Abstract:
Objective: We set an experiment to determine the diagnostic performance of the Widal test and stool culture in
typhoid-suspected cases attending tertiary hospitals in Dar es Salaam, Tanzania using blood culture as a golden
standard. We also evaluated the agreement between Widal, stool and blood culture.
Results: This was a cross-sectional study conducted between June and September 2018, in three Regional Refer ral Hospitals in Dar es Salaam, Tanzania. A total of 158 typhoid-suspected cases were enrolled, after obtaining an
informed consent. Of the 158 patients participated in the study, 128 (81%) tested positive for the Widal test and 17
(11%) patients were stool culture positive. Widal test recorded 81.5% sensitivity, 18.3% specifcity, 10.1% positive
predictive value and 89.7% negative predictive value. Stool culture showed 31.3% sensitivity, 91.5% specifcity, 29%
positive predictive value and 91.5% negative predictive value. In conclusion, Widal test is not reliable for diagnosis of
typhoid fever since false positive and negative results are common. In addition, Widal test recorded poor agreement
with the blood culture (kappa=0.014, p<0.05) while stool culture had strong agreement with the blood culture
(kappa=0.22, p<0.05).
Keywords: Blood culture, Dar es Salaam, Referral Hospital, Stool culture, Widal test
