Résumé
To determine the most reliable, rapid, easy to perform and cheaper test for the diagnosis of typhoid fever. Two years hospital based comparative and analytical study. Place and Duration of the study: This study was carried out at the National Institute of Child Health, Karachi in collaboration with Department of Microbiology, University of Karachi from April 2003 to March 2005. One hundred and ten patients up to 13 years of age were included in the study after taking verbal informed consent from their parents/caregivers. Patients had fever of more than five days with presumptive diagnosis of typhoid. Patients who did not meet the above mentioned inclusion criteria or suffering with any other/obvious cause of fever were excluded from the study. Total leucocyte count, Widal test, blood/bone marrow cultures and typhi dot tests were performed for comparison. Out of 110 patients 90 [81.82%] were confirmed positive for typhoid fever taking bone marrow cultures as standard. Most of the typhoid fever positive cases had normal or slightly raised total leucocyte count. By blood culture isolation rate of pathogen was only 14% while by bone marrow culture isolation rate was 82%. Widal test correlated in about 65% cases. Typhi dot test was performed on 32 patients only, with the positivtiy of 75% and the sensitivity about 100%. It is concluded that Dot Elisa [Typhi Dot] is specific and sensitive and comparatively rapid test, but bone marrow culture still remains the gold standard as it provides high isolation rate of organism and sensitivity pattern too