Ndung'u Mwangi Harrison, Gachara George, Ontweka Lameck, Menza Nelson, Musyoki Abednego, Muturi Margaret
Department of Biochemistry, University of Nairobi, Nairobi, Kenya.
Department of Medical Laboratory sciences, Kenyatta University, Nairobi, Kenya.
East Afr Health Res J. 2023;7(2):131-139. doi: 10.24248/eahrj.v7i2.724. Epub 2023 Nov 30.
Cholera epidemic poses a global public health threat, heavily impacting the global economy and societies, with Africa and Asia particularly affected due to factors like; inadequate sanitation, contaminated water, and overcrowding. The associated high rates of morbidity and mortality strain productivity and healthcare costs while complicating control measures. Consequently, the World Health Organization's cholera control initiative and the Diarrhoeal Diseases Laboratory Network advocate for rapid responses to outbreaks and continuous environmental surveillance, since traditional cholera detection methods relying on phenotypic fingerprinting, although considered the gold standard, suffer from labour-intensiveness, time-consumption, and skill requirements. This results in inadequate surveillance and delayed treatment in remote areas lacking well-equipped laboratories.
A systematic review was conducted to evaluate the development and performance of cholera rapid diagnostic techniques for detecting cholera in clinical samples and for environmental surveillance purposes over the past decade.
Twenty-four commercially produced diagnostics were identified in January 2011. Ten more were mentioned in the literature and yet did not provide enough relevant data due to suspected production withdrawal or fall-back. The vast bulk of tests were discovered to be based on antigen or antibody detection, with DNA accounting for a large proportion of the residual tests. This study revealed a plethora of diagnostic methods, some of which have not yet made it to the commercial market. Promising approaches, such as; Loop-mediated isothermal amplification (LAMP), ELISA, and simplified PCR protocols, are likely to play a significant role in future cholera screening. Findings are herein summarised in tables and figures.
Cholera epidemic continues to present a formidable global health challenge with economic and social repercussions. Traditional detection methods fall short in resource-limited areas, necessitating the exploration of advanced molecular techniques, like aptamers, to improve diagnosis, surveillance, and control measures, especially in regions vulnerable to cholera outbreaks.
霍乱疫情构成全球公共卫生威胁，对全球经济和社会造成严重影响，非洲和亚洲受影响尤为严重，原因包括卫生设施不足、水源污染和过度拥挤等。相关的高发病率和死亡率给生产力和医疗成本带来压力，同时使控制措施复杂化。因此，世界卫生组织的霍乱控制倡议和腹泻病实验室网络主张对疫情爆发做出快速反应并持续进行环境监测，因为传统的霍乱检测方法依赖表型指纹识别，尽管被视为金标准，但存在劳动强度大、耗时且需要技术等问题。这导致在缺乏设备完善实验室的偏远地区监测不足和治疗延误。
进行了一项系统综述，以评估过去十年中用于检测临床样本和环境监测中霍乱的霍乱快速诊断技术的发展和性能。
2011年1月确定了24种商业生产的诊断方法。文献中还提到了另外10种，但由于怀疑生产停止或倒退而未提供足够的相关数据。发现绝大多数检测基于抗原或抗体检测，DNA检测占其余检测的很大一部分。这项研究揭示了大量的诊断方法，其中一些尚未进入商业市场。有前景的方法，如环介导等温扩增（LAMP）、酶联免疫吸附测定（ELISA）和简化的聚合酶链反应（PCR）方案，可能在未来霍乱筛查中发挥重要作用。研究结果在表格和图表中进行了总结。
霍乱疫情继续给全球卫生带来严峻挑战，并产生经济和社会影响。传统检测方法在资源有限的地区存在不足，因此有必要探索先进的分子技术，如适体，以改善诊断、监测和控制措施，特别是在易发生霍乱疫情的地区。
