{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:47:26Z","timestamp":1753876046083,"version":"3.41.2"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Bacterial Vaccines Network","award":["BVNCP5-08"],"award-info":[{"award-number":["BVNCP5-08"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Saliva, as a diagnostic medium, offers a promising alternative to blood by virtue of its non-invasive collection, which enhances patient compliance, especially in paediatric and geriatric populations. In this study, we assessed the utility of saliva as a non-invasive medium for measuring Vibrio cholerae-specific serum antibodies in naturally infected individuals. We tested paired serum and saliva samples obtained from a total of 63 patients with cholera enrolled in a cohort study. Vibriocidal antibodies assay (IgM\/IgG) as markers for accurate determination was used to determine cholera-specific antibody levels. Using receiver operating characteristics (ROC) curve, we found that the best cut-off that maximizes (sensitivity\u2005+\u2005specificity) is 10 titres. At this saliva titre, the sensitivity is 76.9% (95%CI: 60.9%, 87.7%) and specificity is 80.0% (95%CI: 56.6%, 92.5%). Using Spearman\u2019s correlation coefficient, we also found evidence of a positive correlation between V. cholerae saliva and serum antibodies (rho\u2005=\u20050.66, P\u2005&amp;lt;\u20050.001). In conclusion, saliva-based diagnostic cholera tests have high diagnostic accuracy and would be advantageous, cheaper, and quicker for early diagnosis of severe cholera outcomes.<\/jats:p>","DOI":"10.1093\/cei\/uxae092","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T17:54:28Z","timestamp":1729533268000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic accuracy of saliva-based testing as a <i>Vibrio cholerae<\/i> surveillance tool among naturally infected patients"],"prefix":"10.1093","volume":"219","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7850-7915","authenticated-orcid":false,"given":"Caroline C","family":"Chisenga","sequence":"first","affiliation":[{"name":"Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia , Lusaka ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Phiri","sequence":"additional","affiliation":[{"name":"Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia , Lusaka ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harriet","family":"Ng\u2019ombe","sequence":"additional","affiliation":[{"name":"Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia , Lusaka ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mutinta","family":"Muchimba","sequence":"additional","affiliation":[{"name":"Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia , Lusaka ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fraser","family":"Liswaniso","sequence":"additional","affiliation":[{"name":"Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia , Lusaka ,","place":["Zambia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biana","family":"Bernshtein","sequence":"additional","affiliation":[{"name":"Alter Lab, Ragon Institute of MGH, MIT and Harvard ,\u00a0 Boston ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam F","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Institute of Immunology and Immunotherapy, University of Birmingham , Edgbaston, Birmingham ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Sack","sequence":"additional","affiliation":[{"name":"Center for Immunization Research, Johns Hopkins Bloomberg School of Public Health , Baltimore, MD ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Bosomprah","sequence":"additional","affiliation":[{"name":"Enteric Disease and Vaccine Research Unit, Centre for Infectious Disease Research in Zambia , Lusaka ,","place":["Zambia"]},{"name":"Department of Biostatistics, School of Public Health, University of Ghana , Accra ,","place":["Ghana"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"key":"2025041017183433900_CIT0001","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1472-698X-9-8","article-title":"Economic burden of cholera in the WHO African region","volume":"9","author":"Kirigia","year":"2009","journal-title":"BMC Int Health Hum Rights"},{"key":"2025041017183433900_CIT0002","doi-asserted-by":"crossref","first-page":"4","DOI":"10.4103\/0973-029X.131881","article-title":"Evaluation of serum and salivary lipid profile: a correlative study","volume":"18","author":"Singh","year":"2014","journal-title":"J Oral Maxillofacial Pathol"},{"author":"Friedman","doi-asserted-by":"crossref","article-title":"Subclasses of IgA antibodies in serum and saliva samples of newborns and infants immunized against rotavirus","key":"2025041017183433900_CIT0003","DOI":"10.1046\/j.1365-2249.1996.d01-620.x"},{"key":"2025041017183433900_CIT0004","doi-asserted-by":"crossref","first-page":"2437","DOI":"10.4103\/jfmpc.jfmpc_138_20","article-title":"Evaluation and diagnostic usefulness of saliva for detection of HIV antibodies: a\u00a0cross-sectional study","volume":"9","author":"Vohra","year":"2020","journal-title":"J Family Med Prim Care"},{"key":"2025041017183433900_CIT0005","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1128\/jcm.24.2.203-209.1986","article-title":"Saliva, breast milk, and serum antibody responses as indirect measures of intestinal immunity after oral cholera vaccination or natural disease","volume":"24","author":"Jertborn","year":"1986","journal-title":"J Clin Microbiol"},{"key":"2025041017183433900_CIT0006","doi-asserted-by":"crossref","first-page":"e2828","DOI":"10.1371\/journal.pntd.0002828","article-title":"Immunogenicity of a killed bivalent (O1 and O139) whole cell oral cholera vaccine, Shanchol, in Haiti","volume":"8","author":"Charles","year":"2014","journal-title":"PLoS NeglTrop Dis"},{"key":"2025041017183433900_CIT0007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1126\/scitranslmed.aau6242","article-title":"Estimating cholera incidence with cross-sectional serology","volume":"11","author":"Azman","year":"2019","journal-title":"Sci Transl Med"},{"key":"2025041017183433900_CIT0008","first-page":"1","article-title":"Immunogenicity and waning immunity from the oral cholera vaccine (ShancholTM) in adults residing in Lukanga Swamps of Zambia","volume":"17","author":"Ngombe","year":"2022","journal-title":"PLoS One"},{"key":"2025041017183433900_CIT0009","first-page":"1","article-title":"Detection of chikungunya virus in saliva and urine","volume":"13","author":"Musso","year":"2016","journal-title":"Virol J"},{"key":"2025041017183433900_CIT0010","doi-asserted-by":"crossref","first-page":"3737","DOI":"10.1128\/JCM.36.12.3737-3739.1998","article-title":"Detection of specific antibodies in saliva during dengue infection","volume":"36","author":"Cuzzubbo","year":"1998","journal-title":"J Clin Microbiol"},{"key":"2025041017183433900_CIT0011","doi-asserted-by":"crossref","first-page":"e0139481","DOI":"10.1371\/journal.pone.0139481","article-title":"Infectious chikungunya virus in the saliva of mice, monkeys and humans","volume":"10","author":"Gardner","year":"2015","journal-title":"PLoS One"},{"key":"2025041017183433900_CIT0012","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.ijid.2006.05.005","article-title":"Kinetics of antibodies in sera, saliva, and urine samples from adult patients with primary or secondary dengue 3 virus infections","volume":"11","author":"V\u00e1zquez","year":"2007","journal-title":"Int J Infect Dis: IJID"},{"key":"2025041017183433900_CIT0013","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1186\/s12916-022-02603-x","article-title":"Head-to-head comparison of the accuracy of saliva and nasal rapid antigen SARS-CoV-2 self-testing: cross-sectional study","volume":"20","author":"Schuit","year":"2022","journal-title":"BMC Med"},{"key":"2025041017183433900_CIT0014","first-page":"1028","article-title":"Diagnosis of norwalk virus infection by indirect enzyme immunoassay detection of salivary antibodies to recombinant norwalk virus antigen","volume":"11","author":"Moe","year":"2004","journal-title":"Clin Diagn Lab Immunol"},{"key":"2025041017183433900_CIT0015","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1093\/aje\/kwh107","article-title":"A population-based seroprevalence study of hepatitis A virus using oral fluid in England and Wales","volume":"159","author":"Morris-Cunnington","year":"2004","journal-title":"Am J Epidemiol"},{"key":"2025041017183433900_CIT0016","first-page":"1","article-title":"Use of saliva in alternative to serum sampling to monitor biomarkers modifications in professional soccer players","volume-title":"Front. Physiol.\u00a0","author":"Francavilla","year":"2018"},{"key":"2025041017183433900_CIT0017","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/S0002-9343(97)00033-8","article-title":"Accuracy of oral specimen testing for human immunodeficiency virus","volume":"102","author":"Emmons","year":"1997","journal-title":"Am J Med"},{"key":"2025041017183433900_CIT0018","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1017\/S0950268899003234","article-title":"Non-participation in a population-based seroprevalence study of vaccine-preventable diseases","volume":"124","author":"De Melker","year":"2000","journal-title":"Epidemiol Infect"},{"key":"2025041017183433900_CIT0019","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1017\/S0950268800057940","article-title":"A pilot study of infectious intestinal disease in England","volume":"114","author":"Roderick","year":"1995","journal-title":"Epidemiol Infect"},{"key":"2025041017183433900_CIT0020","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1097\/AJP.0000000000000272","article-title":"Far from \u201cjust a poke\u201d: common painful needle procedures and the development of needle fear","volume":"31","author":"McMurtry","year":"2015","journal-title":"Clin J Pain"},{"key":"2025041017183433900_CIT0021","doi-asserted-by":"crossref","first-page":"e0213507","DOI":"10.1371\/journal.pone.0213507","article-title":"IgM specific to lipopolysaccharide of Vibrio cholerae is a surrogate antibody isotype responsible for serum vibriocidal activity","volume":"14","author":"Yang","year":"2019","journal-title":"PLoS One"},{"key":"2025041017183433900_CIT0022","doi-asserted-by":"crossref","first-page":"3571","DOI":"10.1128\/iai.65.9.3571-3576.1997","article-title":"Comparison of immune responses in patients infected with Vibrio cholerae O139 and O1 downloaded from","volume":"65","author":"Qadri","year":"1997","journal-title":"Infect Immun"},{"year":"2008","author":"Best","article-title":"The immunological basis for immunization series. The Immunological Basis for Immunization Series - Module 11: Rubella","key":"2025041017183433900_CIT0023"}],"container-title":["Clinical and Experimental Immunology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cei\/advance-article-pdf\/doi\/10.1093\/cei\/uxae092\/60250014\/uxae092.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cei\/article-pdf\/219\/1\/uxae092\/60250014\/uxae092.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cei\/article-pdf\/219\/1\/uxae092\/60250014\/uxae092.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T17:18:46Z","timestamp":1744305526000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cei\/article\/doi\/10.1093\/cei\/uxae092\/7829132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,21]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1,21]]}},"URL":"https:\/\/doi.org\/10.1093\/cei\/uxae092","relation":{},"ISSN":["0009-9104","1365-2249"],"issn-type":[{"type":"print","value":"0009-9104"},{"type":"electronic","value":"1365-2249"}],"subject":[],"published-other":{"date-parts":[[2025]]},"published":{"date-parts":[[2024,10,21]]},"article-number":"uxae092"}}