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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Evaluation of a rapid dipstick (crystal VC) for the diagnosis of Cholera in Zanzibar and a comparison with previous studies
PLoS ONE, Volume 7, No. 5, Article e36930, Year 2012
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Description
Background: The gold standard for the diagnosis of cholera is stool culture, but this requires laboratory facilities and takes at least 24 hours. A rapid diagnostic test (RDT) that can be used by minimally trained staff at treatment centers could potentially improve the reporting and management of cholera outbreaks. Methods: We evaluated the Crystal VC™ RDT under field conditions in Zanzibar in 2009. Patients presenting to treatment centers with watery diarrhea provided a stool sample for rapid diagnostic testing. Results were compared to stool culture performed in a reference laboratory. We assessed the overall performance of the RDT and evaluated whether previous intake of antibiotics, intravenous fluids, location of testing, and skill level of the technician affected the RDT results. Results: We included stool samples from 624 patients. Compared to culture, the overall sensitivity of the RDT was 93.1% (95%CI: 88.7 to 96.2%), specificity was 49.2% (95%CI: 44.3 to 54.1%), the positive predictive value was 47.0% (95%CI: 42.1 to 52.0%) and the negative predictive value was 93.6% (95%CI: 89.6 to 96.5%). The overall false positivity rate was 50.8% (213/419); fieldworkers frequently misread very faint test lines as positive. Conclusion: The observed sensitivity of the Crystal VC RDT evaluated was similar compared to earlier versions, while specificity was poorer. The current version of the RDT could potentially be used as a screening tool in the field. Because of the high proportion of false positive results when field workers test stool specimens, positive results will need to be confirmed with stool culture. © 2012 Ley et al.
Authors & Co-Authors
Ley, Benedikt B.
South Korea, Seoul
International Vaccine Institute, Seoul
Austria, Vienna
Universität Wien
Khatib, Ahmed M.
Tanzania, Mkokotoni
Ministry of Health Zanzibar
Thriemer, Kamala L.
South Korea, Seoul
International Vaccine Institute, Seoul
Von-Seidlein, Lorenz
Australia, Darwin
Menzies School of Health Research
Deen, Jacqueline L.
Australia, Darwin
Menzies School of Health Research
Mukhopadyay, Asish
India, Kolkata
National Institute of Cholera and Enteric Diseases India
Chang, Na Yoon
South Korea, Seoul
International Vaccine Institute, Seoul
Hashim, Ramadhan
South Korea, Seoul
International Vaccine Institute, Seoul
Schmied, Wolfgang Hellmut
South Korea, Seoul
International Vaccine Institute, Seoul
Busch, Clara J.L.
Austria, Vienna
Institute of Molecular Biotechnology, Vienna
Reyburn, Rita C.
South Korea, Seoul
International Vaccine Institute, Seoul
Wierzba, Thomas F.
South Korea, Seoul
International Vaccine Institute, Seoul
Clemens, John David
South Korea, Seoul
International Vaccine Institute, Seoul
Wilfing, Harald
Austria, Vienna
Universität Wien
Enwere, Godwin C.
Switzerland, Geneva
Organisation Mondiale de la Santé
Aguado, Maria Teresa
Switzerland, Geneva
Organisation Mondiale de la Santé
Jiddawi, Mohamed Saleh
Tanzania, Mkokotoni
Ministry of Health Zanzibar
Sack, David Allen
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Ali, Said Mohammed
Tanzania, Mkokotoni
Ministry of Health Zanzibar
Tanzania
Public Health Laboratory Pemba - Ivo de Carneri
Statistics
Citations: 60
Authors: 19
Affiliations: 9
Identifiers
Doi:
10.1371/journal.pone.0036930
e-ISSN:
19326203
Research Areas
Infectious Diseases