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- Title
Optimizing typhoid fever case definitions by combining serological tests in a large population study in Hechi City, China.
- Authors
Dong B; Galindo CM; Shin E; Acosta CJ; Page AL; Wang M; Kim D; Ochiai RL; Park J; Ali M; Seidlein LV; Xu Z; Yang J; Clemens JD
- Abstract
Blood culture-based diagnosis can only detect a fraction of the total burden of Salmonella enterica subsp. enterica serovar Typhi. The objective of the study was to detect additional typhoid fever cases through serological tests. A total of 1732 prolonged fever episodes were evaluated using three serological tests, Widal, Tubex and Typhidot-M in a typhoid fever endemic area of southern China. A case definition which included a positive Widal test (TO>or=80 & TH>A), a positive Tubex test (>or=4) and a positive Typhidot-M test, increased the detection of cases by more than twofold from 13 to 28 cases. The case definition has a specificity of 100% and a sensitivity of 39%. Case definitions based on combinations of serological tests can detect additional typhoid fever cases with higher specificity than a single serological test. Improved case detection is essential to understand the true disease burden and can help to boost the power of intervention trials.
- Publication
Epidemiology & Infection, 2007, Vol 135, Issue 6, p1014
- ISSN
0950-2688
- Publication type
Journal Article
- DOI
10.1017/s0950268806007801