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Development of a new dipstick (Cholkit) for rapid detection of Vibrio cholerae O1 in acute watery diarrheal stools
- Source :
- PLoS neglected tropical diseases, 12(3):e0006286. Public Library of Science, PLoS Neglected Tropical Diseases, Vol 12, Iss 3, p e0006286 (2018), PLoS Neglected Tropical Diseases
- Publication Year :
- 2018
-
Abstract
- Recognizing cholera cases early, especially in the initial phase of an outbreak and in areas where cholera has not previously circulated, is a high public health priority. Laboratory capacity in such settings is often limited. To address this, we have developed a rapid diagnostic test (RDT) termed Cholkit that is based on an immunochromatographic lateral flow assay for the diagnosis of cholera cases using stool. Cholkit contains a monoclonal antibody (ICL-33) to the O-specific polysaccharide (OSP) component of V. cholerae O1 lipopolysaccharide, and recognizes both Inaba and Ogawa serotypes. We tested the Cholkit dipstick using fresh stool specimens of 76 adults and children presenting with acute watery diarrhea at the icddr,b hospital in Dhaka, Bangladesh. We compared Cholkit’s performance with those of microbial culture, PCR (targeting the rfb and ctxA genes of V. cholerae) and the commercially available RDT, Crystal VC (Span Diagnostics; Surat, India). We found that all stool specimens with a positive culture for V. cholerae O1 (n = 19) were positive by Cholkit as well as Crystal VC. We then used Bayesian latent class modeling to estimate the sensitivity and specificity of each diagnostic assay. The sensitivity of Cholkit, microbiological culture, PCR and Crystal VC was 98% (95% CI: 88–100), 71% (95% CI: 59–81), 74% (95% CI: 59–86) and 98% (95% CI: 88–100), respectively. The specificity for V. cholerae O1 was 97% (95% CI: 89–100), 100%, 97% (95% CI: 93–99) and 98% (95% CI: 92–100), respectively. Of note, two Crystal VC dipsticks were positive for V. cholerae O139 but negative by culture and PCR in this area without known circulating epidemic V. cholerae O139. In conclusion, the Cholkit dipstick is simple to use, requires no dedicated laboratory capacity, and has a sensitivity and specificity for V. cholerae O1 of 98% and 97%, respectively. Cholkit warrants further evaluation in other settings.<br />Author summary Cholera is a severely dehydrating diarrheal disease that can lead to death if remains untreated. The incidence of case fatality is higher at the beginning of the outbreak. Diagnosis of cholera in the early stage of outbreak is a high public health priority. Although countries facing complex emergencies are more vulnerable to cholera outbreak, laboratory capacity in such settings is usually limited. To address this, here we report the development of a rapid diagnostic test (RDT) termed Cholkit for the diagnosis of cholera cases using stool and the assessment of its performance with those of microbial culture, PCR and Crystal VC assay, a commercially available dipstick using a latent class modeling approach.
- Subjects :
- Bacterial Diseases
Male
0301 basic medicine
Serotype
Microbiological culture
Physiology
Pathology and Laboratory Medicine
medicine.disease_cause
Biochemistry
Polymerase Chain Reaction
Disease Outbreaks
Feces
0302 clinical medicine
Medical microbiology
Cholera
Immune Physiology
Medicine and Health Sciences
Public and Occupational Health
Enzyme-Linked Immunoassays
Child
Bangladesh
Rapid diagnostic test
Immune System Proteins
lcsh:Public aspects of medicine
Vibrio cholerae O1
Ascites
O Antigens
Microbial Cultures
Middle Aged
Bacterial Pathogens
3. Good health
Hospitalization
Infectious Diseases
Medical Microbiology
Vibrio cholerae
Child, Preschool
Physical Sciences
Acute Disease
Female
Biological Cultures
Pathogens
Research Article
Neglected Tropical Diseases
Adult
Diarrhea
medicine.medical_specialty
lcsh:Arctic medicine. Tropical medicine
Adolescent
Materials by Structure
lcsh:RC955-962
Materials Science
Immunology
030106 microbiology
030231 tropical medicine
Gastroenterology and Hepatology
Research and Analysis Methods
Microbiology
Crystals
Sensitivity and Specificity
Antibodies
Young Adult
03 medical and health sciences
Vibrio Cholerae
medicine
Humans
Immunoassays
Microbial Pathogens
Vibrio
Bacteriological Techniques
Bacteria
Organisms
Public Health, Environmental and Occupational Health
Biology and Life Sciences
Proteins
Infant
Outbreak
lcsh:RA1-1270
Dipstick
Tropical Diseases
medicine.disease
Monoclonal Antibodies
Immunologic Techniques
Reagent Kits, Diagnostic
Subjects
Details
- Language :
- English
- ISSN :
- 19352727
- Database :
- OpenAIRE
- Journal :
- PLoS neglected tropical diseases, 12(3):e0006286. Public Library of Science, PLoS Neglected Tropical Diseases, Vol 12, Iss 3, p e0006286 (2018), PLoS Neglected Tropical Diseases
- Accession number :
- edsair.doi.dedup.....88ae2f2d9610e66ffa39cde2a4c58b7c