دورية أكاديمية
Accuracy of the direct agglutination test for diagnosis of visceral leishmaniasis: a systematic review and meta-analysis.
| العنوان: | Accuracy of the direct agglutination test for diagnosis of visceral leishmaniasis: a systematic review and meta-analysis. |
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| المؤلفون: | Roberts T; Lao- Oxford-Mahosot Hospital- Wellcome Trust Research Unit, Mahosot Hospital, Mahosot Road, Vientiane, Lao People's Democratic Republic. tamalee.r@tropmedres.ac.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK. tamalee.r@tropmedres.ac., Keddie SH; London School of Hygiene & Tropical Medicine, London, UK., Rattanavong S; Lao- Oxford-Mahosot Hospital- Wellcome Trust Research Unit, Mahosot Hospital, Mahosot Road, Vientiane, Lao People's Democratic Republic., Gomez SR; Department of Infectious Disease Epidemiology, Faculty of Medicine, London Centre for Neglected Tropical Disease Research, St Marys Campus, Imperial College London, London, UK., Bradley J; London School of Hygiene & Tropical Medicine, London, UK., Keogh RH; London School of Hygiene & Tropical Medicine, London, UK., Bärenbold O; London School of Hygiene & Tropical Medicine, London, UK., Falconer J; London School of Hygiene & Tropical Medicine, London, UK., Mens PF; Department of Medical Microbiology, Experimental Parasitology Unit, Amsterdam University Medical Centers, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands., Hopkins H; London School of Hygiene & Tropical Medicine, London, UK., Ashley EA; Lao- Oxford-Mahosot Hospital- Wellcome Trust Research Unit, Mahosot Hospital, Mahosot Road, Vientiane, Lao People's Democratic Republic.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK. |
| المصدر: | BMC infectious diseases [BMC Infect Dis] 2023 Nov 09; Vol. 23 (1), pp. 782. Date of Electronic Publication: 2023 Nov 09. |
| نوع المنشور: | Meta-Analysis; Systematic Review; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001- |
| مواضيع طبية MeSH: | Leishmaniasis, Visceral*/diagnosis , Leishmaniasis, Visceral*/parasitology , HIV Seropositivity*, Humans ; Agglutination Tests/methods ; Serologic Tests/methods ; Sensitivity and Specificity |
| مستخلص: | Background: Parasitological investigation of bone marrow, splenic or lymph node aspirations is the gold standard for the diagnosis of visceral leishmaniasis (VL). However, this invasive test requires skilled clinical and laboratory staff and adequate facilities, and sensitivity varies depending on the tissue used. The direct agglutination test (DAT) is a serological test that does not need specialised staff, with just minimal training required. While previous meta-analysis has shown DAT to have high sensitivity and specificity when using parasitology as the reference test for diagnosis, meta-analysis of DAT compared to other diagnostic techniques, such as PCR and ELISA, that are increasingly used in clinical and research settings, has not been done. Methods: We conducted a systematic review to determine the diagnostic performance of DAT compared to all available tests for the laboratory diagnosis of human VL. We searched electronic databases including Medline, Embase, Global Health, Scopus, WoS Science Citation Index, Wiley Cochrane Central Register of Controlled Trials, Africa-Wide Information, LILACS and WHO Global Index. Three independent reviewers screened reports and extracted data from eligible studies. A meta-analysis estimated the diagnostic sensitivity and specificity of DAT. Results: Of 987 titles screened, 358 were selected for full data extraction and 78 were included in the analysis, reporting on 32,822 participants from 19 countries. Studies included were conducted between 1987-2020. Meta-analysis of studies using serum and DAT compared to any other test showed pooled sensitivity of 95% (95%CrI 90-98%) and pooled specificity of 95% (95%CrI 88-98%). Results were similar for freeze-dried DAT and liquid DAT when analysed separately. Sensitivity was lower for HIV-positive patients (90%, CrI 59-98%) and specificity was lower for symptomatic patients (70%, CrI 43-89%). When comparing different geographical regions, the lowest median sensitivity (89%, CrI 67-97%) was in Western Asia (five studies). Conclusions: This systematic review and meta-analysis demonstrates high estimated pooled sensitivity and specificity of DAT for diagnosis of VL, although sensitivity and specificity were lower for different patient groups and geographical locations. This review highlights the lack of standardisation of DAT methods and preparations, and the lack of data from some important geographical locations. Future well-reported studies could provide better evidence to inform test implementation for different patient populations and use cases. Prospero Registration: CRD42021240830. (© 2023. The Author(s).) |
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| معلومات مُعتمدة: | United Kingdom WT_ Wellcome Trust; 220211 United Kingdom WT_ Wellcome Trust |
| فهرسة مساهمة: | Keywords: Diagnosis; Direct agglutination test; Leishmania; Meta-analysis; Visceral leishmaniasis |
| تواريخ الأحداث: | Date Created: 20231109 Date Completed: 20231113 Latest Revision: 20240210 |
| رمز التحديث: | 20240210 |
| مُعرف محوري في PubMed: | PMC10636880 |
| DOI: | 10.1186/s12879-023-08772-1 |
| PMID: | 37946107 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1471-2334 |
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| DOI: | 10.1186/s12879-023-08772-1 |