PREVALENCE OF SALMONELLA TYPHI AND SALMONELLA PARATYPHI IN STOOL SAMPLES FROM SERO-POSITIVE WIDEL TEST PATIENTS IN DHAMAR CITY, YEMEN

Abstract

Background and Aims: There are various diagnostic tests for typhoid fever. However, because the majority of healthcare facilities solely employ the Widal test without verifying the results with a second test method, misdiagnosis is frequent. In a number of public and private hospitals in Dhamar, Yemen, the study sought to ascertain the incidence of Salmonella typhi and Salmonella paratyphi as well as related factors among clinically diagnosed typhoid fever patients.

Methods: The study included 250 patients with clinical signs of typhoid fever, from whom 250 blood samples were collected. The Widal test was then used to detect typhoid fever. Stool samples were also collected from all patients who tested positive, and these samples were cultured on bismuth sulphite agar to isolate S. typhi and S. paratyphi; then confirmation was done with biochemical reactions. Sociodemographic data were collected from the patients through a structured questionnaire and then analysed using Epi-info 7 software.

Results: Out of 250 blood samples, 194 (77.6%) were positive for seropositivity via the Widal test. Stool samples from these patients were cultured on bismuth sulphide agar, leading to 63 positive cultures (32.5%). Notably, 46 isolates (23%) were from patients recently treated with antibiotics. Among the 63 positives, 9 samples were S. typhi and 54 were S. paratyphi. Affected patients included 45 females (23.2%) and 18 males (9.3%), with the highest prevalence in the 21-30 age group (42.8%); 55 isolates (87.3%) were susceptible to ciprofloxacin and ofloxacin, while 41 (65.1%) were resistant to cefotaxime.

Conclusion: In conclusion, antibiotic treatment for typhoid fever often fails due to high rates of resistance to antibiotics such as ciprofloxacin, ofloxacin, and cefotaxime, which are considered first-line treatments for typhoid. Furthermore, the reliability of the Widal test in diagnosing typhoid fever is questionable due to a high rate of false-positive results.

               

Peer Review History:

Received 17 February 2026;   Reviewed 9 March 2026; Accepted  13 April; Available online 15 May 2026

Academic Editor: Dr. Iman Muhammad Higazy, National Research Center, Egypt, [email protected]

Reviewers:

Prof. Syamsudin Abdillah, Pancasila University, Indonesia, [email protected]

Dr. Mohaddese Mahboubi, Alzahra University, Tehran, Iran, [email protected]