SEROPREVALENCE OF ANTIBODIES AGAINST TYPHOID FEVER IN A CANTON OF THE PROVINCE OF MANABÍ
SEROPREVALENCE OF TYPHOID FEVER
DOI:
https://doi.org/10.26871/ceus.v6i2.224Keywords:
Typhoid fever, Salmonella Typhi, Agglutination tests, Serological tests, Seroepidemiological studiesAbstract
Introduction: The diagnosis of typhoid fever represents a major clinical and laboratory challenge in resource-limited settings, where the Widal test remains the primary diagnostic method available. Objective: To analyze the seroprevalence of antibodies against Salmonella typhi in the El Carmen canton. Methodology: An observational, descriptive, cross-sectional, and retrospective study was conducted, including 183 Widal test reports from afebrile patients processed between March and May 2024 at the Hospital del Día San Francisco. The data were collected through documentary analysis of anonymized clinical records and analyzed using descriptive statistics with SPSS software version 27. Results: The results showed an overall seroprevalence of 12.6%, using cut-off values of ≥1:80 for anti-O and ≥1:160 for anti-H antibodies. A higher frequency of anti-H antibodies (92.3%) compared to anti-O (88.5%) was observed, with predominant titers of 1:40 for anti-O and 1:80 for anti-H. A total of 10.4% of individuals had anti-O titers above 1:160, exceeding the internationally recommended 5% threshold for considering cutoff adjustments. These findings suggest that traditional thresholds may lead to false positives in this population. Conclusions: It is concluded that adjusting the diagnostic cutoff for anti-O to ≥1:160 would improve the specificity of the Widal test in this context, thereby optimizing the clinical management of patients suspected of having typhoid fever in El Carmen canton.
Downloads
Download data is not yet available.
References
1. Masuet-Aumatell C, Atouguia J. Typhoid fever infection - Antibiotic resistance and vaccination strategies: A narrative review. Travel Med Infect Dis. [Internet] 2021 [Consultado 27 Ene 2024]; 40: 101946. Disponible en: https://doi.org/10.1016/j.tmaid.2020.101946.
2. Organización Mundial de la Salud. OMS: Fiebre tifoidea. [Internet]. [Consultado 28 Ene 2024]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/typhoid.
3. Marchello CS, Birkhold M, Crump JA. Complications and mortality of typhoid fever: A global systematic review and meta-analysis. J Infect. [Internet] 2020 [Consultado 28 Ene 2024]; 81(6): 902-10. Disponible en: https://doi.org/10.1016/j.jinf.2020.10.030.
4. Arora P, Thorlund K, Brenner DR, Andrews JR. Comparative accuracy of typhoid diagnostic tools: A Bayesian latent-class network analysis. PLoS Negl Trop Dis. [Internet] 2019 [Consultado 26 Ene 2024]; 13(5): e0007303. Disponible en: https://doi.org/10.1371/journal.pntd.0007303.
5. Ousenu K, Ali IM, Sama LF, Ndam MN, Tchouangueu TF, Tume CB. A Cross-Sectional Comparative Study of the Performance of the Widal Test and the Typhidot Immunoassay for Typhoid Fever Diagnosis in the West Region of Cameroon. Can J Infect Dis Med Microbiol. [Internet] 2021 [Consultado 27 Ene 2024]; 2021: 8279122. Disponible en: https://doi.org/10.1155/2021/8279122.
6. Mahmoud A, Oluyemisi A, Uwishema O, Sun J, Jobran AW, David S, et al. Recent advances in the diagnosis and management of typhoid fever in Africa: A review. Int J Health Plann Manage. [Internet] 2023 [Consultado 24 Ene 2024]; 38(2): 317-29. Disponible en: https://doi.org/10.1002/hpm.3599.
7. Sapkota J, Hasan R, Onsare R, Arafah S, Kariuki S, Shakoor S, et al. 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. J Clin Microbiol. [Internet] 2022 [Consultado 24 Ene 2024]; 60(12): e0100022. Disponible en: https://doi.org/10.1128/jcm.01000-22.
8. Ajibola O, Mshelia MB, Gulumbe BH, Eze AA. Typhoid Fever Diagnosis in Endemic Countries: A Clog in the Wheel of Progress? Medicina (Kaunas). [Internet] 2018 [Consultado 25 Ene 2024]; 54(2): 23. Disponible en: https://doi.org/10.3390/medicina54020023.
9. Mather RG, Hopkins H, Parry CM, Dittrich S. Redefining typhoid diagnosis: what would an improved test need to look like? BMJ Glob Health. [Internet] 2019 [Consultado 25 Ene 2024]; 4(5): e001831. Disponible en: https://doi.org/10.1136/bmjgh-2019-001831.
10. Basnyat B, Qamar FN, Rupali P, Ahmed T, Parry CM. Enteric fever. BMJ. [Internet] 2021 [Consultado 24 Ene 2024]; 372: n437. Disponible en: https://doi.org/10.1136/bmj.n437.
11. Oliva Marín JE. Fiebre tifoidea, el arte del diagnóstico por laboratorio. Alerta. [Internet] 2020 [Consultado 28 Ene 2024]; 3(1): 33-7. Disponible en: https://doi.org/10.5377/alerta.v3i1.9237.
12. Akhtar S, Delu AK, Patel HS. Seroprevalence of Antibodies Against Salmonella Enterica in a Healthy Population. Natl J Med Res. [Internet] 2023 [Consultado 15 Mar 2025]; 13(04): 138-41. Disponible en: https://doi.org/10.55489/njmr.13042023984.
13. Acharya T, Raj Tiwar B, Mani Pokhrel B. Baseline Widal Agglutination Titre in Apparently Healthy Nepalese Blood Donors. JHAS. [Internet] 2019 [Consultado 24 Ene 2024]; 3(1): 27-30. Disponible en: https://doi.org/10.37107/jhas.49.
14. Bahl S, Dogra S, Bahl R, Sachdeva A, Mahajan B. Estimation of Baseline Widal Antibody Titers among Apparently Healthy Urban Population of District Jammu. Indian J Community Med. [Internet] 2021 [Consultado 25 Ene 2024]; 46(2): 292-94. Disponible en: https://doi.org/10.4103/ijcm.ijcm_347_20.
15. López Moreno HS, Casal Rodríguez KA, González Orozco M de J, Beltrán López E, Uribe Beltrán M de J, Osuna Ramírez I. Prevalencia de anticuerpos anti-Salmonella entérica serovar Typhi en individuos de Culiacán, Sinaloa, México. QUIBIOUAS. [Internet] 2024 [Consultado 26 Oct 2024]; 1: 33-9. Disponible en: https://revistas.uas.edu.mx/index.php/QBU/article/view/334.
16. Gupta P, Rajgopal SK, Prateek SP, Gupta DK, Bisht R, Yadav MK. The “Baseline Widal Titre” Amongst Apparently Healthy Adults Working at a Tertiary Care Medical Institution, a Pilot Study, Uttarakhand, India. Int J Trop Dis Health. [Internet] 2024 [Consultado 28 Feb 2025]; 45(7): 89-5. Disponible en: https://doi.org/10.9734/ijtdh/2024/v45i71563.
17. Levine MM, Simon R. The Gathering Storm: Is Untreatable Typhoid Fever on the Way? mBio. [Internet] 2018 [Consultado 30 Ene 2024]; 9(2): e00482-18. Disponible en: https://doi.org/10.1128/mbio.00482-18.
18. Gutiérrez-Murillo WCP, Pin-Paco FF. Análisis microbiológico de Salmonella spp en muestras biológicas de trabajadores asintomáticos de comedores públicos del mercado municipal Jipijapa 2019. [Tesis de pregrado]. Universidad Estatal del Sur de Manabí; 2019.
19. Raheem H. Estimation of Typhoid Fever Between Healthy Students of Wasit University. wjps. [Internet] 2024 [Consultado 2 Mar 2025]; 3(2): 315-8. Disponible en: https://doi.org/10.31185/wjps.419.
20. Vargas-Monroy MC. Incidencia de falsos positivos en la determinación de Antígenos Febriles en pacientes en el Hospital Militar III de Arequipa, 2024. [Tesis de pregrado]. Universidad Nacional de San Agustín de Arequipa; 2024.
21. Mohta A, Jain A, Jain V, Piparsania S, Manoj A, Jain D. Study to determine the distribution pattern of agglutinating antibodies to Salmonella enterica serotype: typhi, paratyphi A and paratyphi B antigens in normal healthy individuals and individuals with afebrile illness in pediatric population. Int J Health Clin Res. [Internet] 2020 [Consultado 20 Mar 2025]; 3(5): 90-6. Disponible en: https://www.ijhcr.com/index.php/ijhcr/article/view/158.
22. Patki R, Lilani S, Lanjewar D. Baseline Antibody Titre against Salmonella enterica in Healthy Population of Mumbai, Maharashtra, India. Int J Microbiol. [Internet] 2017 [Consultado 20 Mar 2025]; 2017: 9042125. Disponible en: https://doi.org/10.1155/2017/9042125.
23. Belachew GT and Paramesh Hanumanthaiah. Prevalence of Enteric Fever Among Patients Attending the Student Clinic at Debre Birhan University, North Shewa, Ethiopia. Biomed J Sci Tech Res. [Internet] 2022 [Consultado 2 Mar 2025]; 47(2): 202238279-38287. Disponible en: http://dx.doi.org/10.26717/BJSTR.2022.47.007473.
24. Bada-Céspedes CM, Raymundo-Padua ER. Incidencia de fiebre tifoidea, fiebre paratifoidea y fiebre de Malta en pobladores del AAHH. Villa María del Triunfo, año 2018. [Tesis de pregrado]. Universidad Norbert Wiener; 2018.
25. Tewari S, Kumar A, Rani E. Evaluation of the baseline widal titre among apparently healthy individuals in Meerut, Uttar Pradesh, India. Int J Sci Res. [Internet] 2020 [Consultado 20 Mar 2025]; 9(8). Disponible en: file:///C:/Users/usuario/Downloads/10-40-1-PB%20(1).pdf.
26. Tula MY, Iyoha O, Okojie RO, Filgona J, Onyeje GA. Seroprevalence of Salmonella Agglutinins among Apparently Healthy Students of a Tertiary Institution in North-Eastern Nigeria. Int Blood Res Rev. [Internet] 2018 [Consultado 15 Mar 2025]; 8(3): 1-7. Disponible en: https://doi.org/10.9734/IBRR/2018/43362.
27. Wani NA, Kannaiyan J, Paulraj B, Veeramani V. Determination of Antibody Titration between Clinical and Community Based Patients for O, H, AH and BH Antigens in Salmonella Samples. J Drug Deliv Ther. [Internet] 2019 [Consultado 6 Mar 2025]; 9(3): 194-99. Disponible en: http://dx.doi.org/10.22270/jddt.v9i3.2640.
28. Khan A, Ashher F, Khanam F, Rahman MM, Khan M, Paul SK, et al. Baseline Widal Titer Among Healthy Adult Males from the Greater Mymensingh Division of Bangladesh. Infect Disord Drug Targets. [Internet] 2018 [Consultado 28 Feb 2025]; 18(3): 233-40. Disponible en: https://doi.org/10.2174/1871526518666180405154337.
29. Illapperuma SC, Corea EM, Agampodi SB. Baseline titres of O, H and AH agglutinins to Salmonella Typhi and Paratyphi A in blood donors in Sri Lanka. Sri Lankan J Infect Dis. [Internet] 2019 [Consultado 20 Mar 2025]; 9(1): 32-41. Disponible en: http://dx.doi.org/10.4038/sljid.v9i1.8230.
2. Organización Mundial de la Salud. OMS: Fiebre tifoidea. [Internet]. [Consultado 28 Ene 2024]. Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/typhoid.
3. Marchello CS, Birkhold M, Crump JA. Complications and mortality of typhoid fever: A global systematic review and meta-analysis. J Infect. [Internet] 2020 [Consultado 28 Ene 2024]; 81(6): 902-10. Disponible en: https://doi.org/10.1016/j.jinf.2020.10.030.
4. Arora P, Thorlund K, Brenner DR, Andrews JR. Comparative accuracy of typhoid diagnostic tools: A Bayesian latent-class network analysis. PLoS Negl Trop Dis. [Internet] 2019 [Consultado 26 Ene 2024]; 13(5): e0007303. Disponible en: https://doi.org/10.1371/journal.pntd.0007303.
5. Ousenu K, Ali IM, Sama LF, Ndam MN, Tchouangueu TF, Tume CB. A Cross-Sectional Comparative Study of the Performance of the Widal Test and the Typhidot Immunoassay for Typhoid Fever Diagnosis in the West Region of Cameroon. Can J Infect Dis Med Microbiol. [Internet] 2021 [Consultado 27 Ene 2024]; 2021: 8279122. Disponible en: https://doi.org/10.1155/2021/8279122.
6. Mahmoud A, Oluyemisi A, Uwishema O, Sun J, Jobran AW, David S, et al. Recent advances in the diagnosis and management of typhoid fever in Africa: A review. Int J Health Plann Manage. [Internet] 2023 [Consultado 24 Ene 2024]; 38(2): 317-29. Disponible en: https://doi.org/10.1002/hpm.3599.
7. Sapkota J, Hasan R, Onsare R, Arafah S, Kariuki S, Shakoor S, et al. 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. J Clin Microbiol. [Internet] 2022 [Consultado 24 Ene 2024]; 60(12): e0100022. Disponible en: https://doi.org/10.1128/jcm.01000-22.
8. Ajibola O, Mshelia MB, Gulumbe BH, Eze AA. Typhoid Fever Diagnosis in Endemic Countries: A Clog in the Wheel of Progress? Medicina (Kaunas). [Internet] 2018 [Consultado 25 Ene 2024]; 54(2): 23. Disponible en: https://doi.org/10.3390/medicina54020023.
9. Mather RG, Hopkins H, Parry CM, Dittrich S. Redefining typhoid diagnosis: what would an improved test need to look like? BMJ Glob Health. [Internet] 2019 [Consultado 25 Ene 2024]; 4(5): e001831. Disponible en: https://doi.org/10.1136/bmjgh-2019-001831.
10. Basnyat B, Qamar FN, Rupali P, Ahmed T, Parry CM. Enteric fever. BMJ. [Internet] 2021 [Consultado 24 Ene 2024]; 372: n437. Disponible en: https://doi.org/10.1136/bmj.n437.
11. Oliva Marín JE. Fiebre tifoidea, el arte del diagnóstico por laboratorio. Alerta. [Internet] 2020 [Consultado 28 Ene 2024]; 3(1): 33-7. Disponible en: https://doi.org/10.5377/alerta.v3i1.9237.
12. Akhtar S, Delu AK, Patel HS. Seroprevalence of Antibodies Against Salmonella Enterica in a Healthy Population. Natl J Med Res. [Internet] 2023 [Consultado 15 Mar 2025]; 13(04): 138-41. Disponible en: https://doi.org/10.55489/njmr.13042023984.
13. Acharya T, Raj Tiwar B, Mani Pokhrel B. Baseline Widal Agglutination Titre in Apparently Healthy Nepalese Blood Donors. JHAS. [Internet] 2019 [Consultado 24 Ene 2024]; 3(1): 27-30. Disponible en: https://doi.org/10.37107/jhas.49.
14. Bahl S, Dogra S, Bahl R, Sachdeva A, Mahajan B. Estimation of Baseline Widal Antibody Titers among Apparently Healthy Urban Population of District Jammu. Indian J Community Med. [Internet] 2021 [Consultado 25 Ene 2024]; 46(2): 292-94. Disponible en: https://doi.org/10.4103/ijcm.ijcm_347_20.
15. López Moreno HS, Casal Rodríguez KA, González Orozco M de J, Beltrán López E, Uribe Beltrán M de J, Osuna Ramírez I. Prevalencia de anticuerpos anti-Salmonella entérica serovar Typhi en individuos de Culiacán, Sinaloa, México. QUIBIOUAS. [Internet] 2024 [Consultado 26 Oct 2024]; 1: 33-9. Disponible en: https://revistas.uas.edu.mx/index.php/QBU/article/view/334.
16. Gupta P, Rajgopal SK, Prateek SP, Gupta DK, Bisht R, Yadav MK. The “Baseline Widal Titre” Amongst Apparently Healthy Adults Working at a Tertiary Care Medical Institution, a Pilot Study, Uttarakhand, India. Int J Trop Dis Health. [Internet] 2024 [Consultado 28 Feb 2025]; 45(7): 89-5. Disponible en: https://doi.org/10.9734/ijtdh/2024/v45i71563.
17. Levine MM, Simon R. The Gathering Storm: Is Untreatable Typhoid Fever on the Way? mBio. [Internet] 2018 [Consultado 30 Ene 2024]; 9(2): e00482-18. Disponible en: https://doi.org/10.1128/mbio.00482-18.
18. Gutiérrez-Murillo WCP, Pin-Paco FF. Análisis microbiológico de Salmonella spp en muestras biológicas de trabajadores asintomáticos de comedores públicos del mercado municipal Jipijapa 2019. [Tesis de pregrado]. Universidad Estatal del Sur de Manabí; 2019.
19. Raheem H. Estimation of Typhoid Fever Between Healthy Students of Wasit University. wjps. [Internet] 2024 [Consultado 2 Mar 2025]; 3(2): 315-8. Disponible en: https://doi.org/10.31185/wjps.419.
20. Vargas-Monroy MC. Incidencia de falsos positivos en la determinación de Antígenos Febriles en pacientes en el Hospital Militar III de Arequipa, 2024. [Tesis de pregrado]. Universidad Nacional de San Agustín de Arequipa; 2024.
21. Mohta A, Jain A, Jain V, Piparsania S, Manoj A, Jain D. Study to determine the distribution pattern of agglutinating antibodies to Salmonella enterica serotype: typhi, paratyphi A and paratyphi B antigens in normal healthy individuals and individuals with afebrile illness in pediatric population. Int J Health Clin Res. [Internet] 2020 [Consultado 20 Mar 2025]; 3(5): 90-6. Disponible en: https://www.ijhcr.com/index.php/ijhcr/article/view/158.
22. Patki R, Lilani S, Lanjewar D. Baseline Antibody Titre against Salmonella enterica in Healthy Population of Mumbai, Maharashtra, India. Int J Microbiol. [Internet] 2017 [Consultado 20 Mar 2025]; 2017: 9042125. Disponible en: https://doi.org/10.1155/2017/9042125.
23. Belachew GT and Paramesh Hanumanthaiah. Prevalence of Enteric Fever Among Patients Attending the Student Clinic at Debre Birhan University, North Shewa, Ethiopia. Biomed J Sci Tech Res. [Internet] 2022 [Consultado 2 Mar 2025]; 47(2): 202238279-38287. Disponible en: http://dx.doi.org/10.26717/BJSTR.2022.47.007473.
24. Bada-Céspedes CM, Raymundo-Padua ER. Incidencia de fiebre tifoidea, fiebre paratifoidea y fiebre de Malta en pobladores del AAHH. Villa María del Triunfo, año 2018. [Tesis de pregrado]. Universidad Norbert Wiener; 2018.
25. Tewari S, Kumar A, Rani E. Evaluation of the baseline widal titre among apparently healthy individuals in Meerut, Uttar Pradesh, India. Int J Sci Res. [Internet] 2020 [Consultado 20 Mar 2025]; 9(8). Disponible en: file:///C:/Users/usuario/Downloads/10-40-1-PB%20(1).pdf.
26. Tula MY, Iyoha O, Okojie RO, Filgona J, Onyeje GA. Seroprevalence of Salmonella Agglutinins among Apparently Healthy Students of a Tertiary Institution in North-Eastern Nigeria. Int Blood Res Rev. [Internet] 2018 [Consultado 15 Mar 2025]; 8(3): 1-7. Disponible en: https://doi.org/10.9734/IBRR/2018/43362.
27. Wani NA, Kannaiyan J, Paulraj B, Veeramani V. Determination of Antibody Titration between Clinical and Community Based Patients for O, H, AH and BH Antigens in Salmonella Samples. J Drug Deliv Ther. [Internet] 2019 [Consultado 6 Mar 2025]; 9(3): 194-99. Disponible en: http://dx.doi.org/10.22270/jddt.v9i3.2640.
28. Khan A, Ashher F, Khanam F, Rahman MM, Khan M, Paul SK, et al. Baseline Widal Titer Among Healthy Adult Males from the Greater Mymensingh Division of Bangladesh. Infect Disord Drug Targets. [Internet] 2018 [Consultado 28 Feb 2025]; 18(3): 233-40. Disponible en: https://doi.org/10.2174/1871526518666180405154337.
29. Illapperuma SC, Corea EM, Agampodi SB. Baseline titres of O, H and AH agglutinins to Salmonella Typhi and Paratyphi A in blood donors in Sri Lanka. Sri Lankan J Infect Dis. [Internet] 2019 [Consultado 20 Mar 2025]; 9(1): 32-41. Disponible en: http://dx.doi.org/10.4038/sljid.v9i1.8230.
Published
2025-10-08
How to Cite
Rivas Dueñas, A., & Bracho Mora, A. (2025). SEROPREVALENCE OF ANTIBODIES AGAINST TYPHOID FEVER IN A CANTON OF THE PROVINCE OF MANABÍ: SEROPREVALENCE OF TYPHOID FEVER. CEUS Scientific Journa, 6(2). https://doi.org/10.26871/ceus.v6i2.224
Issue
Section
Original de Investigación
License
Copyright (c) 2025 Angie Rivas Dueñas, Angela Bracho Mora
This work is licensed under a Creative Commons Attribution 4.0 International License.