Field evaluation of a rapid immunochromatographic dipstick test for the diagnosis of cholera in a high-risk population

BackgroundEarly detection of cholera outbreaks is crucial for the implementation of the most appropriate control strategies.MethodsThe performance of an immunochromatographic dipstick test (Institute Pasteur, Paris, France) specific for Vibrio cholerae O1 was evaluated in a prospective study in Beira, Mozambique, during the 2004 cholera season (January-May). Fecal specimens were collected from 391 patients with acute watery nonbloody diarrhea and tested by dipstick and conventional culture.ResultsThe overall sensitivity and specificity of the rapid test compared to culture were 95% (95% confidence interval [CI]: 91%–99%) and 89% (95% CI: 86%–93%), respectively. After stratification by type of sample (rectal swab/bulk stool) and severity of diarrhea, the sensitivity ranged between 85% and 98% and specificity between 77% and 97%.ConclusionThis one-step dipstick test performed well in the diagnosis of V. cholerae O1 in a setting with seasonal outbreaks where rapid tests are most urgently needed.

[1]  D. Sack.  Underestimating the cholera problem and the potential for vaccination — a case for accelerating the use of cholera vaccines , 1995 .

[2]  H. Oshitani,et al.  Can oral cholera vaccination play a role in controlling a cholera outbreak? , 2004, Vaccine.

[3]  M. A. Malek,et al.  Use of Dipsticks for Rapid Diagnosis of Cholera Caused by Vibrio cholerae O1 and O139 from Rectal Swabs , 2003, Journal of Clinical Microbiology.

[4]  R. Sack,et al.  Development and evaluation of rapid monoclonal antibody-based coagglutination test for direct detection of Vibrio cholerae O139 synonym Bengal in stool samples , 1994, Journal of clinical microbiology.

[5]  R. Sack,et al.  Evaluation of the monoclonal antibody-based kit Bengal SMART for rapid detection of Vibrio cholerae O139 synonym Bengal in stool samples , 1995, Journal of clinical microbiology.

[6]  David Moher,et al.  The STARD Statement for Reporting Studies of Diagnostic Accuracy: Explanation and Elaboration , 2003, Annals of Internal Medicine [serial online].

[7]  K. Monsur.  A highly selective gelatin-taurocholate-tellurite medium for the isolation of Vibrio cholerae. , 1961, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[8]  M. Chongsa-nguan,et al.  Rapid detection of V. cholerae 01 , 1995 .

[9]  G. Losonsky,et al.  Validation and Characterization of a Human Volunteer Challenge Model for Cholera by Using Frozen Bacteria of the New Vibrio cholerae Epidemic Serotype, O139 , 1999, Infection and Immunity.

[10]  M. Cohen,et al.  A human volunteer challenge model using frozen bacteria of the new epidemic serotype, V. cholerae O139 in Thai volunteers. , 2001, Vaccine.

[11]  R. Colwell,et al.  A novel kit for rapid detection of Vibrio cholerae O1 , 1994, Journal of clinical microbiology.

[12]  Frank Buntinx,et al.  The evidence base of clinical diagnosis , 2008 .

[13]  C B Begg,et al.  Biases in the assessment of diagnostic tests. , 1987, Statistics in medicine.

[14]  D. Sack,et al.  One-Step Immunochromatographic Dipstick Tests for Rapid Detection of Vibrio cholerae O1 and O139 in Stool Samples , 2003, Clinical Diagnostic Laboratory Immunology.