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Ranked placement of phage predation as a determinant of dehydration severity among cholera patients in Bangladesh

Madi, N.; Sayeed, M. A.; Cato, E. T.; Creasy-Marrazzo, A.; Islam, K.; Khabir, M. I. U.; Bhuiyan, M. T. R.; Begum, Y.; Freeman, E.; Vustepalli, A.; Brinkley, L.; Kamat, M.; Bailey, L. S.; Basso, K.; Qadri, F.; Khan, A. I.; Shapiro, B. J.; Nelson, E. J.

2025-06-18 infectious diseases
10.1101/2025.06.17.25329780 medRxiv
Show abstract

Phage predation is inversely associated with severe cholera yet its importance as a determinant of dehydration severity is unknown relative to other factors. Here we used machine learning to assess and rank potential host, microbial, and environmental factors as determinants of severe dehydration among a cohort of cholera patients enrolled at hospital admission across Bangladesh. We found the phage to pathogen ratio ranked among the top classifying features, placing just behind patient age and admission location. We advocate that phage predation is a key factor to include in the characterization of cholera for scientific, clinical and epidemiological applications.

Published in The Journal of Infectious Diseases (predicted rank #3) · training set

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