Estimating the proportion of clinically suspected cholera cases that are true Vibrio cholerae infections: A systematic review and meta-analysis
PLOS Medicine·
- DOI
- 10.1371/journal.pmed.1004286
- PMID
- 37708235
- PMCID
- PMC10538743
- OpenAlex
- W4386737449
- Study type
- Systematic review
- Publisher
- Public Library of Science (PLoS)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Relying exclusively on symptomatic reporting likely inflates projected disease incidence by roughly double, underscoring the necessity of integrating laboratory-confirmed data into burden calculations. Regional validation remains essential before applying generalized conversion factors to untested populations.
Structured evidence summary
Research question
What fraction of patients meeting clinical criteria for acute watery diarrhea actually harbor confirmed Vibrio cholerae, and which methodological variables drive differences in detection rates?
Study design
This investigation employed a systematic review and meta-analytic framework to synthesize diagnostic accuracy metrics and pathogen confirmation rates from published laboratory evaluations.
Population and setting
The analysis aggregated data from thirty nations, focusing on individuals evaluated for suspected cholera who underwent microbiological or molecular testing between 2000 and 2023.
Main findings
Adjusted analyses indicated that approximately half of clinically flagged cases corresponded to confirmed infections, with detection odds substantially elevated during outbreak-triggered monitoring campaigns. Researchers noted reduced confirmation rates when sampling frameworks lacked representativeness or imposed age restrictions.
Public-health relevance
Relying exclusively on symptomatic reporting likely inflates projected disease incidence by roughly double, underscoring the necessity of integrating laboratory-confirmed data into burden calculations. Regional validation remains essential before applying generalized conversion factors to untested populations.
Important limitations
The authors explicitly noted that their statistical approach could not fully resolve heterogeneity across varying diagnostic methods, geographic contexts, and inclusion criteria. As this summary derives exclusively from the provided abstract and metadata, complete methodological evaluation requires access to the original manuscript.
GIDS interpretation
Within the Global Infectious Disease Surveillance architecture, this work clarifies how clinical case definitions impact signal purity and highlights the need for localized calibration when translating reported symptoms into actionable epidemiological metrics. It provides methodological context for interpreting historical reporting trends without implying current real-time validation.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 7 auditable classifier relationships to diseases, places, topics, and study design.