Typhoid Fever Diagnosis in Endemic Countries: A Clog in the Wheel of Progress?

Medicina (Kaunas). 2018 Apr 25;54(2):23. doi: 10.3390/medicina54020023.

Abstract

Typhoid fever causes significant morbidity and mortality in developing countries, with inaccurate estimates in some countries affected, especially those situated in Sub-Saharan Africa. Disease burden assessment is limited by lack of a high degree of sensitivity and specificity by many current rapid diagnostic tests. Some of the new technologies, such as PCR and proteomics, may also be useful but are difficult for low-resource settings to apply as point-of-care diagnostics. Weak laboratory surveillance systems may also contribute to the spread of multidrug resistant Salmonella serovar Typhi across endemic areas. In addition, most typhoid-endemic countries employ serological tests that have low sensitivity and specificity making diagnosis unreliable. Here we review currently available typhoid fever diagnostics, and advances in serodiagnosis of S. Typhi.

Keywords: S. Typhi; Typhoid fever; laboratory; multidrug resistance; serodiagnosis.

Publication types

  • Review

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Antigens, Bacterial / blood
  • Bacteriological Techniques / standards
  • Biomarkers / blood
  • DNA, Bacterial / blood
  • DNA, Bacterial / isolation & purification
  • Developing Countries
  • Endemic Diseases*
  • Humans
  • Prevalence
  • Salmonella typhi / genetics
  • Salmonella typhi / isolation & purification*
  • Sensitivity and Specificity
  • Serologic Tests / methods
  • Serologic Tests / standards*
  • Typhoid Fever / diagnosis*
  • Typhoid Fever / epidemiology*
  • Typhoid Fever / microbiology

Substances

  • Antigens, Bacterial
  • Biomarkers
  • DNA, Bacterial