Comparison between Widal Test and Stool Culture in the Diagnosis of Typhoid Fever in the Clinical Set-Up in Niger Delta Region of Nigeria

Abstract

Among Enterobacteriacae are causative agents of typhoid fever, Salmonella typhi and Salmonella paratyphi , a common infection among the inhabitants of Bayelsa State and in Nigeria at large. The aim of this study was to compare the widal test and stool culture for adopting better technique in the diagnosis of Salmonella species and its antibiotic susceptibility evaluation in the clinical setup in Bayelsa. A total of four hundred 400 {stool 200} {blood 200} samples collected from Diete Koki Memorial Hospital, Niger Delta University clinic and Federal Medical Centre, Bayelsa State were immediately taken to the medical microbiology laboratory, Niger Delta University for culture and serological test using Deoxycholate Citrate agar, Selenite-F broth and Smart Diagnostic Kit-Ref F-Kit8X5C.LOT:521-14 respectively. The standardized pure isolates to 0.5 McFarland turbidity standard were subjected to gram staining, biochemical tests and susceptibility testing using Kirby Beur agar diffusion method on Muller Hinton agar. Findings showed that out of two hundred (200) stool samples analyzed, one hundred and twenty-four 124(62%) Salmonella species were isolated 44(22%) Proteus and 32(16%) Escherichia Coli. Of one hundred and twenty-four Salmonella species isolated, 44(35.5%) were Salmonella typhi, 52(42%) Salmonella paratyphi A, while 28(22.5%) were of other Salmonella Species. Serological test on 200 blood samples analyzed revealed eighty-eight 88(44%) Salmonella typhi, eight 8(4%) Salmonella paratyphi A, 12(6%) Salmonella paratyphi B and zero (0%) Salmonella paratyphi C. Serological testing revealed eighty- four 84(42%) negative titre level and some patients with positive serological test had positive stool culture, while some negative but had positive growth of Proteus specie and Escherichia Coli. Antimicrobial susceptibility testing revealed ciprofloxacin as the most potent antibiotic with 100%, followed by ofloxacin 85% for salmonella infection and there was no significant difference at p=0.5 in their effectiveness. One hundred and twenty-four (124) patients were positive to cultural method and eighty-four 84 to serological method. Serological test detects early infection of Salmonella species while stool culture detects late infection (3weeks of incubation). These study has x-ray that both techniques (serological and cultural) should be adopted for effective diagnosis of Salmonella species in the health facilities. In conclusion serological test is Sensitive while stool culture is specific.