Cholera Rapid Test with Enrichment Step Has Diagnostic Performance Equivalent to Culture
MetadataShow full item record
AbstractCholera rapid diagnostic tests (RDT) could play a central role in outbreak detection and surveillance in low-resource settings, but their modest performance has hindered their broad adoption. The addition of an enrichment step may improve test specificity. We describe the results of a prospective diagnostic evaluation of the Crystal VC RDT (Span Diagnostics, India) with enrichment step and of culture, each compared to polymerase chain reaction (PCR), during a cholera outbreak in South Sudan. RDTs were performed on alkaline peptone water inoculated with stool and incubated for 4-6 hours at ambient temperature. Cholera culture was performed from wet filter paper inoculated with stool. Molecular detection of Vibrio cholerae O1 by PCR was done from dry Whatman 903 filter papers inoculated with stool, and from wet filter paper supernatant. In August and September 2015, 101 consecutive suspected cholera cases were enrolled, of which 36 were confirmed by PCR. The enriched RDT had 86.1% (95% CI: 70.5-95.3) sensitivity and 100% (95% CI: 94.4-100) specificity compared to PCR as the reference standard. The sensitivity of culture versus PCR was 83.3% (95% CI: 67.2-93.6) for culture performed on site and 72.2% (95% CI: 54.8-85.8) at the international reference laboratory, where samples were tested after an average delay of two months after sample collection, and specificity was 98.5% (95% CI: 91.7-100) and 100% (95% CI: 94.5-100), respectively. The RDT with enrichment showed performance comparable to that of culture and could be a sustainable alternative to culture confirmation where laboratory capacity is limited.
PublisherPublic Library of Science
- Evaluation of the SD bioline cholera rapid diagnostic test during the 2016 cholera outbreak in Lusaka, Zambia.
- Authors: Mwaba J, Ferreras E, Chizema-Kawesa E, Mwimbe D, Tafirenyika F, Rauzier J, Blake A, Rakesh A, Poncin M, Stoitsova S, Kwenda G, Azman AS, Chewe O, Serafini M, Lukwesa-Musyani C, Cohuet S, Quilici ML, Luquero FJ, Page AL
- Issue date: 2018 Aug
- Alkaline peptone water enrichment with a dipstick test to quickly detect and monitor cholera outbreaks.
- Authors: Bwire G, Orach CG, Abdallah D, Debes AK, Kagirita A, Ram M, Sack DA
- Issue date: 2017 Nov 21
- Field evaluation of a locally produced rapid diagnostic test for early detection of cholera in Bangladesh.
- Authors: Islam MT, Khan AI, Sayeed MA, Amin J, Islam K, Alam N, Sultana N, Jahan N, Rashid MM, Khan ZH, Zion MI, Afrad MH, Siddique SA, Khanam F, Begum YA, Islam MS, Qadri F
- Issue date: 2019 Jan
- Development of a new dipstick (Cholkit) for rapid detection of Vibrio cholerae O1 in acute watery diarrheal stools.
- Authors: Sayeed MA, Islam K, Hossain M, Akter NJ, Alam MN, Sultana N, Khanam F, Kelly M, Charles RC, Kováč P, Xu P, Andrews JR, Calderwood SB, Amin J, Ryan ET, Qadri F
- Issue date: 2018 Mar
- Evaluation of enrichment method for the detection of Vibrio cholerae O1 using a rapid dipstick test in Bangladesh.
- Authors: George CM, Rashid MU, Sack DA, Bradley Sack R, Saif-Ur-Rahman KM, Azman AS, Monira S, Bhuyian SI, Zillur Rahman KM, Toslim Mahmud M, Mustafiz M, Alam M
- Issue date: 2014 Mar