Assessment of Widal Tube Agglutination Test and its Baseline Titres in Amritsar an Endemic Area

ISSN: 2319-7706 Volume 5 Number 10 (2016) pp. 598-604 Journal homepage: http://www.ijcmas.com Typhoid fever, an endemic disease caused by salmonella group of organisms is very common in India due to improper sanitation and poverty. Isolation of the causative organism from the blood and other body fluids remains the definitive test for the diagnosis of typhoid fever. But this isolation requires highly experienced staff and expensive equipments which are lacking in remote settings. Various serological tests for the diagnosis of typhoid fever are available commercially but confusion persists regarding their utility. Widal tube agglutination test which is an affordable easy to perform test can be done in these settings. For the proper interpretation of the test, baseline titres of that endemic area should be known. Aim of this study was to assess the utility of widal test for the diagnosis of typhoid fever in an endemic country like India and to determine the baseline titres of H and O agglutinins against salmonella typhi and salmonella paratyphi in normal persons residing in Amritsar. Serum samples collected from 50 patients of typhoid fever, 50 patients of non typhoid fever and 100 normal healthy individuals residing in Amritsar were subjected to widal test as per manufacturer’s instructions. Data collected was assessed to find sensitivity and Specificity of these tests in an endemic area. Agglutinins against TO and TH were present in 36 % and 41% of normal individuals residing in Amritsar. Significant widal test results were found in 68% of bacteriologically proven patients of typhoid fever and only 4% of non typhoid fever patients. Whereas significant widal test results (TO>160 and TH>320) were not seen in normal individuals residing in Amritsar. Baseline widal titres varies widely in different regions of the same country and in the same region from time to time. Therefore different endemic regions should determine the baseline widal titres for reference and these should be updated every 10-15 years as they are liable to change. Widal test should be done before starting the empiric therapy as widal negative cases can be spared unnecessary antibiotic exposure. There is urgent need for a highly accurate and sensitive test for the diagnosis of typhoid fever in clinical settings till then a properly interpreted widal test has to be relied on in endemic areas. K e y w o r d s