Review of two decades of cholera diagnostics--how far have we really come?
<h4>Background</h4>Cholera, an ancient scourge, continues to inflict high rates of mortality today. The rising incidence of epidemics in areas of poor sanitation and crowding highlight the need for better epidemic prevention and early response. Such interventions require the availability...
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0001845&type=printable |
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| author | Michal H Dick Martine Guillerm Francis Moussy Claire-Lise Chaignat |
| author_facet | Michal H Dick Martine Guillerm Francis Moussy Claire-Lise Chaignat |
| author_sort | Michal H Dick |
| collection | DOAJ |
| description | <h4>Background</h4>Cholera, an ancient scourge, continues to inflict high rates of mortality today. The rising incidence of epidemics in areas of poor sanitation and crowding highlight the need for better epidemic prevention and early response. Such interventions require the availability of rapid and accurate diagnostic techniques to trigger timely response and mitigate the scale of the outbreak. The current gold standard of bacterial culture is inadequate for rapid diagnosis, highlighting the overarching neglect of field diagnostic needs. This paper was written to support the World Health Organisation's Global Task Force on Cholera Control mandated Cholera and diarrhoeal disease laboratory Network (CholdiNet) in devising a protocol for the validation of Rapid Diagnostic Tests (RDTs) for Vibrio cholerae. The status of diagnostic tools for Vibrio cholerae is assessed, describing products that have been commercialised over the last two decades and discussing their peer-reviewed evaluation.<h4>Method</h4>Review of post-1990 peer-reviewed and grey literature on rapid diagnostic tests for Vibrio cholerae.<h4>Results</h4>Since 1990, twenty four diagnostic tests have been developed for the detection of Vibrio cholerae in human faecal samples. Fourteen of these have also been described in the literature, with rapid chromatographic-immuno assays (CIA) featuring strongly. Polymerase chain reaction (PCR) assays maintain the ability to detect the lowest amount of bacteria; however CIAs achieve both low detection thresholds and high sensitivity and specificity, making them possible candidates for use in field conditions. Field and laboratory studies were performed in a wide range of settings demonstrating variability in performance, however only a few of these studies were sufficiently stringent, highlighting five RDTs that showed promise in field conditions; COAT, IP cholera dipstick, SMART, IP dipstick and Medicos. In light of non-independent reporting, the authors would like to see these five products undergoing additional studies, with further technical improvements if needed and commercial production. The authors hope that public health use of such a RDT in limited-resource field conditions on stool samples may contribute to effective reduction in cholera epidemic spread. |
| format | Article |
| id | doaj-art-3d3c8a61250843d1bc1df6b84bab1eb9 |
| institution | Kabale University |
| issn | 1935-2727 1935-2735 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj-art-3d3c8a61250843d1bc1df6b84bab1eb92025-01-16T05:32:28ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352012-01-01610e184510.1371/journal.pntd.0001845Review of two decades of cholera diagnostics--how far have we really come?Michal H DickMartine GuillermFrancis MoussyClaire-Lise Chaignat<h4>Background</h4>Cholera, an ancient scourge, continues to inflict high rates of mortality today. The rising incidence of epidemics in areas of poor sanitation and crowding highlight the need for better epidemic prevention and early response. Such interventions require the availability of rapid and accurate diagnostic techniques to trigger timely response and mitigate the scale of the outbreak. The current gold standard of bacterial culture is inadequate for rapid diagnosis, highlighting the overarching neglect of field diagnostic needs. This paper was written to support the World Health Organisation's Global Task Force on Cholera Control mandated Cholera and diarrhoeal disease laboratory Network (CholdiNet) in devising a protocol for the validation of Rapid Diagnostic Tests (RDTs) for Vibrio cholerae. The status of diagnostic tools for Vibrio cholerae is assessed, describing products that have been commercialised over the last two decades and discussing their peer-reviewed evaluation.<h4>Method</h4>Review of post-1990 peer-reviewed and grey literature on rapid diagnostic tests for Vibrio cholerae.<h4>Results</h4>Since 1990, twenty four diagnostic tests have been developed for the detection of Vibrio cholerae in human faecal samples. Fourteen of these have also been described in the literature, with rapid chromatographic-immuno assays (CIA) featuring strongly. Polymerase chain reaction (PCR) assays maintain the ability to detect the lowest amount of bacteria; however CIAs achieve both low detection thresholds and high sensitivity and specificity, making them possible candidates for use in field conditions. Field and laboratory studies were performed in a wide range of settings demonstrating variability in performance, however only a few of these studies were sufficiently stringent, highlighting five RDTs that showed promise in field conditions; COAT, IP cholera dipstick, SMART, IP dipstick and Medicos. In light of non-independent reporting, the authors would like to see these five products undergoing additional studies, with further technical improvements if needed and commercial production. The authors hope that public health use of such a RDT in limited-resource field conditions on stool samples may contribute to effective reduction in cholera epidemic spread.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0001845&type=printable |
| spellingShingle | Michal H Dick Martine Guillerm Francis Moussy Claire-Lise Chaignat Review of two decades of cholera diagnostics--how far have we really come? PLoS Neglected Tropical Diseases |
| title | Review of two decades of cholera diagnostics--how far have we really come? |
| title_full | Review of two decades of cholera diagnostics--how far have we really come? |
| title_fullStr | Review of two decades of cholera diagnostics--how far have we really come? |
| title_full_unstemmed | Review of two decades of cholera diagnostics--how far have we really come? |
| title_short | Review of two decades of cholera diagnostics--how far have we really come? |
| title_sort | review of two decades of cholera diagnostics how far have we really come |
| url | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0001845&type=printable |
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