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Typhoid and Widal Test

  • Typhoid spreads through contaminated food and water and is caused by Salmonella typhi and other related bacteria.
  • Also known as enteric fever, it presents with a high fever, stomach pain, weakness, and other symptoms like nausea, vomiting, diarrhoea or constipation, and a rash.
  • Some people, called carriers, may remain symptom-free and shed the bacteria in their stool for several months to years.
  • These symptoms mimic those of malaria, dengue, influenza, and typhus, to name a few, each with different treatment modalities. If left untreated, typhoid can be life-threatening.
  • In India, clinicians use the Widal test extensively to diagnose typhoid in both public and private sectors.
Typhoid Data:
As per the World Health Organisation, 90 lakh people are diagnosed worldwide with typhoid every year and 1.1 lakh die of it. A small 2023 study reported the burden to be 576-1173 cases per 100,000 child-years (one child year is one child being followed up for one year) in urban areas and 35 per 100,000 child years in rural Pune.The Indian Council for Medical Research annually publishes a report detailing the resistance patterns of typhoid bacteria. According to the 2021 report, the number of samples tested for susceptibility varied significantly across regions, with as few as one sample from the ‘East’ region and up to 126 samples from the ‘North’ region.

The Widal test rapidly detects and quantifies antibodies.  It’s a point-of-care test and doesn’t need special skills or infrastructure, however, it has several flaws.

  • A single positive Widal test report doesn’t necessarily mean a typhoid infection is present, and a negative report doesn’t confirm the disease’s absence.
  • To diagnose an active infection, clinicians must test at least two serum samples taken at least 7-14 days apart which is rarely feasible and time-consuming.
  • It causes serious complications, like severe intestinal bleeding or perforation. False negatives can thus delay diagnosis and lead to fatal outcomes.

Dig Deeper: Read about WHO-qualified vaccines against typhoid.

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