Diagnosis, Clinical Management, Prevention, and Control of Cholera; A Review Study

Sharifi-Mood, Batool; Metanat, Maliheh

doi:10.17795/iji-18303

Cited by 11 publications

(14 citation statements)

References 20 publications

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“…Macrolide resistance was rarely reported in the studies by Harris et al ., 2012 and Kanskar et al ., 2011 [ 2 , 22 ], yet a high level erythromycin resistance (90.9%) was found in our study. Resistance to erythromycin and other antimicrobial agents among V. cholerae can be acquired through selected mutations over the time, or due to widespread use of antibiotics for prophylaxis in asymptomatic individuals [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Multidrug resistant Vibrio cholerae O1 from clinical and environmental samples in Kathmandu city

Shrestha¹,

Adhikari²,

Maharjan³

et al. 2015

BMC Infect Dis

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BackgroundCholera, an infectious disease caused by Vibrio cholerae, is a major public health problem and is a particularly burden in developing countries including Nepal. Although the recent worldwide outbreaks of cholera have been due to V. cholerae El Tor, the classical biotypes are still predominant in Nepal. Serogroup O1 of the V. cholerae classical biotype was the primary cause of a cholera outbreak in Kathmandu in 2012. Thus, this study was designed to know serotypes and biotypes of V. cholerae strains causing recent outbreak with reference to drug resistant patterns. Moreover, we also report the toxigenic strains of V. cholerae from both environmental and clinical specimens by detecting the ctx gene.MethodsTwenty four V. cholerae (n = 22 from stool samples and n = 2 from water samples) isolated in this study were subjected to Serotyping and biotyping following the standard protocols as described previously. All of the isolates were tested for antimicrobial susceptibility patterns using the modified Kirby-Bauer disk diffusion method as recommended by CLSI guidelines. The screening of the ctx genes (ctxA2-B gene) were performed by PCR method using a pair of primers; C2F (5′-AGGTGTAAAATTCCTTGACGA-3′) and C2R (5′-TCCTCAGGGTATCCTTCATC-3′) to identify the toxigenic strains of V. cholerae.ResultsAmong twenty four V. cholerae isolates, 91.7% were clinical and 8.3% were from water samples. Higher rate of V. cholerae infection was found among adults of aged group 20–30 years. All isolates were serogroups O1 of the V. cholerae classical biotype and sub serotype, Ogawa. All isolates were resistant to ampicillin, nalidixic acid and cotrimoxazole. 90.9% were resistant to erythromycin however, tetracycline was found to be the most effective drug for the isolates. All isolates were multidrug resistant (MDR) and possessed a ctx gene of approximately 400 base pairs indicating the toxigenic strains.ConclusionHundred percent strains of V. cholerae were MDR possessing a ctx gene. It suggests that toxigenic strains be identified and proper antibiotic susceptibility testing be conducted. This will allow effective empirical therapy to be used to treat and control cholera.

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Section: Discussionmentioning

confidence: 99%

Multidrug resistant Vibrio cholerae O1 from clinical and environmental samples in Kathmandu city

Shrestha¹,

Adhikari²,

Maharjan³

et al. 2015

BMC Infect Dis

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“…Early diagnosis of cholera outbreak leads to the prevention, control, and management of the disease. As a result, employing rapid, simple, and inexpensive diagnostic methods is considered as a very critical tool to control the spread of cholera [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Development of IgY-Based Sandwich ELISA as a Robust Tool for Rapid Detection and Discrimination of ToxigenicVibrio cholerae

Bayat

Khabiri

Hemati

2018

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background The conventional methods for diagnosis of Vibrio cholerae are time consuming, complicated, and expensive. Development of rapid detection tests is critical for prevention and management of cholera. This study aimed to introduce two sensitive sandwich ELISAs based on avian antibodies (IgY) targeting outer membrane protein W (OmpW) and cytotoxin B (CtxB) antigens of V. cholerae. Methods The sequences of ompW and ctxB genes were cloned into pET28a vector. Escherichia coli BL21 (DE3) was transformed with the recombinant vectors, and gene expression was induced by IPTG. The expressed proteins were purified by affinity chromatography using Ni-NTA resins. Two groups of white Leghorn chickens were immunized by recombinant proteins, and the generated antibodies were purified from egg yolks of chickens by PEG precipitation. The antibodies were used for the development of α-OmpW and α-CtxB ELISAs. Results The expression and purification yielded 59 and 38 mg of recombinant OmpW and CtxB, respectively, per one liter of bacterial culture. PEG precipitation and purification of egg yolk antibodies yielded on average (±SD) 66.5 ± 1.80 and 50.9 ± 2.23 mg of purified α-OmpW and α-CtxB per egg, respectively. The analytical sensitivity of α-OmpW ELISA was 103 cfu/mL of V. cholerae and that of α-CtxB ELISA was 33 pg/mL of recombinant cytotoxin B. The two developed ELISAs did not show any cross-reactivity to any tested bacteria grown in common conditions. Discussion The current study is the first report on using IgY for detection of V. cholerae. The developed ELISAs were shown to have considerable analytical sensitivity and specificity. Therefore, the assays can be one of the convenient methods for sensitive and specific detection of toxigenic V. cholerae strains in clinical and environmental samples.

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“…A safe water supply and adequate sanitation and hygiene are the major WHO recommendations for cholera prevention [47]. Universally, WASH activities are recognized as a strategic part of disease control and prevention [48,49,50].…”

Section: The Implementation Of Water Sanitation and Hygiene (Wash) Promotion As Prevention Strategiesmentioning

confidence: 99%

Cholera Prevention and Control Strategies; A Global Overview

Tarh

2020

JAMMR

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The observed devastating effects of cholera disease, usually instil fear in the population whenever a cholera outbreak is reported in a particular region. Cholera outbreaks have become key indicators of social development and this is a course for concern, considering the stigmatization that accompanies it. The pathogenic V. cholerae O1/O139 (the watery diarrheal causing agent), is shed in feces, survive as free-living bacteria in water and enters a new host system through the fecoral route. There is therefor, every reason to conclude that, water and food (especially raw or undercooked shellfish), that is contaminated with feces, is the most implicated cause of outbreaks and epidemics in the endemic areas of the world. Cholera mortality rate can rise to about 50% if severe cases are left untreated, but rapid fluid replacement therapy and supportive treatment can reduce the mortality to around 1%. Prompt intervention strategies are therefore necessary if cholera deaths must be prevented and controlled. These strategies may include; getting access to good potable and clean Water, Sanitation and Hygiene (WASH) facilities, good surveillance/community education systems, Oral Cholera Vaccine (OCV), Oral Rehydration Therapy (ORS), and prompt Antibiotic treatment. However, it has been noted that most of the regions that are prone to this flesh eating diarrheal disease, are usually, low resource communities with little or no available road networks and infrastructural facilities. These major challenges render most of these cholera prone areas of the world in accessible. To assist these areas (for example the Nigerian population), in the cholera prevention and preparedness, free-of-cost cholera Vaccines have been sent from the stockpile to the affected areas. Thanks to the concerted efforts made by Gavi, WHO, and partners, who with the NCDC and Borno State Ministry of Health, have made the vaccine available (to Nigeria) and other hot spots. Moreover, the basic requirements for effective surveillance systems, (effective targeted prevention and control) and early warning units, (detection of the index cases, initiation of outbreak control measures through an integrated approach, identification of high risk areas/vulnerable populations and immediate dissemination of information with stakeholders for timely action), have now put been established in most vulnerable location/cholera hot spots in the world. Better still, the Solidarités International (SIs) which was established in Nigeria since 2016, has intervened in cholera outbreaks especially that which occurred in the Borno state in 2017. They make available to susceptible areas, multi-sectorial, life-saving humanitarian aid, especially to the internally displaced and host communities, who suffer from disease outbreaks. Combining the efforts to improve on water quality, sanitation, hygiene (WASH) and OCVs (targeting the highest risk groups first), would help overcome resource/logistical limitations and enable higher coverage. In this review, we seek to look at the prevention and control strategies put in place by the Government and other bodies, to reduce cholera burden in Nigeria and other cholera hotspots, and the level of effectiveness towards achieving their goals.

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Diagnosis, Clinical Management, Prevention, and Control of Cholera; A Review Study

Cited by 11 publications

References 20 publications

Multidrug resistant Vibrio cholerae O1 from clinical and environmental samples in Kathmandu city

Multidrug resistant Vibrio cholerae O1 from clinical and environmental samples in Kathmandu city

Development of IgY-Based Sandwich ELISA as a Robust Tool for Rapid Detection and Discrimination of ToxigenicVibrio cholerae

Cholera Prevention and Control Strategies; A Global Overview

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