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Do You Really Have Typhoid?

“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.

Live more life!

27 Comments

  1. Nze Prisca says:

    That’s a good one. But would someone with thyphoid fever be able to wait for 48 to 72hours for his/her test result before the treatment? I still think the serum widal test should first be done to ascertain if thyphoid present or not, before the blood/stool culture be carried out.

    • Hygeiahmo Admin says:

      Thanks for reading, Prisca. Blood test results can be gotten well within 24 hours these days. There really isn’t much reason for it to take 48 hours.

      • Dayo Shodimu says:

        Still Patient will have to wait 24hrs for result. In the meantime, what should the patient expect from the Hospital?

      • Adenihun says:

        hi doc, i do blood test all the time and its always thypoid….. r u saying d test is not accurate or wat r ur possible suggestions to treat it…tnx

        • Hygeiahmo Admin says:

          Hello Adenihun, you may benefit from seeking a second opinion. Please know that if you have any concerns about the quality of care you’re receiving, just let us know with a quick email to hycare(@)hygeiahmo.com and we’ll help you out.

      • Favour Victor says:

        Great information. Thank you!

  2. chizomam says:

    Very useful ninformation. Thanks a lot

  3. Ubong Utin says:

    Thanks for this piece of advice.
    Very critical for all to know!!!!

  4. Awele says:

    @hygeiahmoadmin regular blood test results can be received under 24 hours yes. But cultures, usually not. Worse still, the HMO may not approve this for an enrollee.
    Isn’t this true?

    • Hygeiahmo Admin says:

      hello Awele, we can only speak for Hygeia HMO :). We do approve medically necessary tests and this would qualify.

  5. Aruwajoye ademulegun Japhet says:

    This is very important information about this sickness.
    Does Hygeia has medium of shearing knowledge with the hospitals representing them?

    • Hygeiahmo Admin says:

      Hello Japhet, thanks for reading. yes, we do share information and research with all our partner hospitals as well.

  6. Adenike Owolola says:

    Thank you. But in the case of taking blood sample and administer some drugs and still have the symptoms, what do you advise such person to do. Or in the area of not taking blood sample and the doctor just gave some drugs i.e malaria drugs what do you advice to do.

    • Hygeiahmo Admin says:

      Thank you for reading, Adenike. The hospital could manage the symptoms in the interim. Doctors should only give malaria drugs only if it has been established that you have malaria. If you feel like you’re not getting the right quality of care, please let us know at Hygeia HMO so we can be your advocate. We are here to help you live more life.

  7. Ibe nkasiobi. N says:

    Nice article,,physicians are aware that only blood and stool culture are diagnostic of typhoid fever while widal test is suggestive of typhoid fever. However an elevated typhoid titre with clinical signs and symptoms of typhoid fever(without complications) is a faster guide than waiting for a culture result which takes 48-72hrs in our environment.

  8. IYIOLA says:

    Good.
    However, 24 hours is like a century in the sight of a patient dying of fever. The disgusting part of it is that after the administration of drugs to combat the confirmed enteric fever, the ugly situation most time still continues. God is our strenght

    • Hygeiahmo Admin says:

      Hello Iyiola, thanks for reading! If you have taken your prescribed medicines and are not getting better, please let us know at Hygeia HMO so that we can be your advocate. We are invested in getting you healthy and will always have your back.

  9. Onuorah Charles Ekene says:

    Good one, but hospitals don’t allow us to do typhoid test. According to them, you (hygeiahmo) didn’t include it under our medical. Is only malaria test that’s allowed. Please clarify.

    • Hygeiahmo Admin says:

      Hello Ekene, thanks for reading! Please always check i with us to confirm what your plan covers – a quick email to hycare(@)hygeiahmo.com should resolve this. Thanks again!

  10. Ifeyinwa Adaku says:

    Thank you for this piece. We will appreciate to have more of this. I’m really enjoying your service. God bless you

    • Hygeiahmo Admin says:

      Thank you so very much for commenting, Ifeyinwa. We are delighted that we get a chance to serve you. God bless you too and keep you healthy.

  11. Oyerinde Akinola says:

    Thanks for this wonderful message.
    Can you please shed more light on the causes of typhoid and treatment or prevention?
    Thanks a lot.

    • Hygeiahmo Admin says:

      Thanks for reading!
      Typhoid fever is caused by a virulent bacterium called Salmonella Typhi passed through contaminated food, water or body contact with people contaminated by the bacteria.

      It can be prevented by washing hands frequently, avoiding drinking untreated water or eating unwashed raw fruits or vegetables. You can also prevent it by getting vaccinated.

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