International Journal of Contemporary Pediatrics | August 2020 | Vol 7 | Issue 8 Page 1677 International Journal of Contemporary Pediatrics Ansari MA et al. Int J Contemp Pediatr. 2020 Aug;7(8):1677-1680 http://www.ijpediatrics.com pISSN 2349-3283 | eISSN 2349-3291 Original Research Article Typhidot IgM as a reliable and rapid diagnostic test for typhoid fever among children in a tertiary care hospital Mohammad Ashfaque Ansari*, Amit Kumar Thakur, Atindra Mishra, Md Jaffer Rain INTRODUCTION Typhoid fever is prolonged febrile illness caused by a systemic infection with Salmonella enteric serovar Typhi (S. Typhi). Paratyphoid is caused by closely related organisms Salmonella enteric Serovar Paratyphi A, Salmonella Schottmulleri (S. Paratyphi B), or Salmonella Hirshfeldii (S. Paratyphi C). S Paratyphi A is the only one of the Paratyphi that has been isolated in Nepal. 1, 2 Typhoid Fever occurs in all parts of the world where there is substandard water supply and sanitation. It has almost been eliminated from developed countries because of sewage and water treatment facilities but remains a common disease and a major cause of morbidity and mortality in the third world countries. Exposure of the individual to contaminated food or water closely correlates with the risk for enteric fever. 3,4 Typhoid Fever was an important cause of illness and death in the overcrowded and unsanitary urban conditions of the United States and Europe in the 19th century. World Health Organization (WHO) conservatively estimates the annual global incidence of typhoid fever at 0.3%. Typhoid Fever remains an important public health issue in many developing countries and predominates in areas with poor sanitation, which aids its transmission and persistence in the human population. 5-7 ABSTRACT Background: Typhoid fever still continues to be a major public health problem in Nepal. A clinical spectrum of typhoid varies widely. It causes significant complication as well as mortality. A simple, reliable, affordable and rapid diagnostic test has been a long felt need of the clinicians to prescribe specific medication, adopt prevention of the emergence of antibiotics resistance and overall reduce the disease burden in the community. Methods: The prospective descriptive study was performed in 125 children between 2 years to 15 years of age admitted to the Pediatrics Department from September 2017 to September 2018. Blood culture, Typhidot rapid IgM were performed. MEDCALC software was used to calculate 95% confidence interval for sensitivity, specificity, predictive value positive, predictive value negative and accuracy. Kappa test was used to determine the agreement between Typhidot IgM and blood culture methods. Results: The study consisted of 125 children with acute febrile illness for more than 3 days with clinical symptomatology, consistent with typhoid fever. The reliability of Typhidot IgM in relation with blood culture and the study lighten that sensitivity 92.3% (95% CI: 63.9, 99.8), specificity 49.1% (95% CI: 39.5, 58.7), PPV 17.4% (95% CI: 14.2, 21.1), NPV 98.2% (95% CI: 89.2, 99.7) and accuracy 53.6% (95% CI: 44.5, 62.6). The two methods i.e. Typhoid IgM and blood culture shows significant agreement with p value 0.004. Conclusions: The present study demonstrates that Typhidot IgM has all the attributes of an ideal screening test. Keywords: Diagnostic, Typhidot IgM, Typhoid fever Department of Pediatrics, National Medical College Teaching Hospital, Birgunj, Parsa, Nepal Received: 07 July 2020 Accepted: 14 July 2020 *Correspondence: Dr. Mohammad Ashfaque Ansari, E-mail: drashfaqmd@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20203096