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    Cholera Rapid Test with Enrichment Step Has Diagnostic Performance Equivalent to Culture

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    Research article (643.1Kb)
    Publication Date
    2016-12-19
    Authors
    Ontweka, Lameck N.
    Deng, Lul O.
    Rauzier, Jean
    Debes, Amanda K.
    Tadesse, Fisseha
    Parker, Lucy A.
    Wamala, Joseph F.
    Bior, Bior K.
    Lasuba, Michael
    But, Abiem Bona
    Grandesso, Francesco
    Jamet, Christine
    Cohuet, Sandra
    Ciglenecki, Iza
    Serafini, Micaela
    Sack, David A.
    Quilici, Marie-Laure
    Azman, Andrew S.
    Luquero, Francisco J.
    Page, Anne-Laure
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    (20 total)
    Editor
    Chaturvedi, Vishnu
    Type
    Article, Journal
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    Citation

    Ontweka LN, Deng LO, Rauzier J, Debes AK, Tadesse F, Parker LA, et al. (2016) Cholera Rapid Test with Enrichment Step Has Diagnostic Performance Equivalent to Culture. PLoS ONE 11 (12): e0168257. doi:10.1371/journal. pone.0168257

    Abstract/Overview

    Cholera 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.

    Subject/Keywords
    Specificity; Prospective diagnostic evaluation; Polymerase chain reaction (PCR); Culture; Cholera
    Further Details

    Copyright: © 2016 Ontweka et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    Publisher
    CrossMark
    Permalink
    https://repository.amref.ac.ke/handle/123456789/710
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    • General - GEN [355]

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