1 Akramaman Health Centre, Ga West Municipal Health Directorate, Amasaman, Accra, Ghana.
2 Department of Nursing and Midwifery, University of Skills Training and Entrepreneurial Development, Mampong,
Ghana.
3 Department of Preventive and Social Medicine, University of Port Harcourt, Rivers State, Nigeria.
4 Department of Public Health, Disease Control Unit, Ghana Health Service, Ada West District, Sege, Ghana.
5 Department of Population and Reproductive Health, Mana Mission Hospital, Accra, Ghana.
6 Department of Public Health, School of Public Health, University of Port Harcourt, Port Harcourt, Nigeria.
7 Department of Population and Reproductive Health, University of Port Harcourt, Port Harcourt, Nigeria.
8 Department of Public Health, Community Health Nursing Training College, Akim Oda, Ghana.
9 Department of Public Health, Disease Control Unit, Assin Fosu Municipal Health Directorate, Assin Fosu, Ghana.
10 Department of Public Health, Federal University of Health Sciences, Azare, Bauchi State, Nigeria.
11 Department of Public Health, Abuakwa South Municipal Health Directorate, Ghana.
12 Department of Public Health, Ghana Health Service, Kpandai District Health Directorate, Kpandai, Ghana.
* Corresponding Author: Email: yeboahmichael7@gmail.com
ORCID Details
Michael Oppong Yeboah: https://orcid.org/0009-0007-0992-9595
Frank Bediako Agyei: https://orcid.org/0000-0003-2889-4803
Omosive Maduka: https://orcid.org/0000-0002-8243-8131
Oscar Vetsi: https://orcid.org/0000-0002-8456-1184
Samira Mastura Sulleman: https://orcid.org/0009-0000-2736-9308
Jerdu Bin-eranaa Nuhu: https://orcid.org/0009-0009-3156-4793
John Kwame Agbenyeavu: https://orcid.org/0009-0007-3643-1311
Rebecca Tricia Morrison: https://orcid.org/0009-0008-4071-5314
Boaz Ahulu: https://orcid.org/0009-0006-8116-0496
Benjamin Kwasi Amoako: https://orcid.org/0009-0001-0955-3678
Abubakar Alhassan: https://orcid.org/0009-0004-1240-8836
Porbilla Ewura Ofosu-Apea: https://orcid.org/0009-0008-8259-8048
Richard Kwaku Essien: https://orcid.org/0009-0005-5932-0193
Eric Addo Owusu: https://orcid.org/0009-0002-2631-3542
World Journal of Advanced Research and Reviews, 2026, 32(01), 1044–1056
Article DOI: 10.30574/wjarr.2026.32.1.2631
Received on 07 September 2026; revised on 13 October 2026; accepted on 15 October 2026
Background: Typhoid fever remains a significant public health challenge in Ghana due to overlapping clinical presentations with malaria and other febrile illnesses. Accurate diagnosis is essential for effective patient management and rational antibiotic use. This study evaluated determinants of diagnostic accuracy of typhoid fever tests in Ga West Municipality, Ghana.
Methods: A cross-sectional comparative diagnostic accuracy study was conducted in seven health facilities. A total of 284 participants with suspected typhoid fever were recruited using consecutive sampling. Data were collected through structured questionnaires, clinical evaluations, and laboratory investigations, including Widal test, RDT IgM, blood culture (reference standard), and PCR. Statistical analyses included descriptive statistics, chi-square tests, multivariable logistic regression, Cohen's kappa, and McNemar's test at a 0.05 significance level.
Results: Previous hospitalization was the strongest predictor of diagnostic accuracy for the Widal test (aOR = 7.74; p < 0.001) and RDT IgM (aOR = 6.96; p < 0.001). Symptom duration of 4–7 days was significantly associated with accuracy for both tests (Widal: aOR = 2.03; p = 0.019; RDT IgM: aOR = 2.51; p = 0.002). Age ≥45 years predicted Widal accuracy (aOR = 3.52; p = 0.016), while prior antibiotic use influenced RDT IgM accuracy (aOR = 2.87; p = 0.016). Widal test showed poor agreement with blood culture (κ = 0.16), RDT IgM showed moderate agreement (κ = 0.58), and PCR showed excellent agreement (κ = 0.92). Combined testing strategies improved diagnostic accuracy.
Conclusion: Diagnostic accuracy depends on patient-related and clinical factors. The Widal test performed poorly as a standalone tool, while PCR and blood culture provided superior accuracy. Integrated diagnostic algorithms combining rapid tests with confirmatory methods are recommended to improve typhoid fever diagnosis and patient outcomes.
Typhoid fever, Diagnostic accuracy, Widal test, RDT IgM, Blood culture, PCR, Ga West Municipality, Ghana
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Michael Oppong Yeboah, Frank Bediako Agyei, Omosive Maduka, Oscar Vetsi, Samira Mastura Sulleman, Jerdu Bin-eranaa Nuhu, John Kwame Agbenyeavu, Rebecca Tricia Morrison, Boaz Ahulu, Benjamin Kwasi Amoako, Abubakar Alhassan, Porbilla Ewura Ofosu-Apea, Richard Kwaku Essien, Eric Addo Owusu and Dadia Stephen. DETERMINANTS OF DIAGNOSTIC ACCURACY OF TYPHOID FEVER TESTS IN GA WEST MUNICIPALITY, GHANA. World Journal of Advanced Research and Reviews, 2026, 32(01), 1044–1056. Article DOI: https://doi.org/10.30574/wjarr.2026.32.1.2631