COMPARATIVE STUDY OF WIDAL TEST WITH STOOL CULTURE IN THE DIAGNOSIS OF SALMONELLA.

Typhoid fever has several diagnostic tests However, misdiagnosis of typhoid fever is common since most primary healthcare relies on only the Widal test without further confirmation. This study compareed the diagnostic accuracy of widal test with stool culture in the diagnosis of typhoid fever at Sangere Primary Health Care Center, Girei Local Government Area, Adamawa State. Recruited in this study were 25 consented patients ≥18 year presenting with symptoms clinically suspected of typhoid fever visiting the Hospital in October, 2024. Blood and stool samples collected from all participants were subjected to Widal test and stool culture to assess antibodies to the Salmonella typhi (S. typhi) H and O antigens using the Widal test kit and isolate Salmonella typhi using culture techniques, respectively. Widal agglutination titre values equal to 1:80 or greater than 1:80 were considered as positive for the widal test. Isolation of S typhi from stool culture indicated an infection. Also, the performance of the Widal test was evaluated using the results from the stool culture as the standard reference. The findings revealed significant insights into the study population. The majority of patients (56%) were aged between 18 and 29 years, and there was a notable gender disparity, with 68% of patients being female. Occupationally, the most affected groups included business individuals (44%), housewives (24%), and students (24%). In terms of diagnostic accuracy, the Widal test demonstrated a positivity rate of 76%, while stool culture yielded only 20%. This indicates that while the Widal test may be more sensitive, it is also prone to false positives, highlighting its limitations as a standalone diagnostic tool. Conversely, stool culture, although more specific, exhibited lower sensitivity, especially when prior antibiotic use may have affected Salmonella detection. The antibiotic susceptibility tests revealed that Salmonella isolates were most sensitive to Gentamycin, Azithromycin, Levofloxacin, and Ciprofloxacin, while Amoxicillin showed no effectiveness against the isolates. This trend indicates a concerning shift towards resistance against older antibiotics, underscoring the necessity for appropriate antibiotic stewardship in treating typhoid fever cases. Widal test is not reliable for diagnosis of typhoid fever Health care personnel should develop a rapid, highly sensitive and cheap diagnostic method that is also capable of differentiating Salmonella infection from other infections.