Evaluation in Papua New Guinea of a urine coagglutination test and a Widal slide agglutination test for rapid diagnosis of typhoid fever.
Two simple rapid tests for the laboratory diagnosis of typhoid fever were evaluated, a coagglutination test for detecting Salmonella typhi antigens in urine and a Widal slide agglutination for detecting serum antibodies. Ninety-two culture-confirmed typhoid cases were compared with 64 non-typhoid fever patients, 50 close contacts of typhoid patients, 30 vaccinated staff and 72 healthy community members. A strong urine Vi coagglutination was found to be 86.5% sensitive and 91.8% specific for typhoid, but was not always easy to read. The slide Widal H was found to be 99% sensitive and 95% specific whereas the slide Widal O was 98% sensitive and 98% specific. These data suggest that a single slide Widal O, at a reciprocal titre of 40, is the most suitable rapid test for the diagnosis of typhoid in a population with low typhoid antibody levels in the community, few other cross-reacting Salmonella infections, and a tendency for patients to present late in the infection.
West
B
B
Papua New Guinea Institute of Medical Research.
Richens
J E
JE
Howard
P F
PF
D000293:Adolescent; D000328:Adult; D000372:Agglutination Tests; D000907:Antibodies, Bacterial / Q000032:analysis*; D000942:Antigens, Bacterial / Q000652:urine*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010219:Papua New Guinea; D011237:Predictive Value of Tests; D012485:Salmonella typhi / Q000276:immunology*; D014435:Typhoid Fever / Q000175:diagnosis*
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial