Comparative Widal Reaction for IgG/IgM Complement C3, lymphocyte and Neutrophils Assay in Patients with Suspected Typhoid Fever in Selected Hospitals in Kaduna State, Nigeria

Abstract

Typhoid also known as enteric fever is endemic in Nigeria most often diagnosed by the widal reaction though the results of this test are being questioned in many quarters. This has necessitated the search for other methods for analysis. This work is aimed at comparing the widal reaction with the rapid immunochromatographic assay the complement C3 and selected haematological indices. Two ml of blood was collected from 350 patients with suspected typhoid infection and analysed by the widal slide agglutination reaction and the IgG/IgM Immunochromatographic assay. Complement C3 was assayed by ELISA while neutrophils and Lymphocyte counts were also performed. The finding showed that 41(11.7%) and 29 (8.3%) were positive for S. typhi IgG and IgM respectively out of 350 patients. It was found that 207 patients had O-antigen widal reaction titres 1/80 and above for S. typhi out of which, 30 (14.5%) and 22(22.6%) were IgG and IgM positive respectively. Those with reactions 1/80 and above to the H-antigen were 118 with 24(20.3%) cases of IgG and 13(11.0%) of IgM. The mean neutrophil and lymphocyte count in the IgM positive were 48.90 ± 20.060 and 60.28±17.64 as compared to the negatives (48.46 ±18.95 and 55.02±19.19 respectively). The mean neutrophil and lymphocyte count of IgG positive were 50.68±19.65 and 57.22±19.72) while the negatives were 48.20±1.08 and 55.23±19.04. the mean plasma levels of complement factors C3 in the IgG positive was 630.70±327.41 as compared to those that are negative (626.97±247.72). The complement C3 levels was significantly higher (P =0.000) in the IgM positive (816.45±406) as compared to the IgM negatives (610.33±233.40). No significant association was observed between the clinical features and the typhoid positives.