Table 1.
Study Characteristicsa
| Study (Language, if Other Than English) | Location | Typhi, Paratyphi Included | Eligibility Criteria | Inpatients or Outpatients | Age Distribution of the Sample (in Years)c | How Long the Blood Was Incubated | Broth Used to Culture the Blood | Agar Used to Subculture the Blood | Other Cultures |
|---|---|---|---|---|---|---|---|---|---|
| Akoh 1991 [13] | Zaria, Nigeria | Typhi | Clinical suspicion | Inpatient | Not reported | Not reported | Thioglycolate | Not reported | Urine and stool |
| Avendano 1986 [14] | Santiago, Chile | Typhi, Paratyphi | Clinical suspicion | Inpatient | Children (ages 3–14) | Not reported | Brain heart infusion with sodium polyanetholsulfonate | Salmonella-Shigella, bismuth sulfite, Kliglers triple sugar iron | Bile |
| Baqi Durrani 1996 [15] | Karachi, Pakistan | Typhi, Paratyphi | Clinical suspicion or 4× rise in titers | Both | Older children (ages 5–20) | 7 days | Thioglycolate | Sheep’s blood, MacConkey’s, Salmonella-Shigella agar plates | |
| Barbagallo 1938 (Italian) [16] | Catania, Italy | Typhi, Paratyphi | Clinical suspicion | Inpatient | Not reported | Not reported | Oxoid (trypticase-soy broth) | MacConkey’s, triple sugar iron | |
| Bassily 1980a[17] | Cairo, Egypt | Typhi, Paratyphi | Patients suspected to have chronic salmonellosis | Inpatient | Older children (ages 10–18) | Not reported | Oxgall (oxbile) | Not reported | Urine culture, data not shown |
| Benavente 1981 [18] | Lima, Peru | Unclear or not reported | Not reported | Both | Not reported | Not reported | Oxgall (oxbile) | Not reported | Stool and bile cultures |
| Benavente 1984 [19] | Lima, Peru | Typhi | Clinical suspicion | Unclear or not reported | Not reported | 2+ days | Oxgall (oxbile) | Salmonella-Shigella | Stool cultures, duodenal cultures |
| Bhutta 1991a [20] | Karachi, Pakistan | Typhi | Patients with prior antibiotic treatment or a long duration of illness | Unclear or not reported | Children (age range not reported) | Not reported | Not reported | Not reported | |
| Chaicumpa 1992 [21] | Jakarta, Indonesia | Typhi | Clinical diagnosis | Inpatient | Not reported | 7 days | Oxgall (oxbile) | MacConkey’s, Salmonella-Shigella, desoxycholate-citrate-sucrose-lactose | Urine and stool |
| Chang 1982 (Spanish)a [22] | Lima, Peru | Typhi | Agglutination >1/160 or “significant” rise in titers, or a positive culture | Unclear or not reported | Children (age range not reported) | Not reported | Not reported | Not reported | |
| Chiragh 2005a [23] | Peshawar, Pakistan | Typhi | Clinical suspicion and a fever of more than 4–5 days; no antibiotics taken in previous 3–4 days | Unclear or not reported | Adults (ages 15+) | Not reported | Not reported | Not reported | Urine, data not shown |
| Dance 1991 [24] | Kathmandu, Nepal | Typhi, Paratyphi | Clinical diagnosis | Unclear or not reported | Not reported | Not reported | Brain heart infusion containing liquid | Not reported | |
| Debre 1935 (French)a [25] | Paris, France | Typhi | Not reported | Unclear or not reported | Not reported | Not reported | Meat liver or bile agar | Not reported | |
| Del Negro 1960 (Portuguese)a [26] | Sao Paulo, Brazil | Typhi, Paratyphi | Culture or serological confirmation of disease | Inpatient | Children (ages 0–15) | Not reported | Not reported | Not reported | Bile, urine, and stool |
| Farooqui 1991 [27] | Karachi, Pakistan | Typhi | Patients at Aga Khan hospital who had fever of unknown origin | Unclear or not reported | Not reported | 7 days | Brain heart infusion and thioglycolate | MacConkey’s, blood | |
| Gasem 1995 [28] | Semarang, Indonesia | Typhi | Fever for 6+ days and symptoms of typhoid fever | Inpatient | Adults (ages 14–60; mean 23.1) | 7 days | Oxgall (oxbile) | Salmonella Shigella, triple sugar iron | |
| Gasem 2003 [29] | Semarang, Indonesia | Typhi | Participants of an RCT of antibiotic treatment of typhoid. Pregnant women were excluded | Inpatient | Adults (ages 14+; mean 24.6; SD 7.7 years) | Not reported | Not reported | Bactec 9120 | |
| Gilman 1975 [30] | Mexico City, Mexico | Typhi | Patients with a clinical suspicion of typhoid who consented to a clinical trial of antibiotics | Unclear or not reported | Not reported | Not reported | Peptone | Not reported | Urine, stool and rose spot cultures |
| Guerra-Caceres 1979 [31] | Lima, Peru | Typhi | Clinical suspicion | Inpatient | All ages (mean 16.8; median 14; range 2–54) | 10 days | Oxoid (trypticase-soy broth) for half the specimens, and Ruiz-Castaneda for the other half | Not reported | Urine and stool |
| Hirsowitz 1951b [32] | Evaton, Transvaal, South Africa | Unclear or not reported | Culture or serological evidence of typhoid fever, or post-mortem examination consistent with typhoid fever | Inpatient | Older children and adults (ages 10+) | Not reported | Oxgall (oxbile) and nutrient | Not reported | Urine and stool |
| Hoffman 1984 [10] | Jakarta, Indonesia | Typhi, Paratyphi | Clinical suspicion | Inpatient | Older children and adults (ages 4–60; mean 22; SD 10.3) | 7 days | Oxgall (oxbile) | MacConkey’s, Salmonella-Shigella, desoxycholate-citrate-sucrose-lactose | Bile culture, rose-spot culture |
| Hoffman 1986 [33] | Jakarta, Indonesia | Typhi, Paratyphi | Clinical suspicion | Inpatient | All ages (mean 21.6; SD 9.4) | 21 days | Oxgall (oxbile) | MacConkey’s, Salmonella-Shigella, desoxycholate-citrate-sucrose-lactose | Streptokinase clot culture and rectal swab |
| James 1997b [34] | Pondicherry, India | Typhi, Paratyphi | Clinical suspicion and no evidence of chloramphenicol or bone marrow depressant use at the time of specimen collection | Unclear or not reported | Older children and adults (ages 13–42; mean 22.5) | Not reported | Not reported | Not reported | Urine and stool |
| Ling 1940 [35] | Shanghai, China | Typhi, Paratyphi | Clinical suspicion | Inpatient | Not reported | Not reported | Not reported | Not reported | Urine and stool |
| Ling 1948 [36] | Shanghai, China | Typhi, Paratyphi | Clinical suspicion | Inpatient | Not reported | 7 days | Sodium citrate solution | Endo’s agar | Bile, urine, and stool |
| Mehta 1984 [37] | Jamnagar, India | Unclear or not reported | Clinical suspicion | Inpatient | Older children and adults (ages 12–40) | 2 days | Oxgall (oxbile) | MacConkey’s | |
| Ott 1938 (German)b [38] | Berlin, Germany | Typhi, Paratyphi | Clinical suspicion | Unclear or not reported | Not reported | Not reported | Oxgall (oxbile) | Not reported | Urine and stool |
| Rajagopal 1986 [39] | Bangalore, India | Typhi, Paratyphi | Clinical suspicion | Inpatient | Not reported | Not reported | Oxgall (oxbile) | Not reported | Urine and stool |
| Rubin 1989 [40] | Jakarta, Indonesia | Typhi | Clinical suspicion | Inpatient | Older children and adults (ages 6+) | 7 days | Oxgall (oxbile) | MacConkey’s, Salmonella-Shigella, desoxycholate-citrate-sucrose-lactose | Rectal swabs |
| Sacks 1941b [41] | Baltimore, MD | Typhi | Clinical suspicion | Inpatient | Older children (ages 11–14) | Not reported | Not reported | Not reported | Stool and urine culture |
| Schlack 1966 (Spanish) [42] | Santiago, Chile | Typhi, Paratyphi | Clinical suspicion | Inpatient | Children (ages 8 months–13 years) | Unclear | Meat liver broth | Not reported | |
| Seidenstucker 1949 (German) [43] | Oldenburg, Germany | Typhi, Paratyphi | Not reported | Unclear or not reported | Not reported | 2 days | Oxgall (oxbile) | Not reported | Urine and stool |
| Sekarwana 1989 [44] | Bandung, Indonesia | Typhi | Clinical suspicion and fever of more than 7 days | Unclear or not reported | Children (ages 2–13; mean 6; median 5) | 7 days | Oxgall (oxbile) | Urine and stool | |
| Seshadri 1977 [45] | Madras (current-day Chennai), Tamil Nadu, India | Typhi | More than 5 days of fever with toxemia; gastrointestinal symptoms; soft splenomegaly | Unclear or not reported | Older children and adults (ages 13–35; mean 20; median 19) | Unclear | Oxgall (oxbile) | MacConkey’s | Urine and stool |
| Shin 1994b [46] | Seoul, South Korea | Typhi | Not reported | Unclear or not reported | Adults (ages 20–56) | Not reported | Not reported | Not reported | Urine and stool |
| Storti 1937 (French)b [47] | Paris, France | Typhi | Clinical suspicion | Inpatient | Not reported | Not reported | Not reported | Not reported | |
| Terminel 1973 (Spanish)b [48] | Mexico City, Mexico | Typhi | Clinical suspicion among patients who had rose spots | Unclear or not reported | Not reported | Not reported | Not reported | Not reported | Rose spot culture, stool cultures |
| Vallenas 1985 [49] | Lima, Peru | Typhi | Clinical suspicion | Unclear or not reported | Children (ages 2–13) | Not reported | Oxgall (oxbile) | Not reported | Rectal swab and duodenal culture |
| Wain 2008 [50] | Ho Chi Minh City, Vietnam and Dong Thap, Vietnam | Typhi | Clinical diagnosis | Inpatient | All ages (age range not reported) | 10 days | Oxgall (oxbile), brain heart infusion | Columbia with 0.05% sulphpolyanethosulphonate | Stool, data not shown |
| West 1989b [51] | Goroka, Papua New Guinea | Typhi | Febrile illness | Inpatient | Older children and adults (ages 10–60; mean 26.3) | 21 days | Oxoid (trypticase-soy broth) | Not reported |
Abbreviations: RCT, randomized controlled trial; SD, standard deviation.
aCitation numbers correspond to the reference list in Supplement S8. Additional details are provided in Supplementary Table S1.
bIndicates that the study will only be included in the summary of the systematic review but not in the analysis examining blood sample volume and sensitivity.
cWe categorized the age of study populations according to the following criteria: children, 0–4 years; older children, 5–15 years; adults, 15+ years.