PERBANDINGAN TINGKAT AKURASI ANTARA TES WIDAL DENGAN TES TUBEX PADA ANAK DENGAN DEMAM TIFOID DI SEMARANG

Abstract

Background: In Indonesia case fatality rate of typhoid fever is still high. There are 900.000 cases of typhoid fever per year with more than 20.000 deaths. About 91% of cases were children aged 3-19 years old. In Semarang in 2009, the number of patients with typhoid fever was 7.965 cases. High incidence and mortality rate could be due to rapid and accurate diagnostic method has not employed yet. Aimed of this study is to compare the accuracy of Widal and Tubex test in children with typhoid fever. Methods: An observational study was performed in the period of March-June 2011. Research subjects were typhoid patients aged 2-14 years old who were treated at Dr. Infection Ward Dr. Kariadi Hospital Semarang. Thyphoid fever diagnosis was determined by Widal test and Tubex test, and confirmed by blood culture. Subjects who received antibiotics prior to the study, fever less than 5 days and have history of typhoid fever were excluded. Clinical and laboratory manifestations have been done at admission or when diagnosed as typhoid. Chi-square and diagnostic test were used to assesed diagnostic performance of Widal and Tubex test. Results: There were 49 patients who have clinical syndrome as typhoid fever. Diagnostic test yield accuracy of Tubex test was 81,6%, sensitivity 100%, specificity 52,96%, PPV 76,9%, NPV 100%, and accuracy Widal test was 38,8%, sensitivity 16,7%, specificity 73,7%, PPV 50%, NPV 35,9%. Conclusion: Tubex test has accuracy rate higher than Widal’s with 81,6%.