Cholera rapid test with enrichment step has diagnostic performance equivalent to culture

Lameck N. Ontweka, Lul O. Deng, Jean Rauzier, Amanda Debes, Fisseha Tadesse, Lucy A. Parker, Joseph F. Wamala, Bior K. Bior, Michael Lasuba, Abiem Bona But, Francesco Grandesso, Christine Jamet, Sandra Cohuet, Iza Ciglenecki, Micaela Serafini, David Allen Sack, Marie Laure Quilici, Andrew Azman, Francisco J. Luquero, Anne Laure Page

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Article numbere0168257
JournalPLoS One
Volume11
Issue number12
DOIs
StatePublished - Dec 1 2016

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cholera
Cholera
Polymerase chain reaction
Routine Diagnostic Tests
polymerase chain reaction
diagnostic techniques
Polymerase Chain Reaction
testing
Disease Outbreaks
Vibrio cholerae O1
Peptones
reference standards
peptones
Sudan
crystals
India
ambient temperature
sampling
Crystals
Temperature

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Ontweka, L. N., Deng, L. O., Rauzier, J., Debes, A., Tadesse, F., Parker, L. A., ... Page, A. L. (2016). Cholera rapid test with enrichment step has diagnostic performance equivalent to culture. PLoS One, 11(12), [e0168257]. https://doi.org/10.1371/journal.pone.0168257

Cholera rapid test with enrichment step has diagnostic performance equivalent to culture. / Ontweka, Lameck N.; Deng, Lul O.; Rauzier, Jean; Debes, Amanda; 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 Allen; Quilici, Marie Laure; Azman, Andrew; Luquero, Francisco J.; Page, Anne Laure.

In: PLoS One, Vol. 11, No. 12, e0168257, 01.12.2016.

Research output: Contribution to journalArticle

Ontweka, LN, Deng, LO, Rauzier, J, Debes, A, Tadesse, F, Parker, LA, Wamala, JF, Bior, BK, Lasuba, M, But, AB, Grandesso, F, Jamet, C, Cohuet, S, Ciglenecki, I, Serafini, M, Sack, DA, Quilici, ML, Azman, A, Luquero, FJ & Page, AL 2016, 'Cholera rapid test with enrichment step has diagnostic performance equivalent to culture', PLoS One, vol. 11, no. 12, e0168257. https://doi.org/10.1371/journal.pone.0168257
Ontweka, Lameck N. ; Deng, Lul O. ; Rauzier, Jean ; Debes, Amanda ; 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 Allen ; Quilici, Marie Laure ; Azman, Andrew ; Luquero, Francisco J. ; Page, Anne Laure. / Cholera rapid test with enrichment step has diagnostic performance equivalent to culture. In: PLoS One. 2016 ; Vol. 11, No. 12.
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