Is Widal Test, introduced over a century ago for the serological diagnosis of enteric or typhoid fever caused by the bacterium, Salmonella typhi, still relevant in the 21st century "omics" science? There are about four serovars associated with human typhoid fever and they include Salmonella enterica, subspecies enterica serovar typhi (D) and, to a lesser extent, related serovars paratyphi A, B, and C.
Salmonella typhi as a human-restricted enteric pathogen affects an estimated 11.9 to 26.9 million people annually (WHO, 2017), mostly people living in low-resource regions with poor sanitation, over-crowding and in countries with social/economic conflicts and travelers to regions of endemicity.
The global estimate of typhoid fever is nothing compared with the situation in Nigeria as news headline in Nigeria reported "Misdiagnosis of typhoid: Trouble as almost everybody tests positive to typhoid".
While Widal test is no longer used for diagnosis of typhoid fever in the Western hemisphere, yet the developing countries, especially Nigeria still rely on it, thus leading to over-diagnosis, unnecessary use of antibiotics, and the emergence of multidrug resistance. The standard for the diagnosis of typhoid fever still remains culture isolation, however, few laboratories in Nigeria rely only on stool culture, which unfortunately yields sensitivity of less than 50%. We seek to determine the gut microbiome composition of subjects who test positive for the Widal test and those with a negative response. This project has the potential to reveal microbial groups that colonize these group of subjects.
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