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Evaluación de tres pruebas diagnósticas rápidas para cólera. ¿Importa la habilidad del técnico?
Author(s) -
Kalluri Pavani,
Naheed Aliya,
Rahman Saifur,
Ansaruzzaman Mohammad,
Faruque Abu Syed Golam,
Bird Michele,
Khatun Fatema,
Bhuiyan Nurul Amin,
Nato Farida,
Fournier JeanMichel,
Bopp Cheryl,
Breiman Robert F.,
Nair Gopinath Balakrish,
Mintz Eric D.
Publication year - 2006
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2005.01539.x
Subject(s) - dipstick , medicine , technician , vibrio cholerae , cholera , virology , biology , engineering , urinary system , electrical engineering , bacteria , genetics
Summary Objective To evaluate SMART TM , Medicos TM Dip Stick and an Institut Pasteur (IP) cholera dipstick tests for accuracy and ease of use. Method Every 50th patient presenting with diarrhoea at ICDDR,B between 1 April 2003 and 30 November 2003 was enrolled. The rapid diagnostic tests were performed by field and laboratory technicians, and sensitivity (Se), specificity (Sp), positive (PPV) and negative (NPV) predictive values calculated. Results We isolated Vibrio cholerae O1 from 116 (38%) of 304 patients. The Se, Sp, PPV and NPV of the SMART TM test were 58%, 95%, 84% and 84% for field technicians, and 83%, 88%, 83% and 88% for laboratory technicians. The Se, Sp, PPV and NPV of the IP dipstick test were 93%, 67%, 63% and 94% for field technicians, and 94%, 76%, 70% and 95% for laboratory technicians. The Se, Sp, PPV and NPV of the Medicos TM test were 84%, 79%, 71% and 90% for field technicians, and 88%, 80%, 72% and 92% for laboratory technicians. A high proportion of indeterminates (30%) hampered the performance of the SMART TM test. The IP dipstick had the highest Se, irrespective of technician skill level. Conclusion The IP dipstick is the most appropriate rapid diagnostic assay for the detection of V. cholerae O1 in locations where the skill level of personnel may be low, such as remote areas or refugee camp settings. High cost may limit the utility of any diagnostic test in the developing world.