SynthesisThe Journal of infectious diseases2018
The Relationship Between Blood Sample Volume and Diagnostic Sensitivity of Blood Culture for Typhoid and Paratyphoid Fever: A Systematic Review and Meta-Analysis.
Synthesis in The Journal of infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
65 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Using hospital-based studies of community-onset bloodstream infections to make inferences about typhoid fever incidence.Tropical medicine & international health : TM & IH · 2019Pooled it
- A Systematic Review of Typhoid Fever Occurrence in Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Pooled it
- The validity of test-negative design for assessment of typhoid conjugate vaccine protection: comparison of estimates by different study designs using data from a cluster-randomised controlled trial.The Lancet. Global health · 2025Trial
- Etiological spectrum of persistent fever in the tropics and predictors of ubiquitous infections: a prospective four-country study with pooled analysis.BMC medicine · 2022Trial
- Estimating enteric fever seroincidence in rural western Cambodia: Findings from a population-based cross-sectional serosurvey.PLoS neglected tropical diseases · 2026Article
- Estimating Enteric Fever Seroincidence in Bangladesh Using Rapid Serosurveys.Open forum infectious diseases · 2026Article
- Structure-guided development of an electrochemical aptasensor for Salmonella Typhi HlyE antigen detection using in silico and experimental approaches.Scientific reports · 2026Article
- Estimating enteric fever seroincidence in rural western Cambodia: findings from a population-based cross-sectional serosurvey.medRxiv : the preprint server for health sciences · 2026Article
- Article
- Estimating enteric fever seroincidence in Bangladesh using rapid serosurveys.medRxiv : the preprint server for health sciences · 2026Article
- Impact of the COVID-19 pandemic and typhoid conjugate vaccine introduction on typhoid fever in Nepal.PLoS neglected tropical diseases · 2026Article
- Sexually transmitted enteric infections in men who have sex with men.Clinical microbiology reviews · 2025Review
- Advancing typhoid conjugate vaccine implementation in Asia: Regional policy priorities.Vaccine · 2025Article
- Leveraging paired serology to estimate the incidence of typhoidal Salmonella infection in the STRATAA study.PLoS neglected tropical diseases · 2025Article
- The global burden of typhoid and paratyphoid fever from 1990 to 2021 and the impact on prevention and control.BMC infectious diseases · 2025Article
- Review
- Integrating Lean Six Sigma into Microbiology Laboratories: Insights from a Literature Review.Healthcare (Basel, Switzerland) · 2025Review
- Epidemiological characteristics and trends of notified enteric fevers in Germany, 2001 to 2023.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Time series data on typhoid fever incidence during outbreaks from 2000 to 2022.Scientific data · 2025Article
- Evaluation of a point-of-care multiplex immunochromatographic assay for the diagnosis of typhoid: results from a retrospective diagnostic accuracy study.Journal of clinical microbiology · 2024Observational
5 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
Background: Blood culture is the standard diagnostic method for typhoid and paratyphoid (enteric) fever in surveillance studies and clinical trials, but sensitivity is widely acknowledged to be suboptimal. We conducted a systematic review and meta-analysis to examine sources of heterogeneity across studies and quantified the effect of blood volume. Methods: We searched the literature to identify all studies that performed blood culture alongside bone marrow culture (a gold standard) to detect cases of enteric fever. We performed a meta-regression analysis to quantify the relationship between blood sample volume and diagnostic sensitivity. Furthermore, we evaluated the impact of patient age, antimicrobial use, and symptom duration on sensitivity. Results: We estimated blood culture diagnostic sensitivity was 0.59 (95% confidence interval [CI], 0.54-0.64) with significant between-study heterogeneity (I2, 76% [95% CI, 68%-82%]; P < .01). Sensitivity ranged from 0.51 (95% CI, 0.44-0.57) for a 2-mL blood specimen to 0.65 (95% CI, 0.58-0.70) for a 10-mL blood specimen, indicative of a relationship between specimen volume and sensitivity. Subgroup analysis showed significant heterogeneity by patient age and a weak trend towards higher sensitivity among more recent studies. Sensitivity was 34% lower (95% CI, 4%-54%) among patients with prior antimicrobial use and 31% lower after the first week of symptoms (95% CI, 19%-41%). There was no evidence of confounding by patient age, antimicrobial use, symptom duration, or study date on the relationship between specimen volume and sensitivity. Conclusions: The relationship between the blood sample volume and culture sensitivity should be accounted for in incidence and next-generation diagnostic studies.
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