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Identifying Recent Cholera Infections Using a Multiplex Bead Serological Assay.

Forrest K Jones1, Taufiqur R Bhuiyan2, Rachel E Muise3

  • 1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

Mbio
|October 26, 2022
PubMed
Summary

A new multiplex bead assay (MBA) accurately identifies recent cholera infections using antibody signals. This scalable tool improves cholera serosurveillance and incidence estimation, aiding global control efforts.

Keywords:
Vibrio choleraemultiplex bead assayseroincidenceserosurveillance

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Area of Science:

  • Epidemiology
  • Immunology
  • Infectious Diseases

Background:

  • Estimating cholera incidence is difficult due to biases in medically attended cases and limited health-seeking behavior.
  • Antibody responses to Vibrio cholerae O1 can estimate infection rates from serologic data, but current methods are resource-intensive and hard to standardize.
  • A high-throughput multiplex bead assay (MBA) offers potential for broader antibody measurement and improved seroincidence accuracy.

Purpose of the Study:

  • To evaluate the efficacy of a multiplex bead assay (MBA) for identifying recent Vibrio cholerae O1 infections.
  • To compare the accuracy of MBA-derived antibody profiles with traditional serologic assays for cholera incidence estimation.
  • To assess the potential of MBA as a scalable tool for cholera serosurveillance.

Main Methods:

  • Tested 305 serum samples from confirmed cholera cases and controls using MBA (IgG/IgA/IgM for 7 antigens) and traditional vibriocidal/ELISA assays.
  • Analyzed antibody responses and half-lives across various post-infection time points (4 to 1083 days).
  • Developed random forest models combining MBA antibody measures to identify recent infections (e.g., within 200 days).

Main Results:

  • Several MBA-measured antibodies showed robust responses with comparable half-lives to traditional markers.
  • Random forest models using MBA data achieved high accuracy in identifying recent cholera infections (cvAUC200 of 92%).
  • MBA-based models demonstrated non-inferior accuracy to traditional assays across different infection windows (45-300 days).

Conclusions:

  • A multiplex bead assay provides a scalable and accurate method for cholera serosurveillance and seroincidence estimation.
  • MBA facilitates the identification of recent infections, overcoming limitations of traditional clinical surveillance.
  • This approach can enhance understanding of cholera epidemiology and guide public health interventions.