title: Clinical value of Tubex and Typhidot rapid diagnostic tests for typhoid fever in an urban community clinic in Bangladesh.
abstract: Tubex and Typhidot, rapid tests for typhoid fever, performed well in evaluations conducted in hospital settings among patients with culture-confirmed typhoid fever. We evaluated these tests in a community clinic in Bangladesh. Blood samples were obtained from 867 febrile patients for culture, Typhidot and Tubex tests. Considering the 43 blood culture-confirmed cases of typhoid fever as typhoid positive and the 24 other confirmed bacteremia cases as typhoid negative, Tubex was 60% sensitive and 58% specific, with 90% positive and 58% negative predictive values (NPVs); Typhidot was 67% sensitive and 54% specific, with 85% positive and 81% NPVs. When blood culture-negative patients and other bacteremia cases together were considered typhoid negative, positive predictive values were only 14% for Tubex and 13% for Typhidot, increasing to only 38% and 20% when restricted to patients with > or = 7 days of fever. We conclude that the value of Tubex and Typhidot tests for typhoid fever diagnosis in a community clinic in urban Bangladesh is low.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka 1212, Bangladesh. anaheed@icddrb.org
authors.forename: Aliya
authors.initials: A
authors.lastname: Naheed
authors.forename: Pavani K
authors.initials: PK
authors.lastname: Ram
authors.forename: W Abdullah
authors.initials: WA
authors.lastname: Brooks
authors.forename: Eric D
authors.initials: ED
authors.lastname: Mintz
authors.forename: Md Anowar
authors.initials: MA
authors.lastname: Hossain
authors.forename: Michele M
authors.initials: MM
authors.lastname: Parsons
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000382:microbiology; D001459:Bangladesh; D001769:Blood / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012485:Salmonella typhi / Q000302:isolation & purification*; D012680:Sensitivity and Specificity; D014435:Typhoid Fever / Q000175:diagnosis* / Q000382:microbiology; D014505:Urban Population