SynthesisPLoS neglected tropical diseases2019
Comparative accuracy of typhoid diagnostic tools: A Bayesian latent-class network analysis.
Synthesis in PLoS neglected tropical diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 35 citations in OpenAlex.
- Etiological spectrum of persistent fever in the tropics and predictors of ubiquitous infections: a prospective four-country study with pooled analysis.BMC medicine · 2022Trial
- A case for eliminating Widal testing for enteric fever, India.Bulletin of the World Health Organization · 2026Article
- Epidemiologic trends, diagnostic limitations, and public health challenges of enteric fever in sub-Saharan Africa: A narrative review.IJID regions · 2026Review
- Structure-guided development of an electrochemical aptasensor for Salmonella Typhi HlyE antigen detection using in silico and experimental approaches.Scientific reports · 2026Article
- Diagnostic accuracy of three tests forPreventive medicine reports · 2025Article
- Diagnostic performance of Typhidot RDT in diagnosis of typhoid fever and antibiotic resistance characterisation in a cross-sectional study in Southern Ghana.BMC infectious diseases · 2024Article
- Review
- Comparative Analysis of Commercially Available Typhoid Point-of-Care Tests: Results of a Prospective and Hybrid Retrospective Multicenter Diagnostic Accuracy Study in Kenya and Pakistan.Journal of clinical microbiology · 2022Article
- Accuracy of C-reactive Protein and Procalcitonin for Diagnosing Bacterial Infections Among Subjects With Persistent Fever in the Tropics.Open forum infectious diseases · 2022Article
- Opportunities and challenges to accurate diagnosis and management of acute febrile illness in adults and adolescents: A review.Acta tropica · 2022Review
- An age-stratified serosurvey against purified Salmonella enterica serovar Typhi antigens in the Lao People´s Democratic Republic.PLoS neglected tropical diseases · 2021Article
- Enteric Fever Diagnosis: Current Challenges and Future Directions.Pathogens (Basel, Switzerland) · 2021Review
- Antibiotic Use Prior to Hospital Presentation Among Individuals With Suspected Enteric Fever in Nepal, Bangladesh, and Pakistan.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Use of Typhoid Vi-Polysaccharide Vaccine as a Vaccine Probe to Delineate Clinical Criteria for Typhoid Fever.The American journal of tropical medicine and hygiene · 2020Article
- The Current Status of Enteric Fever Diagnostics and Implications for Disease Control.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Environmental Surveillance as a Tool for Identifying High-risk Settings for Typhoid Transmission.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Review
- Laboratory Diagnosis of Paratyphoid Fever: Opportunity of Surface Plasmon Resonance.Diagnostics (Basel, Switzerland) · 2020Review
- Article
- A comparable risk of extensively drug-resistant typhoid fever in the pediatric cohort during the COVID-19 pandemic.International journal of health sciencesArticle
Corrections and comments
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTyphoid fevers are infections caused by the bacteria Salmonella enterica serovar Typhi (Salmonella Typhi) and Paratyphi A, B and C (Salmonella Paratyphi). Approximately 17.8 million incident cases of typhoid fever occur annually, and incidence is highest in children. The accuracy of current diagnostic tests of typhoid fever is poorly understood. We aimed to determine the comparative accuracy of available tests for the pediatric population.
methodsWe first conducted a systematic literature review to identify studies that compared diagnostic tests for typhoid fever in children (aged ≤15 years) to blood culture results. We applied a Bayesian latent-class extension to a network meta-analysis model. We modelled known diagnostic properties of bone marrow culture and the relationship between bone marrow and blood culture as informative priors in a Bayesian framework. We tested sensitivities for the proportion of negative blood samples that were false as well as bone marrow sensitivity and specificity.
resultsWe found 510 comparisons from 196 studies and 57 specific to the pediatric population. IgM-based tests outperformed their IgG-based counterparts for ELISA and Typhidot tests. The lateral flow IgG test performed comparatively well with 92% sensitivity (72% to 98% across scenario analyses) and 94% specificity. The most sensitive test of those investigated for the South Asian pediatric population was the Reverse Passive Hemagglutination Assay with 99% sensitivity (98% - 100% across scenario analyses). Adding a Widal slide test to other typhoid diagnostics did not substantially improve diagnostic performance beyond the single test alone, however, a lateral flow-based IgG rapid test combined with the typhoid/paratyphoid (TPT) assay yielded improvements in sensitivity without substantial declines in specificity and was the best performing combination test in this setting.
conclusionIn the pediatric population, lateral-flow IgG, TPT and Reverse Passive Hemagglutination tests had high diagnostic accuracy compared to other diagnostics. Combinations of tests may provide a feasible option to increase diagnostic sensitivity. South Asia has the most informed set of data on typhoid diagnostic testing accuracy, and the evidence base in other important regions needs to be expanded.
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