Evidence map›Paper›PMID 40327685›Full record

ArticlePLoS neglected tropical diseases2025

Enhancing national cholera surveillance using rapid diagnostic tests (RDTs): A mixed methods evaluation.

Erin T Baumgartner, Kendra N Williams, Emee Rai, Erica N Rosser, Rudra P Marasini, Sagar Dahal, Anu Shakya, Julia Lynch, Kshitij Karki, Deepak C Bajracharya and 2 more

Abstract read
In one paragraph

Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Erin T BaumgartnerJohns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.ORCID 0009-0008-1632-7098
Kendra N WilliamsJohns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Emee RaiG.T.A. Foundation, Kathmandu, Nepal.
Erica N RosserJohns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Rudra P MarasiniEpidemiology and Disease Control Division (EDCD), Ministry of Health and Population, Kathmandu, Nepal.
Sagar DahalEpidemiology and Disease Control Division (EDCD), Ministry of Health and Population, Kathmandu, Nepal.
Anu ShakyaEpidemiology and Disease Control Division (EDCD), Ministry of Health and Population, Kathmandu, Nepal.
Julia LynchInternational Vaccine Institute (IVI), Seoul, South Korea.
Kshitij KarkiG.T.A. Foundation, Kathmandu, Nepal.
Deepak C BajracharyaG.T.A. Foundation, Kathmandu, Nepal.
David A SackJohns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Amanda K DebesJohns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

Funding

Gavi AllianceJohns Hopkins Bloomberg School of Public Health
6 · The paper itself

Abstract

Cholera rapid diagnostic tests (RDTs) can strengthen existing surveillance systems by offering a cost-effective screening method that improves understanding of cholera burden allowing for targeted prevention and control efforts. The RDT Implementation Strategy and Evaluation (RISE) project is the pilot study for Gavi's innovative Diagnostic Procurement Platform which provides cholera RDTs to enhance national surveillance. Implementation of cholera RDTs was evaluated following their distribution in 2023 to facilities within Nepal's Early Warning and Reporting System (EWARS). Quantitative data was collected through EWARS surveillance reports, national-level and individual-level REDCap surveys from select facilities in Kathmandu. Key-informant interviews were also conducted in Kathmandu with personnel involved in cholera surveillance and response. Interviews were conducted using a semi-structured interview guide and analyzed according to inductively identified themes. Qualitative findings indicated generally positive perceptions of cholera RDTs, highlighting their speed and ease of use, and suitability for deployment in under-resourced areas by unskilled personnel. However, a lack of awareness of the RDTs, limited training, and concerns about the RDTs' quality, availability, and costs were challenges raised consistently. Quantitative findings revealed underreporting of acute gastroenteritis (AGE) and cholera in EWARS and an underutilization of the cholera RDTs, with only 2.6% of reported AGE cases screened using an RDT. This field evaluation demonstrated that RDTs can have an important role in cholera surveillance but highlighted significant challenges with cholera lab capacity, reporting, and training. Both the qualitative and quantitative findings showed gaps in surveillance reporting, which were exacerbated by the complexity of adding RDTs without strong guidance as well as beliefs about the RDTs' poor validity. These misconceptions and challenges need to be addressed at the local and national level to successfully scale-up cholera RDTs in Nepal and beyond.

Indexed as

CholeraDiagnostic Tests, RoutineEpidemiological MonitoringHumansNepalPilot ProjectsRapid Diagnostic Tests

Identifiers

PMID40327685
PMCPMC12077796

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.