摘要

The development of new approaches to cholera control relies on an accurate understanding of cholera epidemiology. However, most information on cholera incidence lacks laboratory confirmation and instead relies on surveillance systems reporting medically attended acute watery diarrhea. If recent infections could be identified using serological markers, cross-sectional serosurveys would offer an alternative approach to measuring incidence. Here, we used 1569 serologic samples from a cohort of cholera cases and their uninfected contacts in Bangladesh to train machine learning models to identify recent Vibrio cholerae O1 infections. We found that an individual's antibody profile contains information on the timing of V. cholerae O1 infections in the previous year. Our models using six serological markers accurately identified individuals in the Bangladesh cohort infected within the last year [cross-validated area under the curve (AUC), 93.4%; 95% confidence interval (CI), 92.1 to 94.7%], with a marginal performance decrease using models based on two markers (cross-validated AUC, 91.0%; 95% CI, 89.2 to 92.7%). We validated the performance of the two-marker model on data from a cohort of North American volunteers challenged with V. cholerae O1 (AUC range, 88.4 to 98.4%). In simulated serosurveys, our models accurately estimated annual incidence in both endemic and epidemic settings, even with sample sizes as small as 500 and annual incidence as low as two infections per 1000 individuals. Cross-sectional serosurveys may be a viable approach to estimating cholera incidence.

译文

霍乱控制新方法的发展依赖于对霍乱流行病学的准确理解。然而,大多数关于霍乱发病率的信息缺乏实验室确认,而是依赖于报告医学护理的急性水样腹泻的监测系统。如果最近的感染可以用血清学标记来鉴定,横断面血清检测将提供一种测量发病率的替代方法。在这里,我们使用了来自孟加拉国霍乱病例队列及其未感染接触者的 1569 份血清学样本来训练机器学习模型来识别最近的霍乱弧菌 O1 感染。我们发现个体的抗体谱包含前一年霍乱弧菌 O1 感染时间的信息。我们的模型使用六种血清学标记准确识别了去年受感染的孟加拉国队列中的个体 [交叉验证曲线下面积 (AUC),93.4%; 95% 置信区间 (CI), 92.1 到 94.7%],使用基于两个标记的模型时边际性能下降 (交叉验证 AUC,91.0%; 95% CI,89.2 至 92.7%)。我们验证了双标记模型对北美志愿者队列中 O1 霍乱弧菌挑战数据的性能 (AUC 范围,88.4 至 98.4%)。在模拟血清检测中,我们的模型准确地估计了地方性和流行病环境中的年发病率,即使样本量小至 500,年发病率低至每 1000 人两次感染。横断面血清检测可能是估计霍乱发病率的可行方法。

Cholera

消化 肠道传染病 疾病
概述  :  

霍乱(cholera)是由O1和O139群霍乱弧菌(Vibrio cholerae)引起的急性肠道传染病,属三大国际检疫传染病之一,也是我国法定管理的甲类传染病。临床特征为剧烈腹泻、呕吐、大量米泔水样排泄物,水电解质紊乱和周围循环衰竭。 流行病学表现时间分布:霍乱的发病没有明显的季节性变化,但夏秋季发病明显增多。人群分布:霍乱没有明显的年龄、性别、种族的差异。所有人都是本病的易感者。是否会得此病,取决于个人的免疫水平高低和暴露机会的大小。 地理分布:霍乱在地理环境分布上以沿海为主,

cholera 英 [ˈkɒlərə] 美 [ˈkɑːlərə]

释义   n. [内科] 霍乱

例句   Cholera as well as viruses like those that cause influenza and AIDS infect these areas. 霍乱就像那些导致流感和艾滋病的病毒一样会感染这些区域。


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