Evaluation of a rapid dipstick (Crystal VC) for the diagnosis of cholera in Zanzibar and a comparison with previous studies.
<h4>Background</h4>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...
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2012
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oai:doaj.org-article:4c5ccd50a91a48cc9543ce30b54eaf812021-11-18T07:17:26ZEvaluation of a rapid dipstick (Crystal VC) for the diagnosis of cholera in Zanzibar and a comparison with previous studies.1932-620310.1371/journal.pone.0036930https://doaj.org/article/4c5ccd50a91a48cc9543ce30b54eaf812012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22662131/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.Benedikt LeyAhmed M KhatibKamala ThriemerLorenz von SeidleinJacqueline DeenAsish MukhopadyayNa-Yoon ChangRamadhan HashimWolfgang SchmiedClara J-L BuschRita ReyburnThomas WierzbaJohn D ClemensHarald WilfingGodwin EnwereTheresa AguadoMohammad S JiddawiDavid SackSaid M AliPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 5, p e36930 (2012) |
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DOAJ |
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Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Benedikt Ley Ahmed M Khatib Kamala Thriemer Lorenz von Seidlein Jacqueline Deen Asish Mukhopadyay Na-Yoon Chang Ramadhan Hashim Wolfgang Schmied Clara J-L Busch Rita Reyburn Thomas Wierzba John D Clemens Harald Wilfing Godwin Enwere Theresa Aguado Mohammad S Jiddawi David Sack Said M Ali Evaluation of a rapid dipstick (Crystal VC) for the diagnosis of cholera in Zanzibar and a comparison with previous studies. |
| description |
<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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. |
| format |
article |
| author |
Benedikt Ley Ahmed M Khatib Kamala Thriemer Lorenz von Seidlein Jacqueline Deen Asish Mukhopadyay Na-Yoon Chang Ramadhan Hashim Wolfgang Schmied Clara J-L Busch Rita Reyburn Thomas Wierzba John D Clemens Harald Wilfing Godwin Enwere Theresa Aguado Mohammad S Jiddawi David Sack Said M Ali |
| author_facet |
Benedikt Ley Ahmed M Khatib Kamala Thriemer Lorenz von Seidlein Jacqueline Deen Asish Mukhopadyay Na-Yoon Chang Ramadhan Hashim Wolfgang Schmied Clara J-L Busch Rita Reyburn Thomas Wierzba John D Clemens Harald Wilfing Godwin Enwere Theresa Aguado Mohammad S Jiddawi David Sack Said M Ali |
| author_sort |
Benedikt Ley |
| title |
Evaluation of a rapid dipstick (Crystal VC) for the diagnosis of cholera in Zanzibar and a comparison with previous studies. |
| title_short |
Evaluation of a rapid dipstick (Crystal VC) for the diagnosis of cholera in Zanzibar and a comparison with previous studies. |
| title_full |
Evaluation of a rapid dipstick (Crystal VC) for the diagnosis of cholera in Zanzibar and a comparison with previous studies. |
| title_fullStr |
Evaluation of a rapid dipstick (Crystal VC) for the diagnosis of cholera in Zanzibar and a comparison with previous studies. |
| title_full_unstemmed |
Evaluation of a rapid dipstick (Crystal VC) for the diagnosis of cholera in Zanzibar and a comparison with previous studies. |
| title_sort |
evaluation of a rapid dipstick (crystal vc) for the diagnosis of cholera in zanzibar and a comparison with previous studies. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2012 |
| url |
https://doaj.org/article/4c5ccd50a91a48cc9543ce30b54eaf81 |
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