Comparative Study on the Use of Widal Test to Stool Culture in the Laboratory Diagnosis of Typhoid Fever in Holy Family Hospital Akum, North West Region of Cameroon

Elvis C. Wam1, 2, 3, *, Christabel N. Arrey1, Leonard F. Sama2, 4, Lucy A. Agyingi5, 6, Abel N. Wam7, 8
1 School of Medical and Biomedical Sciences, National Polytechnic University Institute Bamenda, Bamenda, Cameroon
2 Department of Biochemistry, University of Dschang, Dschang, Cameroon
3 Department of Biology, Higher Teacher Training College (ENS) Bambili, University of Bamenda, Bamenda, Cameroon
4 Higher institute of Applied Science, Golf of Guinea University Institute, Douala, Cameroon
5 Faculty of Science, University of Dschang, PO Box 67, Dschang, Cameroon
6 Medical Diagnostics Centre, Yaounde, Cameroon
7 Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon
8 Central University Institute, Mile 6 Nkwen Bamenda, Bamenda, Cameroon

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© 2019 Wam et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the School of Medical and Biomedical Sciences, National Polytechnic University Institute Bamenda, Cameroon;
Tel: +237 679-573-177; E-mail:



Typhoid fever has several diagnostic tests. However, misdiagnosis is common since most health care facilities use only the Widal test without confirmation of results with a second test method.


This study aimed at evaluating the performance of Widal test to stool culture in the Laboratory diagnosis of typhoid fever.


Recruited in this study were 112 consented patients ≥1 year presenting with symptoms clinically suspected of typhoid fever visiting the Hospital in April, 2018. Blood and stool samples collected from all participants were subjected to Widal and stool culture, respectively. Serotyping was done using Salmonella O, and H antisera. Widal agglutination titre values ≥1:80 were considered as positive for the Salmonella antigen. Isolation of S. typhi from stool culture indicated an infection. Data was analysed using the Statistical Package for Social Sciences (SPSS). Sensitivity, specificity, Negative Predictive Value (NPV) and Positive Predictive Value (PPV) of Widal test were calculated. The sensitivity and specificity of the stool culture were 100% since it was the ideal to which the Widal test was compared.


Prevalence of typhoid fever using stool culture was 39.3%, sensitivity and specificity of Widal were 40.9% and 32.4%, respectively. NPV and PPV were 6.44% and 28.13%, respectively.


Widal test is not reliable for diagnosis of typhoid fever. Health care personnel should develop a rapid, highly sensitive and cheap diagnostic method that is also capable of differentiating Salmonella infection from other infections.

Keywords: Typhoid fever, Widal slide agglutination test, Stool culture, Sensitivity, Specificity, Negative predictive value, Positive predictive value.