Evaluation of Diagnostic Methods for <i>Salmonella Typhi </i>Detection in Children with Typhoid Fever in Katsina Metropolis, Katsina State, Nigeria

Abstract

Typhoid fever remains a major public health challenge, particularly among children in endemic regions. The causative organism, Salmonella enterica serovar Typhi (S. Typhi), is commonly diagnosed using the Widal agglutination test despite its well-documented limitations in sensitivity and specificity. Culture-based methods, including blood, stool, and urine cultures, provide a more specific diagnosis but are influenced by disease stage and prior antibiotic use. This cross-sectional study was conducted between July and October 2024 among children presenting with symptoms suggestive of typhoid fever. Sociodemographic and clinical data were collected using structured questionnaires. Widal testing was performed, while stool, urine, and blood cultures were used for bacteriological confirmation. Interferon-gamma (IFN-γ) levels were measured using ELISA. The Widal test showed 71% and 45.2% reactivity to O and H antigens, respectively. Culture positivity was 45.2% for stool samples, 51.6% for urine samples, and 32.3% for blood samples. Significant associations were observed between Widal reactivity and stool/urine culture positivity (p < 0.05). IFN-γ levels were not significantly associated with diagnostic outcomes. Typhoid fever remains prevalent among children in Katsina State. While the Widal test shows high reactivity, culture-based methods provide more reliable confirmation. Improved diagnostic strategies are essential for effective disease management.