Dong B, Galindo C M, Shin E, Acosta C J, Page A L, Wang M, Kim D, Ochiai R L, Park J, Ali M, Seidlein L V, Xu Z, Yang J, Clemens J D
Guangxi Center for Disease Prevention and Control, Nanning, Guangxi, China.
Epidemiol Infect. 2007 Aug;135(6):1014-20. doi: 10.1017/S0950268806007801. Epub 2007 Jan 12.
Blood culture-based diagnosis can only detect a fraction of the total burden of Salmonella enterica subsp. enterica serovar Typhi. The objective of the study was to detect additional typhoid fever cases through serological tests. A total of 1732 prolonged fever episodes were evaluated using three serological tests, Widal, Tubex and Typhidot-M in a typhoid fever endemic area of southern China. A case definition which included a positive Widal test (TO>or=80 & TH>A), a positive Tubex test (>or=4) and a positive Typhidot-M test, increased the detection of cases by more than twofold from 13 to 28 cases. The case definition has a specificity of 100% and a sensitivity of 39%. Case definitions based on combinations of serological tests can detect additional typhoid fever cases with higher specificity than a single serological test. Improved case detection is essential to understand the true disease burden and can help to boost the power of intervention trials.
基于血培养的诊断只能检测到肠道沙门氏菌伤寒亚种总感染量的一部分。本研究的目的是通过血清学检测发现更多伤寒热病例。在中国南方伤寒热流行地区，使用维达试验、结核菌素试验和伤寒斑点试验 - M这三种血清学检测方法对总共1732例持续性发热病例进行了评估。一个病例定义包括维达试验阳性（TO≥80且TH＞A）、结核菌素试验阳性（≥4）和伤寒斑点试验 - M阳性，使病例检测数量从13例增加到28例，增加了两倍多。该病例定义的特异性为100%，敏感性为39%。基于血清学检测组合的病例定义比单一血清学检测能以更高的特异性检测到更多伤寒热病例。改进病例检测对于了解真实疾病负担至关重要，并且有助于增强干预试验的效力。
