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Identifying the most sensitive and specific sign and symptom combinations for cholera: results from an analysis of laboratory-based surveillance data from Haiti, 2012-2013.

Lucien MA, Schaad N, Steenland MW, Mintz ED, Emmanuel R, Freeman N, Boncy J, Adrien P, Joseph GA, Katz MA - Am. J. Trop. Med. Hyg. (2015)

Bottom Line: Since October 2010, over 700,000 cholera cases have been reported in Haiti.We used data from laboratory-based surveillance for diarrhea in Haiti to evaluate the sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) of the cholera case definitions recommended by the World Health Organization (WHO).From April 2012 to May 2013, we tested 1,878 samples from hospitalized patients with acute watery diarrhea; 1,178 (62.7%) yielded Vibrio cholerae O1.

View Article: PubMed Central - PubMed

Affiliation: National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti; Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Foodborne, Water and Environmental Diseases, National Center for Emerging and Zoonotic Infections, Centers for Disease Control and Prevention, Atlanta, Georgia; Directorate of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti; Centers for Disease Control and Prevention-Haiti, Port-au-Prince, Haiti lucienmentor@gmail.com.

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The calculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
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Figure 3: The calculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Mentions: Data were entered and stored in a Microsoft Access 2010 database (Microsoft Corporation, Redmond, WA) and analyzed using Epi Info 7 (U.S. Centers for Disease Control and Prevention [CDC], Atlanta, GA). Frequency procedures were used to generate descriptive statistics. Bivariate and multivariate analyses were conducted to assess whether demographic characteristics and clinical symptoms of patients were associated with culture-positive cholera. Only symptoms and characteristics known to be associated with cholera that were present in > 20% patients tested for cholera were included in the analyses. Symptoms and characteristics that were statistically significant were included in a multivariable model, and two-way interactions were assessed. We then evaluated the sensitivity, specificity, PPV, and PPV of the two WHO case definitions and additional combinations of demographic characteristics and clinical symptoms using cholera culture as the gold standard (Figure 3). The various case definitions were evaluated for patients of all ages, as well as patients under 5 years.


Identifying the most sensitive and specific sign and symptom combinations for cholera: results from an analysis of laboratory-based surveillance data from Haiti, 2012-2013.

Lucien MA, Schaad N, Steenland MW, Mintz ED, Emmanuel R, Freeman N, Boncy J, Adrien P, Joseph GA, Katz MA - Am. J. Trop. Med. Hyg. (2015)

The calculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385769&req=5

Figure 3: The calculation of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Mentions: Data were entered and stored in a Microsoft Access 2010 database (Microsoft Corporation, Redmond, WA) and analyzed using Epi Info 7 (U.S. Centers for Disease Control and Prevention [CDC], Atlanta, GA). Frequency procedures were used to generate descriptive statistics. Bivariate and multivariate analyses were conducted to assess whether demographic characteristics and clinical symptoms of patients were associated with culture-positive cholera. Only symptoms and characteristics known to be associated with cholera that were present in > 20% patients tested for cholera were included in the analyses. Symptoms and characteristics that were statistically significant were included in a multivariable model, and two-way interactions were assessed. We then evaluated the sensitivity, specificity, PPV, and PPV of the two WHO case definitions and additional combinations of demographic characteristics and clinical symptoms using cholera culture as the gold standard (Figure 3). The various case definitions were evaluated for patients of all ages, as well as patients under 5 years.

Bottom Line: Since October 2010, over 700,000 cholera cases have been reported in Haiti.We used data from laboratory-based surveillance for diarrhea in Haiti to evaluate the sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) of the cholera case definitions recommended by the World Health Organization (WHO).From April 2012 to May 2013, we tested 1,878 samples from hospitalized patients with acute watery diarrhea; 1,178 (62.7%) yielded Vibrio cholerae O1.

View Article: PubMed Central - PubMed

Affiliation: National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti; Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Foodborne, Water and Environmental Diseases, National Center for Emerging and Zoonotic Infections, Centers for Disease Control and Prevention, Atlanta, Georgia; Directorate of Epidemiology, Laboratory and Research, Ministry of Public Health and Population, Port-au-Prince, Haiti; Centers for Disease Control and Prevention-Haiti, Port-au-Prince, Haiti lucienmentor@gmail.com.

Show MeSH
Related in: MedlinePlus