Syndromic cholera diagnosis masks diverse causes of diarrhoeal disease in Burundi revealed by portable metagenomics.
PLoS neglected tropical diseases·
- DOI
- 10.1371/journal.pntd.0014175
- PMID
- 42679008
- PMCID
- —
- OpenAlex
- W7140210089
- Study type
- Journal article
- Publisher
- Publisher unavailable
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings demonstrate that syndromic cholera diagnosis can miss diverse diarrheal etiologies. Mobile metagenomic sequencing may improve etiological resolution and outbreak response in resource-limited settings where diagnostic capacity is constrained.
Structured evidence summary
Research question
The study evaluated whether mobile metagenomic sequencing could detect gastrointestinal pathogens directly from stool samples in cholera-suspected cases in Burundi.
Study design
Culture-independent metagenomic sequencing using Oxford Nanopore Technologies was deployed on-site at a health center, district hospital, and refugee transit camp. Results were verified using conventional culturing and bioinformatic analyses.
Population and setting
Patients with suspected cholera across three sites in Burundi: a health center, a district hospital, and a refugee transit camp.
Main findings
Vibrio cholerae was detected in only a subset of suspected cholera cases, while many samples showed other bacterial pathogens, most commonly Escherichia coli. Detection of the cholera toxin phage CTXφ correlated strongly with V. cholerae abundance, helping distinguish toxigenic infection from background exposure. Antimicrobial resistance genes were detected across samples.
Public-health relevance
The findings demonstrate that syndromic cholera diagnosis can miss diverse diarrheal etiologies. Mobile metagenomic sequencing may improve etiological resolution and outbreak response in resource-limited settings where diagnostic capacity is constrained.
Important limitations
This summary is limited to the supplied single-article abstract and metadata. The original paper is required for decision-grade interpretation of sample size, representativeness, sequencing sensitivity and specificity, comparative performance against gold standards, and operational feasibility.
GIDS interpretation
The article is linked to Cholera, Burundi, Antimicrobial Resistance, Diagnostics, and Outbreak Investigation topics in classifier metadata, indicating its relevance for surveillance of cholera diagnostics and AMR patterns in East Africa. The study context and pathogen diversity findings provide background for interpreting cholera-suspected case reports.
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 9 auditable classifier relationships to diseases, places, topics, and study design.