[Evaluation of the Widal-Felix serodiagnostic test in Togo]. / Evaluation de la pratique du sérodiagnostic de Widal et Félix au Togo.

PURPOSE: To evaluate the efficacy of Widal-Felix serodiagnostic testing in Togo. METHOD: This study using a cohort of 200 patients recruited at hospitals in Lome and Atakpame from November 2005 to April 2006 was designed to compare the sensitivity and specificity of the routinely used technique (plate agglutination) and reference technique (tube agglutination). RESULTS: Findings showed that the prevalence of typhoid fever was 1.5% while that of paratyphoid fever was nil. The hardest-hit age group was young people between 11 to 20 years. Men were two times more likely than women to be infected (sex-ratio, 0.5). The most useful symptoms for discriminating patients seropositive for Salmonella typhi from other serological profiles were abdominal pain (p<0.034) and diarrhea (p<0.008). The thick-drop malaria test was positive in all 3 patients (100%) with proven typhoid fever in comparison with 3.9% of the 154 patients with negative Widal-Felix serodiagnostic tests and 26.2% of the 42 patients with intermediate serological profiles. The sensitivity and specificity of the plate technique were 60.0% and 98.06% respectively. The sensitivity and specificity of laboratory analysis were 60.0% and 91.08% respectively. CONCLUSION: The gap between the specificity of the routine plate technique and laboratory analysis underscores the difficulty of performing and interpreting the Widal-Felix serodiagnostic test. The low sensitivity and specificity of the Widal-Felix serodiagnostic test also cast doubt on systematic use for diagnosis in patients presenting fever and on initiation of antibiotic treatment based on agglutination of a single antigen. To improve the specificity of the Widal-Felix serodiagnostic test, we recommend standardization of interpretation criteria and use of tube agglutination. We also see the need for development of another reproducible immunologic test for the diagnosis of typhoid and paratyphoid infections.

Self-reported oral hygiene habits, health knowledge, and sources of oral health information in a group of Japanese junior high school students.

The purpose of the present study was to analyze self-reported oral hygiene habits, sources of oral health information, and oral health knowledge in a group of Japanese junior high school students and to determine whether there is a need for improvement in the school's present oral health instruction. A sample of 110 students aged 12-14 in Chiba City were surveyed by means of a questionnaire composed of 24 multiple choice questions. The questions focused on: (1) experience of school-based oral health education, (2) sources of oral health information, (3) knowledge about dental caries, periodontal disease, and the preventive action of fluoride, (4) oral hygiene habits, and (5) dietary behavior. Results showed that more than two-thirds of the students had participated in some kind of school-based oral health education program. Most students (76%) claimed that toothbrushing was the main event attended and 63% claimed that toothbrushing was the main subject they had been taught. The school nurse was identified by 48% of the students as their main source of oral health information in school-based oral health education. When asked to identify their main source of oral health information, most of the students identified "school". Half of the students (48%) identified dental plaque as the main cause of dental caries but only 31%, as the main cause of periodontal disease. Few students (11%) were able to identify the preventive action of fluoride; 58% answered "I don't know"). These results suggest that a meaningful target for the oral health education of children should be the improvement of the school's oral health instruction.