Widal, not valid test for typhoid — Doctors

Medical doctors have said that Widal test, a popular laboratory investigation prescribed by many hospitals for the diagnosis of typhoid in Nigeria, is no longer valid for the clinical diagnosis and treatment of the disease.

According to the experts who spoke to our correspondent on Monday, 70 per cent of typhoid cases treated in Nigeria are as a result of misdiagnosis.

To accurately diagnose typhoid, a General Physician, Dr. James Atanda, noted that in addition to other clinical evaluations, patients must have their fecal and sometimes blood culture tests done.

“Typhoid is an illness you cannot just diagnose from a Widal test. It is not a valid test for diagnosing typhoid but many Nigerians don’t know this. The diagnosis of the disease involves a lot of clinical parameters and tests, including a culture of the patients’ waste products.”Atanda said.

The Medical Director of Daysprings Hospitals, Ikotun, Lagos, Dr. Samuel Adebayo, also raised the alarm that many Nigerians had been made to believe that prolonged fever or malaria infection was typhoid.

According to the physician, typhoid, an enteric fever that affects the intestine and the guts occurs when the bacteria ‘Salmonella Typhi’ or its other specie gains entrance into the body through the drinking of unhygienic water or unhygienic food preparation.

He maintained that the disease could only be diagnosed after a thorough clinical examination and consideration of the patients’ history.

Adebayo said, “There is no direct symptom of typhoid. All symptoms are suggestive. Some typhoid cases do not even show in the Widal test that is being used by quacks to diagnose the disease. It is dangerous to use these results to treat a patient for typhoid. Most doctors are aware of this, especially those who work in teaching hospitals that is why we don’t use it.

“Patients also want to hear that they have typhoid. I have had to convince patients who believed that they had typhoid even after thorough clinical evaluations suggested that they did not have it.”

Also, the Medical Director, Sanomens Hospital, Ejigbo, Lagos, Dr. Marcus Eruaga, said it was high time the public was enlightened on the fact that Widal test was not a conclusive test for the diagnosis of the disease as it was prone to error due to the complexity of the test results.

Eruaga said, “The Widal test is laden with errors, but the public carry it as evidence. Some conditions could increase one’s titre value from the Widal test. The result is nothing without a medical examination. It does not mean you have active typhoid,” he added.

Speaking on the consequences of wrong diagnosis, Adebayo noted that many Nigerians with serious illnesses had been sent to their early graves due to self or wrong medication.

 He said, “Some patients have died from liver and kidney failures because they were told that they had typhoid. If you ask them who confirmed that they had typhoid, you get replies like ‘my neighbour’, ‘the chemist’, or ‘my mother’. It is always a little too late for them when they realise that the symptoms they were treating was of another ailment.”

Eruaga, however, noted that in order to check the confusion clouding the diagnosis of typhoid in the country, the public should be enlightened through advertorials and stiffer penalties should be meted out to health workers who dabbled into areas beyond their specialty.

 “Typhoid is not prolonged malaria. It is caused by different organisms. It is only a doctor that can determine a fever typical of typhoid or malaria. Meeting with an expert is inevitable. You cannot put the cart before the horse,” he added.

Source: Punchng