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Updated: May 1, 2026

On-Site Molecular Detection of Soil-Borne Phytopathogens Using a Portable Real-Time PCR System

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Published on: February 23, 2018

Cholera rapid diagnostic tests at the host-microbe interface: Key Considerations for Global Deployments.

S M Ahmed¹, Md Abu Sayeed², I Sriguha²

¹Department of Epidemiology, Emory University, Atlanta, GA, USA.

Medrxiv : the Preprint Server for Health Sciences

|June 4, 2025

Summary

This summary is machine-generated.

Rapid diagnostic tests (RDTs) for cholera are vulnerable to bacteriophage (phage) and antibiotics. Optimizing RDT use in severe dehydration cases improves accuracy, but phage detection needs further study for better cholera diagnosis.

Keywords:

AMR Bangladesh Cholera RDT Vibrio cholerae antibiotics antimicrobial resistance bacteriophage diarrhea diarrhoea outbreak phage rapid diagnostic test

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Area of Science:

Microbiology
Infectious Diseases
Diagnostic Technologies

Background:

Effective cholera outbreak response relies on accurate bedside rapid diagnostic tests (RDTs) due to limited laboratory access.
Cholera diagnostics face vulnerabilities, including antibiotic interference and bacteriophage (phage) predation specific to Vibrio cholerae (Vc).

Purpose of the Study:

To investigate the impact of phage and antibiotics on RDT performance in cholera diagnosis.
To characterize how diagnostic vulnerabilities affect RDT accuracy in a nationwide study.

Main Methods:

Prospective nationwide study in Bangladesh involving over 2000 patients with diarrheal disease.
Utilized culture, quantitative PCR (qPCR), and mass spectrometry (LC-MS/MS) for Vc detection and antibiotic analysis.

Main Results:

No significant effect of phage on RDT performance was observed with current gold standards (culture/qPCR).
Expanding diagnostic criteria to include phage slightly decreased RDT sensitivity.
RDT sensitivity and specificity significantly increased in patients with moderate to severe dehydration.
Antibiotics were detected in over 80% of samples, limiting assessment of their RDT impact.
Restricting RDT use to severe cases without antibiotic exposure could increase sensitivity by 50%.

Conclusions:

Cholera RDTs have critical limitations impacting global deployment.
Further research is needed to explore the inclusion of phage detection in diagnostic criteria for improved cholera case detection.
Findings may inform diagnostic development for other diseases with similar vulnerabilities.