Comparison of diagnostic performance between conventional and ultrasensitive rapid diagnostic tests for diagnosis of malaria: A systematic review and meta-analysis.
Comparison of diagnostic performance between conventional and ultrasensitive rapid diagnostic tests for diagnosis of malaria: A systematic review and meta-analysis.
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传统和超敏感性快速诊断测试诊断疟疾的诊断性能的比较：系统评价和荟萃分析。
DOI：
10.1371/journal.pone.0263770
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Abbaszadeh Afshar MJ
中科院分区：
文献类型：
--
作者：
Yimam Y;Mohebali M;Abbaszadeh Afshar MJ
成功的疟疾治疗、控制和消除计划需要准确、负担得起且可现场部署的诊断测试。许多研究直接比较了新型超灵敏快速诊断测试（us-RDT）和传统快速诊断测试（co-RDT）在检测疟疾方面的诊断性能。因此，我们进行了本次综述，以直接比较 us-RDT 和 co-RDT 在疟疾检测方面的汇总诊断性能。 PubMed、Web of Science、Scopus、Embase 和 ProQuest 从创建之初到 2021 年 1 月 31 日均进行了检索，并进行了前向和后向引用跟踪。两位作者通过 RevMan5 软件（使用 QUADAS-2 检查表）独立评估了纳入研究的质量。使用 Stata 15 软件中的随机效应模型和 95% 置信区间 (CI) 汇总诊断准确性估计值（敏感性和特异性等）。荟萃分析中纳入了 15 项研究，总共 20,236 项配对的 co-RDT 和 us-RDT 测试。分子方法（15 项研究）和免疫分析测试（1 项研究）被用作与 co-RDT 和 us-RDT 测试进行比较的标准方法。 co-RDT 和 us-RDT 的汇总敏感性分别为 42%（95%CI：25-62%）和 61%（95%CI：47-73%），co-RDT 的特异性为 99%（95%CI：98-100%），us-RDT 的特异性为 99%（95%CI：96-99%）。在无症状个体中，co-RDT 的汇总敏感性和特异性分别为 27%（95%CI：8-58%）和 100%（95%CI：97-100%），而 us-RDT 的敏感性为 50%（95%CI：33-68%），特异性为 98%（95%CI：94-100%）。在低传播环境中，co-RDT 的汇总敏感性为 36% (95%CI: 9·76%)，us RDT 的汇总敏感性为 62% (95%CI: 44·77%)，而在高传播区域，co-RDT 和 us RDT 的汇总敏感性分别为 62% (95%CI: 39·80%) 和 75% (95%CI: 57–87%)。 us-RDT测试表现出比co-RDT测试更好的性能，并且这一特征在无症状个体和低传播地区更为明显；尽管如此，还需要结合一系列气候、地理和人口统计数据进行更多研究，以可靠地了解 us-RDT 的潜力。
Successful malaria treatment, control and elimination programs require accurate, affordable, and field-deployable diagnostic tests. A number of studies have directly compared diagnostic performance between the new ultrasensitive rapid diagnostic test (us-RDT) and conventional rapid diagnostic test (co-RDT) for detecting malaria. Thus, we undertook this review to directly compare pooled diagnostic performance of us-RDT and co-RDT for detection of malaria. PubMed, Web of Science, Scopus, Embase, and ProQuest were searched from their inception until 31 January 2021 accompanied by forward and backward citations tracking. Two authors independently assessed the quality of included studies by RevMan5 software (using the QUADAS-2 checklist). Diagnostic accuracy estimates (sensitivity and specificity and others) were pooled using a random-effect model and 95% confidence interval (CI) in Stata 15 software. Fifteen studies with a total of 20,236 paired co-RDT and us-RDT tests were included in the meta-analysis. Molecular methods (15 studies) and immunoassay test (one study) were used as standard methods for comparison with co-RDT and us-RDT tests. The pooled sensitivity for co-RDT and us-RDT were 42% (95%CI: 25–62%) and 61% (95%CI: 47–73%), respectively, with specificity of 99% (95%CI: 98–100%) for co-RDT, and 99% (95%CI: 96–99%) for us-RDT. In asymptomatic individuals, the pooled sensitivity and specificity of co-RDT were 27% (95%CI: 8–58%) and 100% (95%CI: 97–100%), respectively, while us-RDT had a sensitivity of 50% (95%CI: 33–68%) and specificity of 98% (95%CI: 94–100%). In low transmission settings, pooled sensitivity for co-RDT was 36% (95%CI: 9 76%) and 62% (95%CI: 44 77%) for us RDT, while in high transmission areas, pooled sensitivity for co RDT and us RDT were 62% (95%CI: 39 80%) and 75% (95%CI: 57–87%), respectively. The us-RDT test showed better performance than co-RDT test, and this characteristic is more evident in asymptomatic individuals and low transmission areas; nonetheless, additional studies integrating a range of climate, geography, and demographics are needed to reliably understand the potential of the us-RDT.
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