnosis and Treatment of Human Salmonellosis in Addis Ababa City, Ethiopia. BioMed Research International, 2018. https://doi.org/10.1155/2018/6406405
Awol, R. N., Reda, D. Y., & Gidebo, D. D. (2021). Prevalence of Salmonella enterica serovar Typhi infection, its associated factors and antimicrobial susceptibility patterns among febrile patients at Adare general hospital, Hawassa, southern Ethiopia. BMC Infectious Diseases, 21(1), 1–9. https://doi.org/10.1186/s12879-020-05726-9
Zerfu, B., Medhin, G., Mamo, G., Getahun, G., Tschopp, R., & Legesse, M. (2018). Community-based prevalence of typhoid fever, typhus, brucellosis and malaria among symptomatic individuals in Afar Region, Ethiopia. PLoS Neglected Tropical Diseases, 12(10), 1–16. https://doi.org/10.1371/journal.pntd.0006749
Teferi, M. Y., El-Khatib, Z., Alemayehu, E. A., Adane, H. T., Andualem, A. T., Hailesilassie, Y. A., Kebede, A. S., Asamoah, B. O., Boltena, M. T., & Shargie, M. B. (2022). Prevalence and antimicrobial susceptibility level of typhoid fever in Ethiopia: A systematic review and meta-analysis. Preventive Medicine Reports, 25(May 2021), 101670. https://doi.org/10.1016/j.pmedr.2021.101670
Radhakrishnan, A., Als, D., Mintz, E. D., Crump, J. A., Stanaway, J., Breiman, R. F., & Bhutta, Z. A. (2018). Introductory article on global burden and epidemiology of typhoid fever. American Journal of Tropical Medicine and Hygiene, 99(3), 4–9. https://doi.org/10.4269/ajtmh.18-0032
Zorgani, A., & Ziglam, H. (2014). Typhoid fever: Misuse of Widal test in Libya. Journal of Infection in Developing Countries, 8(6), 680–687. https://doi.org/10.3855/jidc.3700
Islam, K., Sayeed, M. A., Hossen, E., Khanam, F., Charles, R. C., Andrews, J., Ryan, E. T., & Qadri, F. (2016). Comparison of the Performance of the TPTest, Tubex, Typhidot and Widal Immunodiagnostic Assays and Blood Cultures in Detecting Patients with Typhoid Fever in Bangladesh, Including Using a Bayesian Latent Class Modeling Approach. PLoS Neglected Tropical Diseases, 10(4), 1–10. https://doi.org/10.1371/journal.pntd.0004558
Bundalian, R., Valenzuela, M., & Tiongco, R. E. (2019). Achieving accurate laboratory diagnosis of typhoid fever: a review and meta-analysis of TUBEX TF clinical performance. Pathogens and Global Health, 113(7), 297–308. https://doi.org/10.1080/20477724.2019.1695081
Ohanu, M. E., Iroezindu, M. O., Maduakor, U., Onodugo, O. D., & Gugnani, H. C. (2019). Typhoid fever among febrile Nigerian patients: Prevalence, diagnostic performance of the widal test and antibiotic multi-drug resistance. Malawi Medical Journal, 31(3), 184–192. https://doi.org/10.4314/mmj.v31i3.4
Wilairatana, P., Mala, W., Klangbud, W. K., Kotepui, K. U., Rattaprasert, P., & Kotepui, M. (2021). Prevalence, probability, and outcomes of typhoidal/non-typhoidal Salmonella and malaria co-infection among febrile patients: a systematic review and meta-analysis. In Scientific Reports (Vol. 11, Issue 1). Nature Publishing Group UK. https://doi.org/10.1038/s41598-021-00611-0
Fadeel, M. A., House, B. L., Wasfy, M. M., Klena, J. D., Habashy, E. E., Said, M. M., Maksoud, M. A., Rahman, B. A., & Pimentel, G. (2011). Evaluation of a newly developed ELISA against widal, TUBEX-TF and Typhidot for typhoid fever surveillance. Journal of Infection in Developing Countries, 5(3), 169–175. https://doi.org/10.3855/jidc.1339
Hoshino, Y., Masuda, G., Negishi, M., Ajisawa, A., Imamura, A., Hachimori, K., Takayama, N., Yamaguchi, T., & Kimura, M. (2000). Clinical and bacteriological profiles of patients with typhoid fever treated during 1975-1998 in the Tokyo Metropolitan Komagome Hospital. Microbiology and Immunology, 44(7), 577–583. https://doi.org/10.1111/j.1348-0421.2000.tb02536.x
Andrews, J. R., & Ryan, E. T. (2015). Diagnostics for invasive Salmonella infections: Current challenges and future directions. Vaccine, 33(S3), C8–C15. https://doi.org/10.1016/j.vaccine.2015.02.030
Gut, A. M., Vasiljevic, T., Yeager, T., & Donkor, O. N. (2018). Salmonella infection – Prevention and treatment by antibiotics and probiotic yeasts: A review. Microbiology (United Kingdom), 164(11), 1327–1344. https://doi.org/10.1099/mic.0.000709
Deksissa, T., & Gebremedhin, E. Z. (2019). A cross-sectional study of enteric fever among febrile patients at Ambo hospital: Prevalence, risk factors, comparison of Widal test and stool culture and antimicrobials susceptibility pattern of isolates. BMC Infectious Diseases, 19(1), 1–12. https://doi.org/10.1186/s12879-019-3917-3
Pitzer, V. E., Meiring, J., Martineau, F. P., Watson, C. H., Kang, G., Basnyat, B., & Baker, S. (2019). The Invisible Burden: Diagnosing and Combatting Typhoid Fever in Asia and Africa. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America, 69(Suppl 5), S395–S401. https://doi.org/10.1093/cid/ciz611
Andualem, G., Abebe, T., Kebede, N., Gebre-Selassie, S., Mihret, A., & Alemayehu, H. (2014). A comparative study of Widal test with blood culture in the diagnosis of typhoid fever in febrile patients. BMC Research Notes, 7(1), 1–6. https://doi.org/10.1186/1756-0500-7-653
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