Rapid dipstick detection of Vibrio cholerae in household stored and municipal water in Dhaka, Bangladesh: CHoBI7 trial

Mahamud ur Rashid, Zillur Rahman, Vanessa Burrowes, Jamie L. Perin, Munshi Mustafiz, Shirajum Monira, K. M. Saif-Ur-Rahman, Sazzadul Islam Bhuyian, Md Toslim Mahmud, R. Bradley Sack, David Allen Sack, Munirul Alam, Christine Marie George

Research output: Contribution to journalArticle

Abstract

Objective: In urban Dhaka, Bangladesh, 30% of source water samples collected from the households of patients with cholera had detectable Vibrio cholerae. These findings indicate an urgent need for a public health intervention for this population. The Crystal VC® dipstick test is a rapid method for detecting V. cholerae in stool and water. However, to date no study has investigated the use of the rapid dipstick test for household surveillance of stored drinking water. Methods: The efficacy of the Crystal VC® dipstick test for detecting V. cholerae in the Dhaka city municipal water supply and stored household drinking water sources after enrichment for 18 h in alkaline peptone water (APW) was compared to bacterial culture as the gold standard. Results: A total of 1648 water samples (824 stored household drinking water samples and 824 municipal water supply samples) were collected from households of patients with cholera. The overall specificity and sensitivity of the dipstick test compared to bacterial culture was 99.6% (95% confidence interval (CI): 99.2%, 99.9%) and 65.6% (95% CI: 55.2%, 75%), respectively. The specificities for stored household drinking water and Dhaka city municipal supply water compared to bacterial culture were 99.8% (95% CI: 99.1%, 100%) and 99.5% (95% CI: 98.6%, 99.9%), respectively (P = 0.138), and the sensitivities were 66.7% (95% CI: 43.0%, 85.4%) and 65.3% (95% CI: 53.5%, 76.0%), respectively (P = 0.891). Conclusion: The Crystal VC® dipstick is a promising screening tool for cholera outbreak surveillance in resource-limited settings where elimination of false-positive results is critical. The lower than expected sensitivity should be further investigated in future studies.

Original languageEnglish (US)
JournalTropical Medicine and International Health
DOIs
StateAccepted/In press - 2016

Fingerprint

Vibrio cholerae
Bangladesh
Confidence Intervals
Drinking Water
Water
Water Supply
Cholera
Peptones
Disease Outbreaks
Public Health
Sensitivity and Specificity
Population

Keywords

  • Vibrio cholerae
  • Cholera
  • Dipstick test
  • Outbreak
  • Rapid test
  • Stored water
  • Supply water

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Rapid dipstick detection of Vibrio cholerae in household stored and municipal water in Dhaka, Bangladesh : CHoBI7 trial. / Rashid, Mahamud ur; Rahman, Zillur; Burrowes, Vanessa; Perin, Jamie L.; Mustafiz, Munshi; Monira, Shirajum; Saif-Ur-Rahman, K. M.; Bhuyian, Sazzadul Islam; Mahmud, Md Toslim; Sack, R. Bradley; Sack, David Allen; Alam, Munirul; George, Christine Marie.

In: Tropical Medicine and International Health, 2016.

Research output: Contribution to journalArticle

Rashid, Mahamud ur ; Rahman, Zillur ; Burrowes, Vanessa ; Perin, Jamie L. ; Mustafiz, Munshi ; Monira, Shirajum ; Saif-Ur-Rahman, K. M. ; Bhuyian, Sazzadul Islam ; Mahmud, Md Toslim ; Sack, R. Bradley ; Sack, David Allen ; Alam, Munirul ; George, Christine Marie. / Rapid dipstick detection of Vibrio cholerae in household stored and municipal water in Dhaka, Bangladesh : CHoBI7 trial. In: Tropical Medicine and International Health. 2016.
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title = "Rapid dipstick detection of Vibrio cholerae in household stored and municipal water in Dhaka, Bangladesh: CHoBI7 trial",
abstract = "Objective: In urban Dhaka, Bangladesh, 30{\%} of source water samples collected from the households of patients with cholera had detectable Vibrio cholerae. These findings indicate an urgent need for a public health intervention for this population. The Crystal VC{\circledR} dipstick test is a rapid method for detecting V. cholerae in stool and water. However, to date no study has investigated the use of the rapid dipstick test for household surveillance of stored drinking water. Methods: The efficacy of the Crystal VC{\circledR} dipstick test for detecting V. cholerae in the Dhaka city municipal water supply and stored household drinking water sources after enrichment for 18 h in alkaline peptone water (APW) was compared to bacterial culture as the gold standard. Results: A total of 1648 water samples (824 stored household drinking water samples and 824 municipal water supply samples) were collected from households of patients with cholera. The overall specificity and sensitivity of the dipstick test compared to bacterial culture was 99.6{\%} (95{\%} confidence interval (CI): 99.2{\%}, 99.9{\%}) and 65.6{\%} (95{\%} CI: 55.2{\%}, 75{\%}), respectively. The specificities for stored household drinking water and Dhaka city municipal supply water compared to bacterial culture were 99.8{\%} (95{\%} CI: 99.1{\%}, 100{\%}) and 99.5{\%} (95{\%} CI: 98.6{\%}, 99.9{\%}), respectively (P = 0.138), and the sensitivities were 66.7{\%} (95{\%} CI: 43.0{\%}, 85.4{\%}) and 65.3{\%} (95{\%} CI: 53.5{\%}, 76.0{\%}), respectively (P = 0.891). Conclusion: The Crystal VC{\circledR} dipstick is a promising screening tool for cholera outbreak surveillance in resource-limited settings where elimination of false-positive results is critical. The lower than expected sensitivity should be further investigated in future studies.",
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author = "Rashid, {Mahamud ur} and Zillur Rahman and Vanessa Burrowes and Perin, {Jamie L.} and Munshi Mustafiz and Shirajum Monira and Saif-Ur-Rahman, {K. M.} and Bhuyian, {Sazzadul Islam} and Mahmud, {Md Toslim} and Sack, {R. Bradley} and Sack, {David Allen} and Munirul Alam and George, {Christine Marie}",
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T1 - Rapid dipstick detection of Vibrio cholerae in household stored and municipal water in Dhaka, Bangladesh

T2 - CHoBI7 trial

AU - Rashid, Mahamud ur

AU - Rahman, Zillur

AU - Burrowes, Vanessa

AU - Perin, Jamie L.

AU - Mustafiz, Munshi

AU - Monira, Shirajum

AU - Saif-Ur-Rahman, K. M.

AU - Bhuyian, Sazzadul Islam

AU - Mahmud, Md Toslim

AU - Sack, R. Bradley

AU - Sack, David Allen

AU - Alam, Munirul

AU - George, Christine Marie

PY - 2016

Y1 - 2016

N2 - Objective: In urban Dhaka, Bangladesh, 30% of source water samples collected from the households of patients with cholera had detectable Vibrio cholerae. These findings indicate an urgent need for a public health intervention for this population. The Crystal VC® dipstick test is a rapid method for detecting V. cholerae in stool and water. However, to date no study has investigated the use of the rapid dipstick test for household surveillance of stored drinking water. Methods: The efficacy of the Crystal VC® dipstick test for detecting V. cholerae in the Dhaka city municipal water supply and stored household drinking water sources after enrichment for 18 h in alkaline peptone water (APW) was compared to bacterial culture as the gold standard. Results: A total of 1648 water samples (824 stored household drinking water samples and 824 municipal water supply samples) were collected from households of patients with cholera. The overall specificity and sensitivity of the dipstick test compared to bacterial culture was 99.6% (95% confidence interval (CI): 99.2%, 99.9%) and 65.6% (95% CI: 55.2%, 75%), respectively. The specificities for stored household drinking water and Dhaka city municipal supply water compared to bacterial culture were 99.8% (95% CI: 99.1%, 100%) and 99.5% (95% CI: 98.6%, 99.9%), respectively (P = 0.138), and the sensitivities were 66.7% (95% CI: 43.0%, 85.4%) and 65.3% (95% CI: 53.5%, 76.0%), respectively (P = 0.891). Conclusion: The Crystal VC® dipstick is a promising screening tool for cholera outbreak surveillance in resource-limited settings where elimination of false-positive results is critical. The lower than expected sensitivity should be further investigated in future studies.

AB - Objective: In urban Dhaka, Bangladesh, 30% of source water samples collected from the households of patients with cholera had detectable Vibrio cholerae. These findings indicate an urgent need for a public health intervention for this population. The Crystal VC® dipstick test is a rapid method for detecting V. cholerae in stool and water. However, to date no study has investigated the use of the rapid dipstick test for household surveillance of stored drinking water. Methods: The efficacy of the Crystal VC® dipstick test for detecting V. cholerae in the Dhaka city municipal water supply and stored household drinking water sources after enrichment for 18 h in alkaline peptone water (APW) was compared to bacterial culture as the gold standard. Results: A total of 1648 water samples (824 stored household drinking water samples and 824 municipal water supply samples) were collected from households of patients with cholera. The overall specificity and sensitivity of the dipstick test compared to bacterial culture was 99.6% (95% confidence interval (CI): 99.2%, 99.9%) and 65.6% (95% CI: 55.2%, 75%), respectively. The specificities for stored household drinking water and Dhaka city municipal supply water compared to bacterial culture were 99.8% (95% CI: 99.1%, 100%) and 99.5% (95% CI: 98.6%, 99.9%), respectively (P = 0.138), and the sensitivities were 66.7% (95% CI: 43.0%, 85.4%) and 65.3% (95% CI: 53.5%, 76.0%), respectively (P = 0.891). Conclusion: The Crystal VC® dipstick is a promising screening tool for cholera outbreak surveillance in resource-limited settings where elimination of false-positive results is critical. The lower than expected sensitivity should be further investigated in future studies.

KW - Vibrio cholerae

KW - Cholera

KW - Dipstick test

KW - Outbreak

KW - Rapid test

KW - Stored water

KW - Supply water

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