Abstract

Assessing Clot Culture Technique and Relationship between Typhoid Antibodies and Red Blood Cell Indices

Enteric or typhoid fever is a systemic infection mostly caused by Salmonella typhi and Salmonella paratyphi A. Blood culture and rapid diagnostic antibody detection is widely used in the diagnosis of enteric fever in Ghana. Isolation of Salmonella from blood culture is challenging. The study accessed clot culture technique in diagnosing typhoid fever. The correlation between parameters of red blood cell indices and IgM IgG was also assessed. 400 patients were suspected of having typhoid fever. 94 were not on medication or treatment for typhoid fever. 43 out of the 94 were typhoid IgM positive. Clot culture and the conventional culture techniques were used to isolate Salmonella from the 43 patients. Complete blood counts were obtained from 94 patients. The results showed no bacteria growth for both clot culture and conventional blood culture techniques. The presents of typhoid IgG in the blood is weakly associated with decreasing levels of red blood cell count irrespective of age and sex. For every unit increase in mean cell hemoglobin concentration and hematocrit, the odds of not detecting the presents of typhoid IgM is 0.56 and 0 respectively at a 95% confidence interval. Therefore increasing concentrations of mean cell hemoglobin and hematocrit will result in a false-negative IgM RDT test which is not a result of the faulty Test kit or test procedure. Based on the findings of this research, diagnosing typhoid fever with blood culture remains a challenge as well as IgM detection using RDT test kits.

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