COMPARISON OF TUBE WIDAL TEST AND SLIDE WIDAL TEST IN THE DIAGNOSIS OF ENTERIC FEVER

R. RADHIKA¹*, N. SUBATHRA^2
1Department of Microbiology, Coimbatore Medical College, Avinashi road, Coimbatore, 641 014, Tamilnadu, India
²Department of Microbiology, Government Mohan Kumaramangalam Medical College, Salem, 636 030, Tamilnadu, India
* Corresponding Author : radhikasoubarnika@gmail.com

Received : 25-03-2017     Accepted : 14-04-2017     Published : 28-04-2017
Volume : 9     Issue : 4       Pages : 888 - 890
Int J Microbiol Res 9.4 (2017):888-890

Keywords : Typhoid fever, Slide Widal test, Tube Widal test, Titer
Conflict of Interest : None declared
Acknowledgements/Funding : We gratefully acknowledge Dr. Rajendran, B.Sc., MD., Professor and HOD (Rtd) of Microbiology, Coimbatore Medical College, Coimbatore for his suggestions and support. We also thank all the Laboratory Personnel who gave us technical support.
Author Contribution : All author equally contributed

Background and Objective: Typhoid fever has been remaining important public health Problem in developing countries for the past hundred years. In developing countries, the culture facilities for isolation of Salmonella are often not available at smaller set ups and the patients usually present to the clinicians during the late course of the illness during which the organism could not be isolated from blood culture. So the Widal test still remains the only serological test to diagnose Typhoid fever. This study is aimed to evaluate the diagnostic accuracy and reliability of Slide Widal test with Tube Wida ltest in the diagnosis of enteric fever. Methods: Serum samples were obtained from 300 patients, clinically suspected to have Typhoid fever. Serum samples were also obtained from 300 patients with febrile diseases other than typhoid fever to use them as controls. All samples were tested using Slide Widal test, semi-quantitatively and Tube Widal test quantitatively for the presence of O and H agglutinins for S typhiin the Microbiology Diagnostic Laboratory, Govt. tertiary hospital over a period of six months (June 2011–November 2011).All samples which showed positive clumps in slide Widal agglutination tests were again tested with Tube Widal test. The significant titer for O agglutinin 1:80 and for H agglutinin 1:160 were taken as positive. Results: Slide Widal test showed many false positive reactions (56.6%) which were negative by Tube Widal test and clinically proved to be non - enteric cases. Of 276 slide positive samples only 99 (43.4%) samples showed positive by tube Widal test. Comparison of results of both the tests were carried out statistically to analyze the sensitivity, specificity, Positive Predictive value and Negative Predictive values using tube Widal test as a standard one. Conclusion: Slide Widal test should not be used to confirm the serological diagnosis of enteric fever and laboratories should perform only Tube Widal test, which is conventional, more reliable test for detecting antibodies and can be done in any set up. In addition, the slide Widal test has more sensitivity (75.3%) and Negative Predictive Value (77.2%) when compared to tube Widal test (Sensitivity 32.6%; NPV 59.6%). So the slide Widal test could be used as a good initial screening test for Typhoid fever.

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