Diagnostic accuracy of rapid diagnostic tests for vibrio cholerae serogroups O1 and O139: A systematic review and meta-analysis.
Xitong Yao, Han Wang, Kuo Jiang et al.
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In 30 seconds
This systematic review and meta-analysis assessed field performance of rapid diagnostic tests (RDTs) for Vibrio cholerae O1/O139, using culture or PCR as reference standards. Across 22 studies, 46 data points and 20,353 specimens, pooled sensitivity was 0.95 (95% CI: 0.93-0.97) and specificity was 0.95 (95% CI: 0.91-0.97); both exceeded the 2024 GTFCC Target Product Profile requirements. Performance was poorer for dual-target than single-target assays, while alkaline peptone water enrichment reduced sensitivity without significantly improving specificity.
Key findings
- Pooled sensitivity was 0.95 (95% CI: 0.93-0.97) and specificity was 0.95 (95% CI: 0.91-0.97), exceeding 2024 GTFCC requirements.
- Dual-target O1+O139 RDTs performed significantly worse than single-target assays (P = 0.03).
- APW enrichment reduced sensitivity from 0.96 to 0.94 (P < 0.001), without a significant specificity gain.
- The diagnostic odds ratio was 718 with PCR reference testing versus 363 with culture.
Why it matters
Reliable field diagnostics can support cholera surveillance and case detection. The pooled estimates suggest that evaluated RDTs meet updated global performance standards, while differences by assay target and enrichment method indicate that test configuration can affect accuracy. The higher diagnostic odds ratio against PCR also highlights how the choice of reference standard may shape estimates of RDT performance.
What to keep in mind
The review combined studies using different reference standards, and the abstract reports heterogeneity analysis but does not provide its results or study-level limitations.