Journal of Applied Holistic Nursing Science
Vol. 3 No. 1 (2026): October 2026

The Relationship Between Widal Agglutination Titer Categories and Neutrophil-to-Lymphocyte Ratio in Patients with Acute Fever

Anak Agung Istri Tika Ulundia (Wira Medika Bali Institute of Health Sciences)
Anak Agung Ayu Eka Cahyani (Wira Medika Bali Institute of Health Sciences)
Moh. Fairuz Abadi (Wira Medika Bali Institute of Health Sciences)



Article Info

Publish Date
01 Oct 2026

Abstract

Background: Acute fever is a common clinical condition caused by various infectious agents, including Salmonella Typhi. The Widal test is widely used to support typhoid diagnosis because it is simple, rapid, and inexpensive, although its diagnostic accuracy is limited. The Neutrophil-Lymphocyte Ratio (NLR) is a hematological parameter reflecting systemic inflammation. This study aimed to determine the relationship between Widal agglutination titer categories and NLR in patients with fever Methods : This observational analytical study used a cross-sectional approach. Secondary data were obtained from medical records and laboratory results. A total of 134 patients with fever were selected using purposive sampling. Widal titers and neutrophil and lymphocyte counts were recorded, and NLR was calculated by dividing the neutrophil count by the lymphocyte count. Data were analyzed using Spearman’s correlation test at 0.05. Results: Moderately positive Widal titers (1:160) predominated, accounting for 29.9% of patients. Low NLR values (<3) predominated at 44.0%. Spearman analysis showed a significant positive relationship between Widal titer categories and NLR (p = 0.030; r = 0.187), with a very weak correlation. Conclusion: There was a significant positive relationship between Widal titers and NLR. However, the very weak correlation indicates that other factors may influence NLR values.

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Journal Info

Abbrev

JAHNS

Publisher

Subject

Health Professions Nursing

Description

Journal of Applied Holistic Nursing Science is an nursing journal which publishes scientific works for nurses, academics, and practitioners. JAHNS welcomes and invites original and relevant research articles in nursing, as well as systematic study and case report particularly in nursing. This ...