Sensitivity of diagnostic tests for human soil-transmitted helminth infections: a meta-analysis in the absence of a true gold standard.
Sensitivity of diagnostic tests for human soil-transmitted helminth infections: a meta-analysis in the absence of a true gold standard.
复制标题
DOI：
10.1016/j.ijpara.2014.05.009
复制
发表时间：
2014-10-01
影响因子：
4
通讯作者：
Pullan, Rachel L.
中科院分区：
文献类型：
--
作者：
Nikolay, Birgit;Brooker, Simon J.;Pullan, Rachel L.
对土壤传播蠕虫的诊断试验进行贝叶斯潜类荟萃分析。评估的诊断试验的总体敏感性较低。感染强度对测试成绩有很大影响。在两个强度组中，FLOTAC方法的总体灵敏度最高。加藤-卡茨法在高强度环境下的表现是可以接受的。可靠、灵敏和实用的诊断测试是疾病控制规划中用于制图、影响评估和监测的重要工具。为了对检测土壤传播蠕虫的现有诊断工具的相对性能进行强有力的全球评估，我们进行了一项荟萃分析，比较了最常用的土壤传播蠕虫的共显微诊断方法（即Kato-Katz、直接显微镜、甲醛醚浓度、McMaster、FLOTAC和Mini-FLOTAC）的灵敏度和定量性能。在缺乏完善参考标准的情况下，我们采用贝叶斯潜类分析来估计对每一种土壤传播蠕虫种蚓蛔虫、毛线虫和钩虫的比较诊断测试的真实、未观察到的灵敏度。为了调查不同传播环境的影响，我们随后根据感染强度对分析进行了分层。总的来说，不同方法的灵敏度估计不同，从直接显微镜的42.8%到FLOTAC的92.7%不等。普遍采用的双玻片Kato-Katz法对3种土壤传播蠕虫在高感染强度下的敏感性为74 ~ 95%，在低感染强度下敏感性降至53 ~ 80%，其中对钩虫和蚓类最低。总的来说，在两个强度组中，FLOTAC方法的灵敏度最高，而Mini-FLOTAC方法的灵敏度与Kato-Katz方法相当。FLOTAC的平均卵数估计明显低于Kato-Katz，而比较麦克马斯特的卵数则有所不同。总之，我们证明了Kato-Katz和Mini-FLOTAC方法具有相当的灵敏度。我们进一步表明，加藤-卡茨方法的测试灵敏度降低在低传输设置。
A Bayesian latent class meta-analysis of diagnostic tests for soil-transmitted helminths was performed. Overall sensitivity of evaluated diagnostic tests was low. Test performance was strongly influenced by intensity of infection. FLOTAC method sensitivity was highest overall and in both intensity groups. The performance of the Kato-Katz method in high intensity settings was acceptable. Reliable, sensitive and practical diagnostic tests are an essential tool in disease control programmes for mapping, impact evaluation and surveillance. To provide a robust global assessment of the relative performance of available diagnostic tools for the detection of soil-transmitted helminths, we conducted a meta-analysis comparing the sensitivities and the quantitative performance of the most commonly used copro-microscopic diagnostic methods for soil-transmitted helminths, namely Kato-Katz, direct microscopy, formol-ether concentration, McMaster, FLOTAC and Mini-FLOTAC. In the absence of a perfect reference standard, we employed a Bayesian latent class analysis to estimate the true, unobserved sensitivity of compared diagnostic tests for each of the soil-transmitted helminth species Ascaris lumbricoides, Trichuris trichiura and the hookworms. To investigate the influence of varying transmission settings we subsequently stratified the analysis by intensity of infection. Overall, sensitivity estimates varied between the different methods, ranging from 42.8% for direct microscopy to 92.7% for FLOTAC. The widely used double slide Kato-Katz method had a sensitivity of 74–95% for the three soil-transmitted helminth species at high infection intensity, however sensitivity dropped to 53–80% in low intensity settings, being lowest for hookworm and A. lumbricoides. The highest sensitivity, overall and in both intensity groups, was observed for the FLOTAC method, whereas the sensitivity of the Mini-FLOTAC method was comparable with the Kato-Katz method. FLOTAC average egg count estimates were significantly lower compared with Kato-Katz, while the compared McMaster counts varied. In conclusion, we demonstrate that the Kato-Katz and Mini-FLOTAC methods had comparable sensitivities. We further show that test sensitivity of the Kato-Katz method is reduced in low transmission settings.
登录
查看更多内容
比较Kato-Katz，Koga琼脂板，以太浓度和FLOTAC的诊断精度，用于曼森和土壤传播的蠕虫。
影响因子：
3.8
作者：
Glinz, Dominik;Silue, Kigbafori D.;Knopp, Stefanie;Lohourignon, Laurent K.;Yao, Kouassi P.;Steinmann, Peter;Rinaldi, Laura;Cringoli, Giuseppe;N'Goran, Eliezer K.;Utzinger, Juerg
通讯作者：
Utzinger, Juerg
影响因子：
3.8
作者：
Assefa LM;Crellen T;Kepha S;Kihara JH;Njenga SM;Pullan RL;Brooker SJ
通讯作者：
Brooker SJ
影响因子：
1.9
作者：
Habtamu, Kassahun;Degarege, Abraham;Erko, Berhanu
通讯作者：
Erko, Berhanu
影响因子：
1.9
作者：
Dendukuri, N;Joseph, L
通讯作者：
Joseph, L
影响因子：
7.2
作者：
Ihorst, G.;Forster, J.;Schumacher, M.
通讯作者：
Schumacher, M.