1. Sensitivity, Specificity, and Public-Health Utility of Clinical Case Definitions Based on the Signs and Symptoms of Cholera in Africa.
- Author
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Nadri J, Sauvageot D, Njanpop-Lafourcade BM, Baltazar CS, Banla Kere A, Bwire G, Coulibaly D, Kacou N'Douba A, Kagirita A, Keita S, Koivogui L, Landoh DE, Langa JP, Miwanda BN, Mutombo Ndongala G, Mwakapeje ER, Mwambeta JL, Mengel MA, and Gessner BD
- Subjects
- Adolescent, Adult, Africa epidemiology, Child, Child, Preschool, Cholera epidemiology, Cholera microbiology, Diarrhea epidemiology, Diarrhea microbiology, Epidemiological Monitoring, Feces microbiology, Female, Humans, Infant, Male, Middle Aged, Public Health, Sensitivity and Specificity, Symptom Assessment, Young Adult, Cholera diagnosis, Diarrhea diagnosis, Disease Outbreaks, Vibrio cholerae isolation & purification
- Abstract
During 2014, Africa reported more than half of the global suspected cholera cases. Based on the data collected from seven countries in the African Cholera Surveillance Network (Africhol), we assessed the sensitivity, specificity, and positive and negative predictive values of clinical cholera case definitions, including that recommended by the World Health Organization (WHO) using culture confirmation as the gold standard. The study was designed to assess results in real-world field situations in settings with recent cholera outbreaks or endemicity. From June 2011 to July 2015, a total of 5,084 persons with suspected cholera were tested for Vibrio cholerae in seven different countries of which 35.7% had culture confirmation. For all countries combined, the WHO case definition had a sensitivity = 92.7%, specificity = 8.1%, positive predictive value = 36.1%, and negative predictive value = 66.6%. Adding dehydration, vomiting, or rice water stools to the case definition could increase the specificity without a substantial decrease in sensitivity. Future studies could further refine our findings primarily by using more sensitive methods for cholera confirmation.
- Published
- 2018
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