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Baseline Antibody Titre to Salmonella Typhi And Salmonella Paratyphi A among Apparently Healthy Individuals

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– Baseline Antibody Titre to Salmonella Typhi And Salmonella Paratyphi A among Apparently Healthy Individuals –

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Abstract

Typhoid fever is endemic in the tropics and sub-tropical regions of the world. It is a major public health problem in most developing countries including Nigeria. Efforts are ongoing to develop new test techniques and improve existing ones in order to mitigate the morbidities and mortalities of typhoid and paratyphoid infections.

As such 180 serum samples from apparently healthy blood donors of the Department of Hematology, Ahmadu Bello University Teaching Hospital Zaria were evaluated for the levels of Salmonella typhi and Salmonella paratyphi A somatic O and flagella H antibodies using the quick tile technique and the Widal microtitire plate method to determine the baseline antibody titres.

The standard Salmonella O and H (Oxoid/Remmel diagnostic) antigens were used. The presence of specific IgM/IgG antibodies was also tested among the subjects using the Typhidot IgM/IgG test cassettes.

The occurrence of specific IgM in the study population was found in 3.9% of the samples studied while IgG occurred in only 1.1% of the population.

The distributions of the antibody titres of S. typhi and S. paratyphi A among the subjects were determined. Since titres of ≤ 1:20, 1:20, 1:40, were found in a significant proportion (>80%) of the population tested for S. typhi O and H, the cut off titre for Salmonella typhi was found to be 1:80 for both O and H antibodies.

Titres above 1:80 are therefore significant for the diagnosis of typhoid in our locality. For Salmonella paratyphi A, the cut off titre was found to be 1:40 for both anti O and anti H antibodies. Titres ≥ 1:80 are therefore significant titres for S. paratyphi A infections when using  the Widal technique.

Introduction

1.1 Background of the Study

Every year, thousands of cases of typhoid and paratyphoid infections are reported worldwide (Hurley et al., 2014). Salmonella enterica serovar typhi (S. typhi) and Salmonella paratyphi A,B,C are the causative agents of enteric fevers.

Typhoid fever is an acute, life threatening febrile illness caused by S. typhi which results in about 200,000 deaths worldwide each year largely in developing countries (Crump and  Mintz, 2010). Salmonella typhi infections exact a heavy toll on human populations particularly among children.

Despite the explosion of knowledge on the pathogenesis of enteric diseases experienced during the past decade, the number of diarrheal episodes and human deaths reported worldwide remain remarkably high (Fiorentino et al., 2013).

Due to the importance of Salmonella in the clinical and public health setting, there has been a significant effort to improve on the laboratory diagnosis of typhoid and paratyphoid fever.

The definitive diagnosis of typhoid fever requires the isolation of Salmonella typhi from blood, feces, urine, or other body fluids (Kataria et al., 2013).

In developing countries facilities for isolation and culture are often not available especially in primary and secondary health institutions.

However, where facilities are available, easy access to across the counter drugs by patients especially antibiotics make isolation of the organism difficult.

Diagnosis relies greatly upon the clinical features and the detection of agglutinating antibodies to S. typhi by the Widal test.

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