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The accuracy of widal test for typhoid fever diagnosis in Ethiopia: Systematic review and meta-analysis
Journal article   Open access   Peer reviewed

The accuracy of widal test for typhoid fever diagnosis in Ethiopia: Systematic review and meta-analysis

Oumer Abdu Muhie, Seid Getahun Abdela and Koku Tamirat
Ethiopian Medical Journal, Vol.61(2), pp.161-169
2023
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Open Access CC BY-NC-ND V4.0
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Abstract

Accuracy Ethiopia Meta-analysis Systematic review Typhoid fever Widal test
Widal agglutination test is a serologic laboratory investigation that is used in the diagnosis of typhoid fever. It is an easy, relatively cheap, and readily available test with questionable reliability. The test performance differs from setting to setting depending on the technique used and other factors. The accuracy of this test in Ethiopia is poorly understood. So, the aim of this study was to evaluate the diagnostic accuracy of the Widal agglutination test for typhoid fever in Ethiopia. We conducted a systematic review and meta-analysis. Electronic databases (PubMed/Medline and Google scholar) were searched using preset search engines to identify relevant studies. The methodological quality of the included studies was assessed with a QUADAS2. We extracted important variables from the eligible articles. Statistical analysis was performed by STATA version 14. The electronic searches yielded 42 articles of which 8 were found eligible for analysis. The quality of these studies was rated to be moderate based on the QUADAS-2. The pooled sensitivity, specificity, and negative and positive predictive values of the Widal test were 80.8%, 53.0%, 98.5%, and 2.1% respectively. The widal agglutination test has average specificity, very good negative predictive value, and very poor positive predictive value for the diagnosis of typhoid fever. Relying on Widal for the diagnosis of typhoid fever may lead to over-diagnosis of typhoid fever and related complications including inappropriate use of antibiotics. There is an urgent need for rapid and reliable tests for the diagnosis of typhoid fever, particularly in settings like Ethiopia where doing timely culture is not feasible. The protocol of this systematic review and meta-analysis is registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42020194252.

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