ArticlePreventive medicine reports2025
Diagnostic accuracy of three tests for
Article in Preventive medicine reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Accurate and timely diagnosis of typhoid fever is undermined by the absence of reliable reference test(s). The objective here was to estimate the sensitivity (Se), specificity (Sp), negative and positive predictive values (NPV and PPV) of the Widal, Methods: This cross-sectional study enrolled patients symptomatic of typhoid fever at three health facilities situated within an informal urban settlement in Nairobi County, Kenya. Using the patients' diagnostic data, a Bayesian latent class model was used to infer the tests' diagnostic accuracy. Results: The Rapid Ab test recorded the highest Se (94.9% [95% PCI 76.1, 99.8]) compared to Widal (59.5% [95% PCI 48.6, 77.9]) and SAT (54.2% [95% PCI 43.5, 64.8]). The assay's Sp (95.9% [95% PCI 85.0, 99.8]) was statistically similar to Widal (85.9% [95% PCI 80.8, 91.7] but superior to SAT (67.1% [95% PCI 60.7, 73.0]). PPVs for the Rapid Ab and Widal tests were comparable but distinct from SAT. NPV for the Rapid Ab test was the highest. Conclusion: The Rapid Ab assay lends itself as a suitable standalone diagnostic to guide surveillance, diagnosis and treatment of acute typhoid fever in high-burden, resource-limited settings.
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