COMPARISON OF PERFORMANCE OF TWO WIDAL TEST TECHNIQUES WITH STOOL CULTURE IN THE DIAGNOSIS OF TYPHOID FEVER AT THE DSCHANG DISTRICT HOSPITAL, WEST CAMEROON

Objective: This study is aimed to compare the performance of two Widal test techniques with stool culture in the diagnosis of typhoid fever. Methods: A cross-sectional study was performed at the Dschang District Hospital in patients clinically suspected to have typhoid fever, whose stool was collected for stool culture. Furthermore, venous blood was collected and the serum was tested by both Widal slide agglutination test and Widal tube titration test. Results: The results showed that out of 750 participants include in the study, 325 (43.33%) were positive for Widal slide agglutination test, 174 (23.20%) for Widal tube titration test, and 159 (21.20%) for stool culture. The sensitivity, specificity, positive predictive value, and negative predictive value of Widal slide agglutination test with respect to stool culture were 97.48%, 71.23%, 47.69%, and 99.22%, respectively, but 100%, 97.46%, 91.37%, and 100% for the Widal tube titration test. With the stool culture, Widal slide agglutination test had a moderate agreement (kappa = 0.47), but Widal tube titration test had an absolute agreement (kappa = 0.94). Conclusion: Widal tube titration test should be used in place of Widal slide agglutination test in the diagnosis of typhoid fever in the case of limited access to stool culture test.