Fararouei Mohammad, Sarkari Bahador, Abdolahi Khabisi Samaneh, Rezaei Zahra
Shiraz University of Medical Sciences, Shiraz, Iran.
Zahedan University of Medical Sciences, Zahedan, Iran.
J Infect Dev Ctries. 2018 Dec 31;12(12):1045-1051. doi: 10.3855/jidc.10185.
Latex agglutination test (KAtex) has been used in the last two decades for the diagnosis of visceral leishmaniasis (VL) in different VL-endemic areas. Here, we present a meta-analysis of studies which evaluated the KAtex for the diagnosis of VL to find out its overall diagnostic performance. A database search was performed on PubMed, Scopus, ISI Web of Science, Iranmedex and Google Scholar. The search of databases found 57 papers, of which 17 articles fulfilled our eligibility criteria. Meta-analysis of diagnostic accuracy (MADA) and Hierarchical Summary Receiver Operating Curve (HSROC) packages were used to do the meta-analysis and to obtain pooled estimates of sensitivity and specificity. Fixed effect bivariate analysis was conducted, using Mantel-Haenszel estimator, to measure the performance and diagnosis odds ratio (DOR) of the test. Heterogeneity of the test results was assessed by Chi-squared test. The sensitivity of individual studies ranged from 39.8 to 100%, and the specificity ranged from 64 to100%. The combined sensitivity and specificity estimates of KAtex were 77% (95% CI, 70-83%), and 97% (95% CI, 93-97%), respectively. Comparing the performance of the test by region suggests a significant difference where the lowest and highest sensitivities are reported from Nepal/Tunisia and Europe/Middle East respectively (p < 0.05). On the other hand, the lowest and highest rates of specificity were reported from Sudan and America/Middle East respectively. The overall specificity of KAtex is satisfactory. However, KAtex suffers from low sensitivity and this shortcoming should be improved. The test provides a rapid and simple diagnosis of VL and improvement of its sensitivity deserve further studies.
在过去二十年中，乳胶凝集试验（KAtex）已被用于不同内脏利什曼病（VL）流行地区的VL诊断。在此，我们对评估KAtex用于VL诊断的研究进行了荟萃分析，以了解其总体诊断性能。我们在PubMed、Scopus、ISI Web of Science、Iranmedex和谷歌学术上进行了数据库搜索。数据库搜索找到57篇论文，其中17篇文章符合我们的纳入标准。使用诊断准确性荟萃分析（MADA）和分层汇总接受者操作特征曲线（HSROC）软件包进行荟萃分析，并获得敏感性和特异性的合并估计值。使用Mantel-Haenszel估计量进行固定效应双变量分析，以测量该试验的性能和诊断比值比（DOR）。通过卡方检验评估试验结果的异质性。各研究的敏感性范围为39.8%至100%，特异性范围为64%至100%。KAtex的合并敏感性和特异性估计值分别为77%（95%CI，70-83%）和97%（95%CI，93-97%）。按地区比较该试验的性能表明存在显著差异，尼泊尔/突尼斯报告的敏感性最低，欧洲/中东报告的敏感性最高（p<0.05）。另一方面，苏丹和美洲/中东分别报告了最低和最高的特异性率。KAtex的总体特异性令人满意。然而，KAtex的敏感性较低，这一缺点应予以改进。该试验提供了一种快速简便的VL诊断方法，提高其敏感性值得进一步研究。
