Performance of Widal test and stool culture in the diagnosis of typhoid fever among suspected patients in Dar es Salaam, Tanzania.
OBJECTIVE
We set an experiment to determine the diagnostic performance of the Widal test and stool culture in typhoid-suspected cases attending tertiary hospitals in Dar es Salaam, Tanzania using blood culture as a golden standard. We also evaluated the agreement between Widal, stool and blood culture.


RESULTS
This was a cross-sectional study conducted between June and September 2018, in three Regional Referral Hospitals in Dar es Salaam, Tanzania. A total of 158 typhoid-suspected cases were enrolled, after obtaining an informed consent. Of the 158 patients participated in the study, 128 (81%) tested positive for the Widal test and 17 (11%) patients were stool culture positive. Widal test recorded 81.5% sensitivity, 18.3% specificity, 10.1% positive predictive value and 89.7% negative predictive value. Stool culture showed 31.3% sensitivity, 91.5% specificity, 29% positive predictive value and 91.5% negative predictive value. In conclusion, Widal test is not reliable for diagnosis of typhoid fever since false positive and negative results are common. In addition, Widal test recorded poor agreement with the blood culture (kappa = 0.014, p < 0.05) while stool culture had strong agreement with the blood culture (kappa = 0.22, p < 0.05).
['Mawazo|Akili|A|http://orcid.org/0000-0002-6026-0248', 'Bwire|George M|GM|', 'Matee|Mecky I N|MIN|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000372:Agglutination Tests D000071997:Blood Culture D018929:Cell Culture Techniques D002648:Child D002675:Child, Preschool D003430:Cross-Sectional Studies D003955:Diagnostic Tests, Routine D005188:False Negative Reactions D005189:False Positive Reactions D005243:Feces D005260:Female D006761:Hospitals D006801:Humans D008297:Male D008875:Middle Aged D012485:Salmonella typhi D012680:Sensitivity and Specificity D013636:Tanzania D014435:Typhoid Fever
Widal test Stool culture Dar es Salaam Blood culture Referral Hospital