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Journal of Clinical Microbiology, May 2004, p. 1885-1889, Vol. 42, No. 5
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.5.1885-1889.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Evaluation of Rapid Diagnostic Tests for Typhoid Fever

Sonja J. Olsen,1 Jim Pruckler,1 William Bibb,1 Nguyen Thi My Thanh,2 Tran My Trinh,2 Nguyen Thi Minh,3 Sumathi Sivapalasingam,1 Amita Gupta,1 Phan Thu Phuong,4 Nguyen Tran Chinh,5 Nguyen Vinh Chau,5 Phung Dac Cam,4 and Eric D. Mintz1*

Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia,1 Pasteur Institute,2 Hospital for Tropical Diseases, Ho Chi Minh City,5 Cai Lay Medical Center Cai Lay,3 National Institute of Hygiene and Epidemiology, HanoiVietnam4

Received 10 September 2003/ Returned for modification 7 January 2004/ Accepted 12 January 2004

Laboratory diagnosis of typhoid fever requires isolation and identification of Salmonella enterica serotype Typhi. In many areas where this disease is endemic, laboratory capability is limited. Recent advances in molecular immunology have led to the identification of sensitive and specific markers for typhoid fever and technology to manufacture practical and inexpensive kits for their rapid detection. We evaluated three commercial kits for serologic diagnosis of typhoid fever. Patients presenting with >= 4 days of fever were enrolled at two hospitals in Southern Vietnam. Cases were patients with serotype Typhi isolated from blood samples, and controls were patients with other laboratory-confirmed illnesses. Serotype Typhi isolates were confirmed and tested for antimicrobial susceptibility at the Pasteur Institute in Ho Chi Minh City. The Widal test was run at the hospitals and the Pasteur Institute. Sera were shipped frozen to the Centers for Disease Control and Prevention and tested by using Multi-Test Dip-S-Ticks, TyphiDot, and TUBEX to detect immunoglobulin G (IgG), IgG and IgM, and IgM, respectively. Package insert protocol instructions were followed. We enrolled 59 patients and 21 controls. The sensitivity and specificity findings were as follows: 89 and 53% for Multi-Test Dip-S-Ticks, 79 and 89% for TyphiDot, 78 and 89% for TUBEX, and 64 and 76% for Widal testing in hospitals and 61% and 100% for Widal testing at the Pasteur Institute. For all assays, the sensitivity was highest in the second week of illness. The Widal test was insensitive and displayed interoperator variability. Two rapid kits, TyphiDot and TUBEX, demonstrated promising results.

* Corresponding author. Mailing address: Foodborne and Diarrheal Disease Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS A-38, Atlanta, GA 30333. Phone: (404) 639-2206. Fax: (404) 639-2205. E-mail: edm1{at}cdc.gov.

Journal of Clinical Microbiology, May 2004, p. 1885-1889, Vol. 42, No. 5
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.5.1885-1889.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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