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Optimizing typhoid fever case definitions by combining serological tests in a large population study in Hechi City, China

2007; Cambridge University Press; Volume: 135; Issue: 6 Linguagem: Inglês

10.1017/s0950268806007801

1469-4409

B. DONG, Claudia M. Galindo, Eun‐Hee Shin, Camilo J. Acosta, A. L. Page, M. WANG, D. KIM, R. Leon Ochiai, Jin‐Kyung Park, Mohammad Ali, Lorenz von Seidlein, Zhou Xu, H. J. Yang, John D. Clemens,

Viral gastroenteritis research and epidemiology

SUMMARY Blood culture-based diagnosis can only detect a fraction of the total burden of Salmonella enterica subsp. enterica serovar Typhi. The objective of the study was to detect additional typhoid fever cases through serological tests. A total of 1732 prolonged fever episodes were evaluated using three serological tests, Widal, Tubex ® and Typhidot-M ® in a typhoid fever endemic area of southern China. A case definition which included a positive Widal test (TO⩾80 & TH>A), a positive Tubex ® test (⩾4) and a positive Typhidot-M ® test, increased the detection of cases by more than twofold from 13 to 28 cases. The case definition has a specificity of 100% and a sensitivity of 39%. Case definitions based on combinations of serological tests can detect additional typhoid fever cases with higher specificity than a single serological test. Improved case detection is essential to understand the true disease burden and can help to boost the power of intervention trials.