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Comparison of results obtained by semi-quantitative slide agglutination and tube widal tests in the diagnosis of suspected typhoid fever cases

Authors:Lavanya V, Shivakumar S Solabannavar, Suresh B Sonth.
Int J Biol Med Res. 2013; 4(1): 3001-3003  |  PDF File

Abstract

The diagnosis of enteric fever currently depends upon the isolation of Salmonella from a patient, most commonly by blood culture. This facility is not available in many areas where the disease is endemic. The Widal agglutination test which demonstrates the presence of somatic (O) and flagellar (H) agglutinins to Salmonella in the patient’s serum using O and H antigen suspension, is one of the most utilized diagnostic tests for typhoid fever in developing countries. In the recent past, a rapid slide test was developed which is now the most commonly used technique in local laboratories because of its convenience. The semi-quantitiative slide test provides an approximation to the tube test titre. The present study was an attempt to compare the results of semi-quantitative slide agglutination with that of the quantitative tube method to ascertain any significant difference between the two methods. Methods: Acute phase serum samples from a total of 45 clinically suspected typhoid fever cases were collected over a period of 3 months and subjected to semi-quantitative rapid slide and single tube Widal tests using commercially available Salmonella antigen test kit (Span Diagnostics Limited). Results and conclusion: From the 45 samples studied, 29 (64.4%) were seropositive by semi-quantitative slide method and 19 (42.2%) by tube method with antibody titres > 1/80 for O and > 1/160 for H antigens. Present study shows considerable difference (P<0.05) in the results obtained by the two methods of Widal test, emphasizing the need for confirmation by the quantitative tube Widal test for all suspected cases of typhoid fever.