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Clinical and Diagnostic Laboratory Immunology, July 2002, p. 938-941, Vol. 9, No. 4
1071-412X/02/$04.00+0     DOI: 10.1128/CDLI.9.4.938-941.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Widal Test in Diagnosis of Typhoid Fever in Turkey

Ayse Willke,^1* Onder Ergonul,² and Banu Bayar³

Kocaeli Universitesi Tip Fakultesi Klinik Bakteriyoloji ve Infeksiyon Hastaliklari AD, Izmit,¹ Ankara Numune Egitim ve Arastirma Hastanesi, Infeksiyon Hastaliklari ve Klinik Mikrobiyoloji Klinigi,² Ankara Universitesi Tip Fakultesi, Klinik Bakteriyoloji ve Infeksiyon Hastaliklari AD, Ankara, Turkey³

Received 15 November 2001/ Returned for modification 21 March 2002/ Accepted 18 April 2002

We studied the value of the Widal tube agglutination test for the diagnosis of typhoid fever. The subjects were all adults >18 years of age and were divided into four groups: (i) 317 healthy blood donor controls, (ii) 31 bacteriologically confirmed patients with Salmonella enterica serotype Typhi, (iii) 21 patients with a clinical diagnosis of typhoid fever, and (iv) 41 febrile nontyphoid patients. Blood donor controls were screened with a slide agglutination test for the Salmonella enterica serotype Typhi O and H antigens, and positives were then tested with the Widal test. Acute- and convalescent-phase sera from patients in groups 2, 3, and 4 were obtained 7 to 10 days apart and tested by the Widal test. Using a cutoff of 1/200 for the O antigen test performed on acute-phase serum gave a sensitivity of 52% and a specificity of 88% with a positive predictive value (PPV) of 76% and a negative predictive value (NPV) of 71%. This increased to 90% sensitivity and specificity with a PPV of 88% and an NPV of 93% when the convalescent-phase serum was tested. We concluded that O and H agglutinin titers of 1/200 are of diagnostic significance. The Widal test is easy, inexpensive, and relatively noninvasive. It can be of diagnostic value when blood cultures are not available or practical. The results must be interpreted cautiously because of the low sensitivity of the test. The Widal test done on convalescent-phase serum gave more-reliable results with higher specificity and sensitivity.

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* Corresponding author. Mailing address: KOU Tip Fakultesi Hastanesi, Sopali ciftligi, Derince, Izmit, 41900 Turkey. Phone: 90 262 2335981. Fax: 90 262 2335487. E-mail: dyse_willke2002{at}yahoo.com.

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Clinical and Diagnostic Laboratory Immunology, July 2002, p. 938-941, Vol. 9, No. 4
1071-412X/02/$04.00+0     DOI: 10.1128/CDLI.9.4.938-941.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

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