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Accuracy of rapid point-of-care serological tests for leprosy diagnosis: a systematic review and meta-analysis

BACKGROUND: Leprosy is a chronic infectious disease, still endemic in many countries that may lead to neurological, ophthalmic, and motor sequelae if not treated early. Access to timely diagnosis and multidrug therapy (MDT) remains a crucial element in the World Health Organization’s strategy to eli...

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Autores principales: Romero, Carmen Phang, Castro, Rodolfo, do Brasil, Pedro Emmanuel A, Pereira, Daniella R, Pinheiro, Roberta Olmo, Toscano, Cristiana M, de Oliveira, Maria Regina Fernandes
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Instituto Oswaldo Cruz, Ministério da Saúde 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000963/
https://www.ncbi.nlm.nih.gov/pubmed/35416839
http://dx.doi.org/10.1590/0074-02760220317
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author Romero, Carmen Phang
Castro, Rodolfo
do Brasil, Pedro Emmanuel A
Pereira, Daniella R
Pinheiro, Roberta Olmo
Toscano, Cristiana M
de Oliveira, Maria Regina Fernandes
author_facet Romero, Carmen Phang
Castro, Rodolfo
do Brasil, Pedro Emmanuel A
Pereira, Daniella R
Pinheiro, Roberta Olmo
Toscano, Cristiana M
de Oliveira, Maria Regina Fernandes
author_sort Romero, Carmen Phang
collection PubMed
description BACKGROUND: Leprosy is a chronic infectious disease, still endemic in many countries that may lead to neurological, ophthalmic, and motor sequelae if not treated early. Access to timely diagnosis and multidrug therapy (MDT) remains a crucial element in the World Health Organization’s strategy to eliminate the disease as a public health problem. OBJECTIVES: This systematic review aims to evaluate the accuracy of rapid point-of-care (POC) tests for diagnosis of leprosy. METHODS: Searches were carried out in electronic databases (PubMed, EMBASE, CRD, Cochrane Library and LILACS) in April 2021 for patients with suspicion or confirmatory diagnostic of leprosy, classified in multibacillary (MB) or paucibacillary (PB) cases, performing rapid POC serological tests compared to clinical evaluation, smear microscopy and immunohistochemistry analysis. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2). A meta-analysis was undertaken to generate pooled estimates of diagnostic parameters, presenting sensitivity, specificity and diagnostic odds ratio (DOR) values. The review protocol was registered at PROSPERO, CRD # 42014009658. FINDINGS: From 893 potentially relevant references, 12 articles were included reporting 16 diagnostic tests accuracy studies with 5395 individuals enrolled. Meta-analysis of NDO-LID and PGL-I tests data in MB patients showed sensitivity and specificity [95% confidence interval (CI)] of 0.83 (0.71-0.91), 0.91 (0.72-0.97); and 0.92 (0.86-0.96), 0.93 (0.78-0.98); respectively, with high heterogeneity among the studies. MAIN CONCLUSIONS: Our results can inform policymakers regarding the possibility of implementing accurate, rapid POC tests for leprosy in public health services, especially within primary health care.
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spelling pubmed-90009632022-04-18 Accuracy of rapid point-of-care serological tests for leprosy diagnosis: a systematic review and meta-analysis Romero, Carmen Phang Castro, Rodolfo do Brasil, Pedro Emmanuel A Pereira, Daniella R Pinheiro, Roberta Olmo Toscano, Cristiana M de Oliveira, Maria Regina Fernandes Mem Inst Oswaldo Cruz Research Article BACKGROUND: Leprosy is a chronic infectious disease, still endemic in many countries that may lead to neurological, ophthalmic, and motor sequelae if not treated early. Access to timely diagnosis and multidrug therapy (MDT) remains a crucial element in the World Health Organization’s strategy to eliminate the disease as a public health problem. OBJECTIVES: This systematic review aims to evaluate the accuracy of rapid point-of-care (POC) tests for diagnosis of leprosy. METHODS: Searches were carried out in electronic databases (PubMed, EMBASE, CRD, Cochrane Library and LILACS) in April 2021 for patients with suspicion or confirmatory diagnostic of leprosy, classified in multibacillary (MB) or paucibacillary (PB) cases, performing rapid POC serological tests compared to clinical evaluation, smear microscopy and immunohistochemistry analysis. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2). A meta-analysis was undertaken to generate pooled estimates of diagnostic parameters, presenting sensitivity, specificity and diagnostic odds ratio (DOR) values. The review protocol was registered at PROSPERO, CRD # 42014009658. FINDINGS: From 893 potentially relevant references, 12 articles were included reporting 16 diagnostic tests accuracy studies with 5395 individuals enrolled. Meta-analysis of NDO-LID and PGL-I tests data in MB patients showed sensitivity and specificity [95% confidence interval (CI)] of 0.83 (0.71-0.91), 0.91 (0.72-0.97); and 0.92 (0.86-0.96), 0.93 (0.78-0.98); respectively, with high heterogeneity among the studies. MAIN CONCLUSIONS: Our results can inform policymakers regarding the possibility of implementing accurate, rapid POC tests for leprosy in public health services, especially within primary health care. Instituto Oswaldo Cruz, Ministério da Saúde 2022-04-08 /pmc/articles/PMC9000963/ /pubmed/35416839 http://dx.doi.org/10.1590/0074-02760220317 Text en https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Research Article
Romero, Carmen Phang
Castro, Rodolfo
do Brasil, Pedro Emmanuel A
Pereira, Daniella R
Pinheiro, Roberta Olmo
Toscano, Cristiana M
de Oliveira, Maria Regina Fernandes
Accuracy of rapid point-of-care serological tests for leprosy diagnosis: a systematic review and meta-analysis
title Accuracy of rapid point-of-care serological tests for leprosy diagnosis: a systematic review and meta-analysis
title_full Accuracy of rapid point-of-care serological tests for leprosy diagnosis: a systematic review and meta-analysis
title_fullStr Accuracy of rapid point-of-care serological tests for leprosy diagnosis: a systematic review and meta-analysis
title_full_unstemmed Accuracy of rapid point-of-care serological tests for leprosy diagnosis: a systematic review and meta-analysis
title_short Accuracy of rapid point-of-care serological tests for leprosy diagnosis: a systematic review and meta-analysis
title_sort accuracy of rapid point-of-care serological tests for leprosy diagnosis: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000963/
https://www.ncbi.nlm.nih.gov/pubmed/35416839
http://dx.doi.org/10.1590/0074-02760220317
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