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Am J Trop Med Hyg. 2016 Mar;94(3):537-43. doi: 10.4269/ajtmh.15-0496. Epub 2016 Jan 11.

Clinical and Environmental Surveillance for Vibrio cholerae in Resource Constrained Areas: Application During a 1-Year Surveillance in the Far North Region of Cameroon.

Author information

1
Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon; Meilleur Accès aux Soins de Santé (M.A. SANTE), Yaoundé, Cameroon; Clinical Research Unit, Division of Health Operations Research, Ministry of Public Health, Yaoundé, Cameroon adebes1@jhu.edu.
2
Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon; Meilleur Accès aux Soins de Santé (M.A. SANTE), Yaoundé, Cameroon; Clinical Research Unit, Division of Health Operations Research, Ministry of Public Health, Yaoundé, Cameroon.

Abstract

Biological confirmation of the presence of Vibrio cholerae in clinical and environmental samples is often constrained due to resource- and labor-intensive gold standard methods. To develop low-cost, simple, and sustainable surveillance techniques, we modified previously published specimen sampling and culture techniques and applied the use of enriched dipstick testing in conjunction with the use of filter paper for DNA specimen preservation during clinical and environmental surveillance in the Far North of Cameroon from August 2013 to October 2014. The enriched dipstick methodology during routine use in a remote setting demonstrated a specificity of 99.8% compared with polymerase chain reaction (PCR). The novel application of filter paper as a preservation method for cholera DNA specimens reduced the need for cold chain storage and allowed for PCR characterization and confirmation of V. cholerae. The application of basic technologies such as the enriched dipstick, the use of simplified gauze filtration for environmental sample collection, and the use of filter paper for sample preservation enabled early case identification with reduced logistics and supply cost while reporting minimal false-positive results. Simplified laboratory and epidemiological methodologies can improve the feasibility of cholera surveillance in rural and resource-constrained areas, facilitating early case detection and rapid response implementation.

PMID:
26755564
PMCID:
PMC4775888
DOI:
10.4269/ajtmh.15-0496
[Indexed for MEDLINE]
Free PMC Article

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