Evaluating alternatives to the Widal test for typhoid fever diagnosis in developing countries: A targeted literature review.

IF 0.6 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Journal of Public Health in Africa Pub Date : 2025-02-14 eCollection Date: 2025-01-01 DOI:10.4102/jphia.v16i1.700
Bereket A Tegene, Meron T Eshetie
{"title":"Evaluating alternatives to the Widal test for typhoid fever diagnosis in developing countries: A targeted literature review.","authors":"Bereket A Tegene, Meron T Eshetie","doi":"10.4102/jphia.v16i1.700","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Typhoid disease, caused by <i>Salmonella typhi</i>, is prevalent in developing countries with poor sanitation. The Widal test, despite its century-old history, has drawbacks in diagnostic capacity because of inherent characteristics, cross-reactivity and repeated exposure to the pathogen in endemic regions.</p><p><strong>Aim: </strong>The study evaluates the utility of the Widal test for the diagnosis of typhoid infections and emphasises the need for a better diagnostic modality in endemic regions.</p><p><strong>Setting: </strong>The study included research conducted in developing countries where typhoid fever is endemic.</p><p><strong>Method: </strong>A targeted literature review was conducted utilising the MEDLINE and Embase databases on 19 October 2022, encompassing publications from the preceding 10 years. Manual searches were executed using Google Scholar and the Google Search Engine on 02 November 2022. The initial search yielded 657 articles, of which 20 met the inclusion criteria and were subsequently incorporated into the final review.</p><p><strong>Results: </strong>The mean sensitivity, specificity, positive predictive value and negative predictive value of the Widal test in this study were 62.94 ± 17.83 (95% confidence interval [CI]: 49.23-76.64); 73.31 ± 18.75 (95% CI: 58.89-87.73); 58.85 ± 40.07 (95% CI: 16.80-100.90) and 75.96 ± 25.93 (95% CI: 46.08-100.45), respectively.</p><p><strong>Conclusion: </strong>The different studies in this review have shown that the Widal test performs poorly in identifying typhoid infections compared to other rapid diagnostic tests (RDTs). In addition, the current alternative RDTs are not accurate enough to reliably identify or rule out typhoid infection.</p><p><strong>Contributions: </strong>A shift in diagnostic approach for typhoid fever in developing countries is required and an accurate and feasible point-of-care test is urgently needed.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"16 1","pages":"700"},"PeriodicalIF":0.6000,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905174/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Public Health in Africa","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/jphia.v16i1.700","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Typhoid disease, caused by Salmonella typhi, is prevalent in developing countries with poor sanitation. The Widal test, despite its century-old history, has drawbacks in diagnostic capacity because of inherent characteristics, cross-reactivity and repeated exposure to the pathogen in endemic regions.

Aim: The study evaluates the utility of the Widal test for the diagnosis of typhoid infections and emphasises the need for a better diagnostic modality in endemic regions.

Setting: The study included research conducted in developing countries where typhoid fever is endemic.

Method: A targeted literature review was conducted utilising the MEDLINE and Embase databases on 19 October 2022, encompassing publications from the preceding 10 years. Manual searches were executed using Google Scholar and the Google Search Engine on 02 November 2022. The initial search yielded 657 articles, of which 20 met the inclusion criteria and were subsequently incorporated into the final review.

Results: The mean sensitivity, specificity, positive predictive value and negative predictive value of the Widal test in this study were 62.94 ± 17.83 (95% confidence interval [CI]: 49.23-76.64); 73.31 ± 18.75 (95% CI: 58.89-87.73); 58.85 ± 40.07 (95% CI: 16.80-100.90) and 75.96 ± 25.93 (95% CI: 46.08-100.45), respectively.

Conclusion: The different studies in this review have shown that the Widal test performs poorly in identifying typhoid infections compared to other rapid diagnostic tests (RDTs). In addition, the current alternative RDTs are not accurate enough to reliably identify or rule out typhoid infection.

Contributions: A shift in diagnostic approach for typhoid fever in developing countries is required and an accurate and feasible point-of-care test is urgently needed.

评估发展中国家用于伤寒诊断的维达尔试验的替代方法:一项有针对性的文献综述。
背景:伤寒由伤寒沙门氏菌引起,在卫生条件差的发展中国家流行。尽管Widal试验已有百年历史,但由于其固有特征、交叉反应性和在流行地区反复接触病原体,它在诊断能力方面存在缺陷。目的:该研究评估了维达尔试验诊断伤寒感染的效用,并强调在流行地区需要一种更好的诊断方法。环境:该研究包括在伤寒流行的发展中国家进行的研究。方法:于2022年10月19日利用MEDLINE和Embase数据库进行有针对性的文献综述,包括近10年的出版物。手动搜索在2022年11月2日使用谷歌Scholar和谷歌搜索引擎执行。初步检索得到657篇文章,其中20篇符合纳入标准,随后纳入最终审查。结果:本研究中Widal检验的平均敏感性、特异度、阳性预测值和阴性预测值为62.94±17.83(95%可信区间[CI]: 49.23 ~ 76.64);73.31±18.75 (95% ci: 58.89 ~ 87.73);分别为58.85±40.07 (95% CI: 16.80 ~ 100.90)和75.96±25.93 (95% CI: 46.08 ~ 100.45)。结论:本综述中的不同研究表明,与其他快速诊断试验(RDTs)相比,Widal试验在识别伤寒感染方面表现较差。此外,目前的替代rdt不够准确,无法可靠地识别或排除伤寒感染。贡献:发展中国家需要改变伤寒的诊断方法,迫切需要一种准确和可行的即时检测方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Public Health in Africa
Journal of Public Health in Africa PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
自引率
0.00%
发文量
82
审稿时长
10 weeks
期刊介绍: The Journal of Public Health in Africa (JPHiA) is a peer-reviewed, academic journal that focuses on health issues in the African continent. The journal editors seek high quality original articles on public health related issues, reviews, comments and more. The aim of the journal is to move public health discourse from the background to the forefront. The success of Africa’s struggle against disease depends on public health approaches.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信