Validity of Immunoglobulin M Anti Salmonella typhi Serologic Test in Childhood Typhoid Fever
Abstract: Typhoid fever, which
mostly affects children, remains a major health problem in developing
countries. Early diagnosis will help the management and thus, reduce morbidity
and mortality. However, a rapid diagnostic test that detects the presence of
immunoglobulin M (IgM) directed towards Salmonella typhi (S. typhi) antigen
remains controversial despite its popularity. This study was aimed to assess
the validity of IgM anti S. typhi serologic test in childhood typhoid fever.
Methods: This retrospective diagnostic test, used blood culture as gold
standard. Forty-one typhoid fever children with fever of 1–14 days admitted to
Dr. Hasan Sadikin General Hospital Bandung from 2013 to 2015 were recruited.
Diagnosis of typhoid fever is made clinically. Data were analyzed by Receiver
Operating Characteristic (ROC) curve and diagnostic test.
Results: Forty one children diagnosed with typhoid fever, 37 were
positive for IgM anti S. typhi, but only 18 were positive for S. typhi in blood
culture. IgM anti S. typhi (cut-off ≥4) test had an Area Under the Curve (AUC)
of 59%, sensitivity of 100% and specificity of 17.39%. IgM anti S. typhi with
cut-off >8 showed the highest AUC with sensitivity of 55.56% and specificity
of 73.68%.
Conclusions: IgM anti S. typhi test of cut-off >8 performs better than
cut-off ≥4 in terms of AUC.
Keywords: Children, diagnostic
test, immunoglobulin M anti Salmonella typhi, typhoid fever
Author: Hilda Marsela,
Djatnika Setiabudi, Agnes Rengga Indrati
Journal Code: jpkedokterangg170101
