Open forum infectious diseases · 2026
Diagnostic Accuracy of a Simple and Rapid Diagnostic Test RLDT for the Detection of Cholera in Bangladesh.
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Islam Kamrul, Khan Ashraful Islam, Bhuiyan M D Taufiqur Rahman, He Fan, Khan Zahid Hasan, Islam Md Taufiqul, Qadri Firdausi, Chakraborty Subhra
Аннотация
BACKGROUND: The rising incidence and case fatality rates of cholera outbreaks underscore the need for better diagnostic tests for early detection and confirmation of the outbreak to enable rapid responses and obtain reliable surveillance data. We evaluated the Rapid LAMP-based Diagnostic Test (RLDT) for detecting cholera to determine if this test has the potential to fill the gap.
METHODS: This study included training and evaluation of RLDT in the cholera reference laboratory in Bangladesh. Stool samples collected from suspected cholera patients seeking care at the icddr,b hospital, Dhaka, were tested using cholera RLDT, microbiological culture, Rapid Diagnostic Test (RDT crystal VC O1, O139), and PCR and compared.
RESULTS: Out of 205 cases analyzed, 136 (66%) were positive for cholera by RLDT, 131 (64%) by PCR, 92 (45%) by culture, and 90 (44%) by RDT. The RLDT was highly specific, as all the culture positives were positive by RLDT, except 1 (sensitivity of 99%), and could detect all the PCR positives except 2 (sensitivity of 97%). Almost perfect agreement was found between RLDT and PCR (kappa 0.9). Rapid LAMP-based Diagnostic Test being more sensitive than culture and RDT, the agreement was moderate (kappa 0.6 and 0.5, respectively). Rapid Diagnostic Test missed detection of cholera in 11 samples, positive by other tests. The accuracy of RLDT was 100% in detecting cholera from water samples.
CONCLUSIONS: Rapid LAMP-based Diagnostic Test was specific and sensitive, detecting 21% more cholera-positive cases than culture or RDT. Rapid LAMP-based Diagnostic Test has the potential to improve the rapid detection of cholera in outbreak situations and for surveillance data.
METHODS: This study included training and evaluation of RLDT in the cholera reference laboratory in Bangladesh. Stool samples collected from suspected cholera patients seeking care at the icddr,b hospital, Dhaka, were tested using cholera RLDT, microbiological culture, Rapid Diagnostic Test (RDT crystal VC O1, O139), and PCR and compared.
RESULTS: Out of 205 cases analyzed, 136 (66%) were positive for cholera by RLDT, 131 (64%) by PCR, 92 (45%) by culture, and 90 (44%) by RDT. The RLDT was highly specific, as all the culture positives were positive by RLDT, except 1 (sensitivity of 99%), and could detect all the PCR positives except 2 (sensitivity of 97%). Almost perfect agreement was found between RLDT and PCR (kappa 0.9). Rapid LAMP-based Diagnostic Test being more sensitive than culture and RDT, the agreement was moderate (kappa 0.6 and 0.5, respectively). Rapid Diagnostic Test missed detection of cholera in 11 samples, positive by other tests. The accuracy of RLDT was 100% in detecting cholera from water samples.
CONCLUSIONS: Rapid LAMP-based Diagnostic Test was specific and sensitive, detecting 21% more cholera-positive cases than culture or RDT. Rapid LAMP-based Diagnostic Test has the potential to improve the rapid detection of cholera in outbreak situations and for surveillance data.