Accuracy of diagnostic tests for American tegumentary leishmaniasis: a systematic literature review with meta‐analyses
作者：Héber Paulino Pena, Vinícius Silva Belo, José Cândido Caldeira Xavier‐Júnior, Rafael Gonçalves Teixeira‐Neto, Saulo Nascimento de Melo, Diego Andrade Pereira, Igor de Campos Fontes, Ingrid Morselli Santos, Valeriana Valadares Lopes, Wagner Luiz Tafuri, Gustavo Adolfo Sierra Romero, Eduardo Sérgio da Silva · 发表于：Tropical Medicine & International Health · 年份：2020 · DOI：10.1111/tmi.13465 · 被引用次数：28 · 研究领域：Research on Leishmaniasis Studies、Trypanosoma species research and implications、Toxoplasma gondii Research Studies
OBJECTIVES: To analyse the accuracy of American tegumentary leishmaniasis (ATL) diagnostic methods and evaluate the quality of the existing publications by means of a systematic review. METHODS: Diagnostic tests evaluated in at least two studies with common reference standards were included in the sensitivity and/or specificity meta-analyses. Quality and susceptibility to bias were analysed using the QUADAS-2 and STARD tools. RESULTS: The title and abstract of 3387 publications were evaluated after deduplication resulting from database searches. Thirty-eight studies were included in the review, and 26 of them had results inserted in meta-analyses. The diagnostic methods with the highest pooled sensitivity values were ELISA, polymerase chain reaction (PCR), indirect immunofluorescence reaction and Montenegro's intradermal reaction. Cytometry was assessed in only two studies and presented 100% sensitivity in both. Smear slide microscopy and histopathology showed low pooled values of sensitivity. For specificity, the highest pooled values were identified for PCR. High values were also identified for ELISA, except for studies in which the reference standard for defining negative participants included individuals with Chagas' disease or paracoccidioidomycosis, which also occurred for cytometry. IFR had lower specificities than ELISA. There was a predominance of case-control designs of phase 1 or 2 and only four studies were strongly recommended as evidence generators. Several refe...