Skip to content
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Menu
Home
About Us
Resources
Profiles Metrics
Authors Directory
Institutions Directory
Top Authors
Top Institutions
Top Sponsors
AI Digest
Contact Us
Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Clinical and Epidemiological Features of Typhoid Fever in Pemba, Zanzibar: Assessment of the Performance of the WHO Case Definitions
PLoS ONE, Volume 7, No. 12, Article e51823, Year 2012
Notification
URL copied to clipboard!
Description
Background: The gold standard for diagnosis of typhoid fever is blood culture (BC). Because blood culture is often not available in impoverished settings it would be helpful to have alternative diagnostic approaches. We therefore investigated the usefulness of clinical signs, WHO case definition and Widal test for the diagnosis of typhoid fever. Methodology/Principal Findings: Participants with a body temperature ≥37.5°C or a history of fever were enrolled over 17 to 22 months in three hospitals on Pemba Island, Tanzania. Clinical signs and symptoms of participants upon presentation as well as blood and serum for BC and Widal testing were collected. Clinical signs and symptoms of typhoid fever cases were compared to other cases of invasive bacterial diseases and BC negative participants. The relationship of typhoid fever cases with rainfall, temperature, and religious festivals was explored. The performance of the WHO case definitions for suspected and probable typhoid fever and a local cut off titre for the Widal test was assessed. 79 of 2209 participants had invasive bacterial disease. 46 isolates were identified as typhoid fever. Apart from a longer duration of fever prior to admission clinical signs and symptoms were not significantly different among patients with typhoid fever than from other febrile patients. We did not detect any significant seasonal patterns nor correlation with rainfall or festivals. The sensitivity and specificity of the WHO case definition for suspected and probable typhoid fever were 82.6% and 41.3% and 36.3 and 99.7% respectively. Sensitivity and specificity of the Widal test was 47.8% and 99.4 both forfor O-agglutinin and H- agglutinin at a cut-off titre of 1:80. Conclusions/Significance: Typhoid fever prevalence rates on Pemba are high and its clinical signs and symptoms are non-specific. The sensitivity of the Widal test is low and the WHO case definition performed better than the Widal test. © 2012 Thriemer et al.
Authors & Co-Authors
Thriemer, Kamala L.
South Korea, Seoul
International Vaccine Institute, Seoul
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Ley, Benedikt B.
South Korea, Seoul
International Vaccine Institute, Seoul
Austria, Vienna
Universität Wien
Ame, Shaali Makame
Tanzania
Public Health Laboratory Pemba
Tanzania, Zanzibar City
Ministry of Health and Social Welfare
Deen, Jacqueline L.
South Korea, Seoul
International Vaccine Institute, Seoul
Australia, Darwin
Menzies School of Health Research
de Pak, Giok
South Korea, Seoul
International Vaccine Institute, Seoul
Chang, Na Yoon
South Korea, Seoul
International Vaccine Institute, Seoul
Hashim, Ramadhan
South Korea, Seoul
International Vaccine Institute, Seoul
Schmied, Wolfgang Hellmut
South Korea, Seoul
International Vaccine Institute, Seoul
Busch, Clara J.L.
South Korea, Seoul
International Vaccine Institute, Seoul
Nixon, Shanette
United States, Durham
Duke University
Morrissey, Anne B.
United States, Durham
Duke University
Puri, Mahesh K.
South Korea, Seoul
International Vaccine Institute, Seoul
Ochiai, R. Leon
South Korea, Seoul
International Vaccine Institute, Seoul
Wierzba, Thomas F.
South Korea, Seoul
International Vaccine Institute, Seoul
Clemens, John David
South Korea, Seoul
International Vaccine Institute, Seoul
Ali, Mohammad M.
South Korea, Seoul
International Vaccine Institute, Seoul
Jiddawi, Mohamed Saleh
Tanzania, Zanzibar City
Ministry of Health and Social Welfare
Von-Seidlein, Lorenz
Australia, Darwin
Menzies School of Health Research
Ali, Said Mohammed
Tanzania
Public Health Laboratory Pemba
Tanzania, Zanzibar City
Ministry of Health and Social Welfare
Statistics
Citations: 86
Authors: 19
Affiliations: 7
Identifiers
Doi:
10.1371/journal.pone.0051823
e-ISSN:
19326203
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Tanzania