Naheed Aliya, Ram Pavani K, Brooks W Abdullah, Mintz Eric D, Hossain Md Anowar, Parsons Michele M, Luby Stephen P, Breiman Robert F
International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka 1212, Bangladesh.
Diagn Microbiol Infect Dis. 2008 Aug;61(4):381-6. doi: 10.1016/j.diagmicrobio.2008.03.018. Epub 2008 May 22.
Tubex and Typhidot, rapid tests for typhoid fever, performed well in evaluations conducted in hospital settings among patients with culture-confirmed typhoid fever. We evaluated these tests in a community clinic in Bangladesh. Blood samples were obtained from 867 febrile patients for culture, Typhidot and Tubex tests. Considering the 43 blood culture-confirmed cases of typhoid fever as typhoid positive and the 24 other confirmed bacteremia cases as typhoid negative, Tubex was 60% sensitive and 58% specific, with 90% positive and 58% negative predictive values (NPVs); Typhidot was 67% sensitive and 54% specific, with 85% positive and 81% NPVs. When blood culture-negative patients and other bacteremia cases together were considered typhoid negative, positive predictive values were only 14% for Tubex and 13% for Typhidot, increasing to only 38% and 20% when restricted to patients with > or = 7 days of fever. We conclude that the value of Tubex and Typhidot tests for typhoid fever diagnosis in a community clinic in urban Bangladesh is low.
Tubex和Typhidot这两种伤寒热快速检测方法，在医院环境中对血培养确诊的伤寒热患者进行的评估中表现良好。我们在孟加拉国的一家社区诊所对这些检测方法进行了评估。从867名发热患者身上采集血样进行血培养、Typhidot检测和Tubex检测。将43例血培养确诊的伤寒热病例视为伤寒阳性，将其他24例确诊的菌血症病例视为伤寒阴性，Tubex的敏感性为60%，特异性为58%，阳性预测值为90%，阴性预测值为58%；Typhidot的敏感性为67%，特异性为54%，阳性预测值为85%，阴性预测值为81%。当血培养阴性患者和其他菌血症病例一起被视为伤寒阴性时，Tubex的阳性预测值仅为14%，Typhidot为13%；当仅限于发热≥7天的患者时，阳性预测值仅分别增至38%和20%。我们得出结论，在孟加拉国城市的一家社区诊所中，Tubex和Typhidot检测方法用于伤寒热诊断的价值较低。
