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Comparison of the Performance of the TPTest, Tubex, Typhidot and Widal Immunodiagnostic Assays and Blood Cultures in Detecting Patients with Typhoid Fever in Bangladesh, Including Using a Bayesian Latent Class Modeling Approach
- Source :
- PLoS Neglected Tropical Diseases, Vol 10, Iss 4, p e0004558 (2016), PLoS Neglected Tropical Diseases
- Publication Year :
- 2016
- Publisher :
- Public Library of Science (PLoS), 2016.
-
Abstract
- Background There is an urgent need for an improved diagnostic assay for typhoid fever. In this current study, we compared the recently developed TPTest (Typhoid and Paratyphoid Test) with the Widal test, blood culture, and two commonly used commercially available kits, Tubex and Typhidot. Methodology For analysis, we categorized 92 Bangladeshi patients with suspected enteric fever into four groups: S. Typhi bacteremic patients (n = 28); patients with a fourfold change in Widal test from day 0 to convalescent period (n = 7); patients with Widal titer ≥1:320 (n = 13) at either acute or convalescent stage of disease; and patients suspected with enteric fever, but with a negative blood culture and Widal titer (n = 44). We also tested healthy endemic zone controls (n = 20) and Bangladeshi patients with other febrile illnesses (n = 15). Sample size was based on convenience to facilitate preliminary analysis. Principle findings Of 28 S. Typhi bacteremic patients, 28 (100%), 21 (75%) and 18 (64%) patients were positive by TPTest, Tubex and Typhidot, respectively. In healthy endemic zone controls, the TPTest method was negative in all, whereas Tubex and Typhidot were positive in 3 (15%) and 5 (25%), respectively. We then estimated sensitivity and specificity of all diagnostic tests using Bayesian latent class modeling. The sensitivity of TPTest, Tubex and Typhidot were estimated at 96.0% (95% CI: 87.1%-99.8%), 60.2% (95% CI: 49.3%-71.2%), and 59.6% (95% CI: 50.1%-69.3%), respectively. Specificity was estimated at 96.6% (90.7%-99.2%) for TPTest, 89.9% (79.6%-96.8%) for Tubex, and 80.0% (67.7%-89.7%) for Typhidot. Conclusion These results suggest that the TPTest is highly sensitive and specific in diagnosing individuals with typhoid fever in a typhoid endemic setting, outperforming currently available and commonly used alternatives.<br />Author Summary We compared the performance of the recently developed TPTest (Typhoid and Paratyphoid Test) with the Widal test, blood culture, and commercially available kits, Tubex and Typhidot in diagnosing the patients with typhoid fever. There is no acceptable gold standard; therefore, we estimated the sensitivity and specificity of these diagnostic methods with Bayesian latent class modeling. We found that the sensitivity and specificity of the TPTest is higher than other commonly used methods for diagnosis of typhoid fever.
- Subjects :
- Male
Bacterial Diseases
Physiology
Widal test
Fevers
Salmonella typhi
Pathology and Laboratory Medicine
Salmonella Typhi
0302 clinical medicine
Salmonella
Medicine and Health Sciences
Typhoid
Blood culture
030212 general & internal medicine
Enzyme-Linked Immunoassays
Bangladesh
medicine.diagnostic_test
lcsh:Public aspects of medicine
Paratyphoid fever
Hematology
Middle Aged
Microbial Cultures
Antibodies, Bacterial
3. Good health
Tubex
Body Fluids
Bacterial Pathogens
Titer
Blood
Infectious Diseases
Serology
Medical Microbiology
Widal Test
Female
Biological Cultures
Anatomy
Pathogens
Research Article
Adult
medicine.medical_specialty
lcsh:Arctic medicine. Tropical medicine
Adolescent
lcsh:RC955-962
030231 tropical medicine
Immunologic Tests
Research and Analysis Methods
Sensitivity and Specificity
Microbiology
Typhoid fever
03 medical and health sciences
Signs and Symptoms
Enterobacteriaceae
Diagnostic Medicine
Internal medicine
Paratyphoid Fever
medicine
Humans
Typhoid Fever
Immunoassays
Microbial Pathogens
Bacteria
business.industry
Public Health, Environmental and Occupational Health
Organisms
Biology and Life Sciences
Bayes Theorem
lcsh:RA1-1270
medicine.disease
Immunology
Immunologic Techniques
Typhidot
Reagent Kits, Diagnostic
business
Subjects
Details
- Language :
- English
- ISSN :
- 19352735 and 19352727
- Volume :
- 10
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- PLoS Neglected Tropical Diseases
- Accession number :
- edsair.doi.dedup.....f1abd2538e51ec13232a56af7a4bb617