Folia Medica Indonesiana
ISSN 0303-7932
Vol. 40 / No. 1 / Published : 2004-01
Order : 4, and page :10 - 20
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Original Article :
Dot-eia typhoid test using omp salmonella typhi local phage type antigen to support the diagnosis of typhoid fever
Author :
- Rahayu Anggraini*1
- Indro Handoyo*2
- Aryati*3
- Department of Clinical Pathology Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya
- Department of Clinical Pathology Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya
- Department of Clinical Pathology Airlangga University School of Medicine Dr Soetomo Teaching Hospital, Surabaya
Abstract :
A laboratory study was carried out on 44 sera of typhoid patients (age: 15-45 years, 24 females and 20 males) with positive blood culture for S. typhi, 41 sera non typhoid febrile patients (age: 16-51 years, 17 females & 24 males) with negative blood culture and negative Widal test, 136 sera of healthy persons as normal controls (age: 20-49 years, 95 females & 41 males). The basic principle of the Dot-EIA typhoid test was an indirect Elisa method using nitrocellulose as a solid phase and OMP S. typhi from five locally prevalent phage types as the antigens. Goat anti-human IgM alkaline phosphatase for the Dot-EIA typhoid IgM test and goat antihuman IgG alkaline phosphatase for the Dot-EIA typhoid IgG test were used as conjugates. BCIP/NBT was used as a chromogenic substrate and the results were visible as gray-blue spots on the surface of the nitrocellulose. The Dot-EIA typhoid test could produce results within 3 hours. The result of the Dot-EIA typhoid test showed a good diagnostic value for typhoid fever, a diagnostic sensitivity of 66 % for IgM and 86.4% for IgG and when both were determined (IgM and IgG) the diagnostic sensitivity was 97.7%. The diagnostic specificity was 100% for IgM and 90.24% for IgG and if both were determined (IgM and IgG) the diagnostic specificity was 90.24%. The diagnostic efficiency was 82.35% for IgM and 88.24% for IgG and when both were determined (IgM and IgG) the diagnostic efficiency was 94.12%. The diagnostic positive predictive value was 100% for IgM and 90.48% for IgG and when both were determined (IgM and IgG) the diagnostic positive predictive value was 97.7%. The diagnostic efficiency was 82.35% for IgM and 90.24% for IgG and when both were determined (IgM and IgG) the diagnostic efficiency was 90.24%. The diagnostic positive predictive value was 100% for IgM and 90.48% for IgG and when both were determined (IgM and IgG) the diagnostic positive predictive value was 97.7%. From a practical point of view under field conditions, the performance of the Dot-EIA typhoid IgM and IgG test could be considered as moderately practicable and not very expensive (Rp 5.025,- per test). Thus this test could be performed in laboratories up to small hospitals (C type hospitals). Based on these results, it can be concluded that the Dot-EIA typhoid test has a good clinical validity, a moderate practicability and is not very expensive.
Keyword :
Dot-EIA typhoid test, OMP S. typhi antigen, typhoid fever,
References :
Hoffman SL,(1991) Typhoid Fever. In: Hunter’s Tropical Medicine. 7th ed. Edition. Dyson J. Philadelphia : WB. Sounders Co.
Baron EJ, Finegold SM,(1990) Enterobacteriaceae. In Bailey and Scott’s Diagnostic Microbiology. 8th edition St. Lois : Mosby - Year Book
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