Utilization and value of Widal test in febrile children

Abstract

Summary: Rising cost of medical care in Nigeria prompted us to undertake a retrospective study of the utilization and value of the Widal test in 973 febrile children, in whom a total of 1135 of this test was performed. A maUtilization and value of Widal test in febrile childrenjority (63.4 percent) of the 1135 blood samples tested negative for Widal (titre below 1:64). The remaining tests were reported as borderline (titre 1:64) in eight percent of 1135 tests and positive (titre above 1:64) in 29 percent of the tests. There were only 29 percent of the 973 children in the present series who were confirmed either from blood cultures, or from a four-fold rise in Widal titres, to have had typhoid fever. The post-Widal plan of management revealed that the results of the Widal test were under utilized. There was only 44 percent of the 973 children whose Widal test results were used in their management. It is suggested from the findings in the present study that the Widal test would be strongly indicated in the older child with a long duration of a febrile illness and a high degree of pyrexia, as such a child is most likely to have typhoid fever. There is need, however, to develop clear-cut criteria for deciding on when to undertake Widal test in febrile children, as a large number of such children have non-typhoid febrile illness.