Validation of clinical and epidemiological diagnosis criterion for confirming cholera

Abstract

To validate the clinical and epidemiological diagnosis criterion for confirming cholera suspect cases. The study comprised 2,687 and 716 patients admitted with diarrhea to a public hospital in Macei , Brazil, in 1992 and 1997 respectively. Culture of V. cholerae O1 (Koch, 1884) in TCBS-agar was performed and the clinical and epidemiological criterion was applied and compared to the gold standard. The statistical analysis was carried out in two age-groups: less than five years old and five years old or more. There were studied 833 patients, of which 517 in 1992 and 316 in 1997; 72 aged less than five years and 761 aged five years or more. In those aged less than five years in 1992, sensitivity was 40% and specificity 84.6%. For this same age-group in 1997, sensitivity was 28.6% and specificity 62.5%. In patients aged five years or more in 1992, sensitivity was 99% and specificity 1.2%. For this same age-group in 1997, sensitivity was 86.9% and specificity 8.7%. The higher sensitivity of the clinical and epidemiological cholera diagnosis criterion in patients aged five years or more found in the study support its application during epidemics periods. In periods of lower incidence, all cases need to be confirmed using laboratory methods.