Do You Really Have Typhoid Fever?

“They say I have Typhoid fever again”, Funmi moaned to her sister on the phone, staring at the test results. “How many times will I have typhoid this year alone na? And I took all the drugs the last time oh”

Typhoid fever or enteric fever to the more technically inclined is one of the more commonly encountered disease conditions in the developing world. In Nigeria, it is common that incidents of ill health with fever symptoms is often suspected to be either malaria or typhoid fever. This is so prevalent that patients even demand typhoid tests when they visit the hospital with complaints of body pain.

The most commonly used diagnostic tool for typhoid fever in Nigeria is the Widal test. Over time, doctors now include these typhoid tests as part of the routine investigations carry out in cases of fever.

There is just one thing though: there is no significant clinical or diagnostic value to single Widal tests. Widal tests often test positive even when the patient does not have Typhoid fever.

Widal Test: Inadequate For Accurately Diagnosing Typhoid Fever
Though the Widal test has played a major role in the diagnosis of typhoid fever in the past, recent technical developments have revealed several pitfalls in its use and in the interpretation of its results.

Primarily because there are no symptoms that are exclusive to typhoid fever, Widal tests have contributed to misdiagnosis and thus poor management of Typhoid fever. The test does not provide sufficient evidence to prove that a fever or other symptoms is caused by the Salmonella Typhi bacteria responsible for Typhoid fever.

Anything that can cause fever will cause an elevated titre in a Widal test and lead to an erroneous diagnosis of Typhoid fever. Widal tests only indicate that a patient has been exposed to the bacteria, in the past or recently and so is not a reliable diagnostic tool.

What Is An Accurate Way to Diagnose Typhoid Fever?
As an enteric disease, the diagnosis of typhoid fever on clinical grounds is difficult, as the presenting symptoms are diverse and similar to those observed with other febrile illnesses.

However, Typhoid fever can be accurately diagnosed by analyzing blood cultures or stool specimens for the Salmonella Typhi bacteria that causes the condition. It is either of these analyses that are validly recognized as accurate ways to diagnose Typhoid fever.

So next time you’re at the hospital and your doctor suspects that you have Typhoid fever, please insist on a stool or blood sample test.

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