{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:38:39Z","timestamp":1787027919182,"version":"build-2736575974"},"reference-count":37,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T00:00:00Z","timestamp":1636761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP20wm0125004"],"award-info":[{"award-number":["JP20wm0125004"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The rapid diagnosis of cholera contributes to adequate outbreak management. This meta-analysis assesses the diagnostic accuracy of cholera rapid tests (RDTs) to detect Vibrio cholerae O1. Methods: Systematic review and meta-analysis. We searched four databases (Medline, EMBASE, Google Scholar, and Web of Science up to 8 September 2021) for studies that evaluated cholera RDTs for the detection of V. cholerae O1 compared with either stool culture or polymerase chain reaction (PCR). We assessed the studies\u2019 quality using the QUADAS-2 criteria. In addition, in this update, GRADE approach was used to rate the overall certainty of the evidence. We performed a bivariate random-effects meta-analysis to calculate the pooled sensitivity and specificity of cholera RDTs. Results: Overall, 20 studies were included in this meta-analysis. Studies were from Africa (n = 11), Asia (n = 7), and America (Haiti; n = 2). They evaluated eight RDTs (Crystal VC-O1, Crystal VC, Cholkit, Institut Pasteur cholera dipstick, SD Bioline, Artron, Cholera Smart O1, and Smart II Cholera O1). Using direct specimen testing, sensitivity and specificity of RDTs were 90% (95% CI, 86 to 93) and 86% (95% CI, 81 to 90), respectively. Cholera Sensitivity was higher in studies conducted in Africa [92% (95% CI, 89 to 94)] compared with Asia [82% (95% CI, 77 to 87)]. However, specificity [83% (95% CI, 71 to 91)] was lower in Africa compared with Asia [90% (95% CI, 84 to 94)]. GRADE quality of evidence was estimated as moderate. Conclusions: Against culture or PCR, current cholera RDTs have moderate sensitivity and specificity for detecting Vibrio cholerae O1.<\/jats:p>","DOI":"10.3390\/diagnostics11112095","type":"journal-article","created":{"date-parts":[[2021,11,14]],"date-time":"2021-11-14T20:48:36Z","timestamp":1636922916000},"page":"2095","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Cholera Rapid Diagnostic Tests for the Detection of Vibrio cholerae O1: An Updated Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Basilua Andre","family":"Muzembo","sequence":"first","affiliation":[{"name":"Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Kitahara","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan"},{"name":"Collaborative Research Center, Okayama University for Infectious Diseases in India, Kolkata 700010, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayumu","family":"Ohno","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusuya","family":"Debnath","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keinosuke","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Ichi","family":"Miyoshi","sequence":"additional","affiliation":[{"name":"Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1016\/S0140-6736(17)30559-7","article-title":"Cholera","volume":"390","author":"Clemens","year":"2017","journal-title":"The Lancet Cholera. Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S154","DOI":"10.1093\/infdis\/jiy444","article-title":"Individual and Household Risk Factors for Symptomatic Cholera Infection: A Systematic Review and Meta-analysis","volume":"218","author":"Richterman","year":"2018","journal-title":"J. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1038\/nature10392","article-title":"Evidence for several waves of global transmission in the seventh cholera pandemic","volume":"477","author":"Mutreja","year":"2011","journal-title":"Nature"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Azman, A.S., Luquero, F.J., Ciglenecki, I., Grais, R.F., Sack, D.A., and Lessler, J. (2015). The Impact of a One-Dose versus Two-Dose Oral Cholera Vaccine Regimen in Outbreak Settings: A Modeling Study. PLoS Med., 12.","DOI":"10.1371\/journal.pmed.1001867"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S23","DOI":"10.1093\/infdis\/jit196","article-title":"Diagnosis of Vibrio cholerae O1 infection in Africa","volume":"208","author":"Keddy","year":"2013","journal-title":"J. Infect. Dis."},{"key":"ref_6","unstructured":"World Health Organization (WHO) (2021, September 09). Global Task Force on Cholera Control Surveillance Laboratory Working Group. The Use of Cholera Rapid Diagnostic Tests. Available online: https:\/\/www.gtfcc.org\/wp-content\/uploads\/2019\/10\/gtfcc-interim-use-of-cholera-rapid-diagnostic-tests.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Muzembo, B.A., Kitahara, K., Debnath, A., Okamoto, K., and Miyoshi, S. (2021). Accuracy of cholera rapid diagnostic tests: A systematic review and meta-analysis. Clin. Microbiol. Infect., in press.","DOI":"10.1016\/j.cmi.2021.08.027"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1001\/jama.2017.19163","article-title":"Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement","volume":"319","author":"McInnes","year":"2018","journal-title":"JAMA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"529","DOI":"10.7326\/0003-4819-155-8-201110180-00009","article-title":"QUADAS-2: A revised tool for the quality assessment of diagnostic accuracy studies","volume":"155","author":"Whiting","year":"2011","journal-title":"Ann. Intern. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1136\/bmj.39500.677199.AE","article-title":"Grading quality of evidence and strength of recommendations for diagnostic tests and strategies","volume":"336","author":"Oxman","year":"2008","journal-title":"BMJ"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1186\/2046-4053-2-82","article-title":"Cochrane diagnostic test accuracy reviews","volume":"2","author":"Leeflang","year":"2013","journal-title":"Syst. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1111\/1469-0691.12474","article-title":"Systematic reviews and meta-analyses of diagnostic test accuracy","volume":"20","author":"Leeflang","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.4269\/ajtmh.20-1280","article-title":"Laboratory and Field Evaluation of the Crystal VC-O1 Cholera Rapid Diagnostic Test","volume":"104","author":"Debes","year":"2021","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Chowdhury, G., Senapati, T., Das, B., Kamath, A., Pal, D., Bose, P., Deb, A., Paul, S., Mukhopadhyay, A.K., and Dutta, S. (2021). Laboratory evaluation of the rapid diagnostic tests for the detection of Vibrio cholerae O1 using diarrheal samples. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009521"},{"key":"ref_15","first-page":"4990","article-title":"Rapid detection of vibrio cholerae O1 And O139 In stool samples by one-step immunochromatographic dip-stick test","volume":"6","author":"Vijaya","year":"2015","journal-title":"Int. J. Biol. Med. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"ofaa493","DOI":"10.1093\/ofid\/ofaa493","article-title":"Field Evaluation of Cholkit Rapid Diagnostic Test for Vibrio Cholerae O1 During a Cholera Outbreak in Malawi, 2018","volume":"7","author":"Chibwe","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Islam, T., Khan, A.I., Sayeed, A., Amin, J., Islam, K., Alam, N., Sultana, N., Jahan, N., Rashid, M., and Khan, Z.H. (2019). Field evaluation of a locally produced rapid diagnostic test for early detection of cholera in Bangladesh. PLoS Negl. Trop. Dis., 13.","DOI":"10.1371\/journal.pntd.0007124"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Sayeed, A., Islam, K., Hossain, M., Akter, N.J., Alam, N., Sultana, N., Khanam, F., Kelly, M., Charles, R.C., and Kov\u00e1\u010d, P. (2018). Development of a new dipstick (Cholkit) for rapid detection of Vibrio cholerae O1 in acute watery diarrheal stools. PLoS Negl. Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0006286"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1111\/tmi.13084","article-title":"Evaluation of the SD bioline cholera rapid diagnostic test during the 2016 cholera outbreak in Lusaka, Zambia","volume":"23","author":"Mwaba","year":"2018","journal-title":"Trop. Med. Int. Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"537","DOI":"10.4269\/ajtmh.15-0496","article-title":"Clinical and Environmental Surveillance for Vibrio cholerae in Resource Constrained Areas: Application During a 1-Year Surveillance in the Far North Region of Cameroon","volume":"94","author":"Debes","year":"2016","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"24","DOI":"10.4103\/amhs.amhs_20_18","article-title":"Evaluation of a rapid dipstick test (Crystal Vc\u00ae) for the diagnosis of cholera in Maiduguri, Northeastern Nigeria","volume":"6","author":"Denue","year":"2018","journal-title":"Arch. Med. Health Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/tmi.12252","article-title":"Evaluation of enrichment method for the detection of Vibrio cholerae O1 using a rapid dipstick test in Bangladesh","volume":"19","author":"George","year":"2014","journal-title":"Trop. Med. Int. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.diagmicrobio.2013.03.010","article-title":"Performance and utility of a rapid diagnostic test for cholera: Notes from Haiti","volume":"76","author":"Boncy","year":"2013","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Ley, B., Khatib, A.M., Thriemer, K., Von Seidlein, L., Deen, J., Mukhopadyay, A., Chang, N.-Y., Hashim, R., Schmied, W., and Busch, C.J.L. (2012). Evaluation of a rapid dipstick (Crystal VC) for the diagnosis of cholera in Zanzibar and a comparison with previous studies. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0036930"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Page, A.-L., Alberti, K.P., Mondonge, V., Rauzier, J., Quilici, M.-L., and Guerin, P. (2012). Evaluation of a rapid test for the diagnosis of cholera in the absence of a gold standard. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0037360"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"234","DOI":"10.7883\/yoken.63.234","article-title":"Evaluation of a rapid immunochromatographic dipstick kit for diagnosis of cholera emphasizes its outbreak utility","volume":"63","author":"Mukherjee","year":"2010","journal-title":"Jpn. J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1111\/j.1365-3156.2009.02335.x","article-title":"Field evaluation of crystal VC Rapid Dipstick test for cholera during a cholera outbreak in Guinea-Bissau","volume":"14","author":"Harris","year":"2009","journal-title":"Trop. Med. Int. Health"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Wang, X.-Y., Ansaruzzaman, M., Vaz, R., Mondlane, C., Lucas, M.E.S., Von Seidlein, L., Deen, J.L., Ampuero, S., Puri, M., and Park, T. (2006). Field evaluation of a rapid immunochromatographic dipstick test for the diagnosis of cholera in a high-risk population. BMC Infect. Dis., 6.","DOI":"10.1186\/1471-2334-6-17"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3939","DOI":"10.1128\/JCM.41.8.3939-3941.2003","article-title":"Use of dipsticks for rapid diagnosis of cholera caused by Vibrio cholerae O1 and O139 from rectal swabs","volume":"41","author":"Bhuiyan","year":"2003","journal-title":"J. Clin. Microbiol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Bwire, G., Orach, C.G., Abdallah, D., Debes, A.K., Kagirita, A., Ram, M., and Sack, D.A. (2017). Alkaline peptone water enrichment with a dipstick test to quickly detect and monitor cholera outbreaks. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2824-8"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Matias, W.R., Julceus, E.F., Abelard, C., Mayo-Smith, L.M., Franke, M., Harris, J.B., and Ivers, L.C. (2017). Laboratory evaluation of immunochromatographic rapid diagnostic tests for cholera in Haiti. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0186710"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Ontweka, L.N., Deng, L.O., Rauzier, J., Debes, A.K., Tadesse, F., Parker, L.A., Wamala, J.F., Bior, B.K., Lasuba, M., and But, A.B. (2016). Cholera Rapid Test with Enrichment Step Has Diagnostic Performance Equivalent to Culture. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0168257"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e002000","DOI":"10.1136\/bmjgh-2019-002000","article-title":"The multi-sectorial emergency response to a cholera outbreak in Internally Displaced Persons camps in Borno State, Nigeria, 2017","volume":"5","author":"Ngwa","year":"2020","journal-title":"BMJ Glob. Health"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1111\/acem.12255","article-title":"Understanding the direction of bias in studies of diagnostic test accuracy","volume":"20","author":"Kohn","year":"2013","journal-title":"Acad. Emerg. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e00412-20","DOI":"10.1128\/JCM.00412-20","article-title":"Gold Standard Cholera Diagnostics Are Tarnished by Lytic Bacteriophage and Antibiotics","volume":"58","author":"Nelson","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3918","DOI":"10.1128\/JCM.00616-10","article-title":"Diagnostic limitations to accurate diagnosis of cholera","volume":"48","author":"Alam","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.cmi.2020.02.024","article-title":"Rapid diagnostic tests for infectious diseases in the emergency department","volume":"27","author":"Bouzid","year":"2021","journal-title":"Clin. Microbiol. Infect."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/11\/2095\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:29:42Z","timestamp":1760167782000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/11\/2095"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,13]]},"references-count":37,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11]]}},"alternative-id":["diagnostics11112095"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11112095","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,13]]}}}