Programa De Pós-Graduação Em Ciências Da Saúde, Universidade De Pernambuco (UPE), Recife, Brasil.
Departamento De Parasitologia, Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz (FIOCRUZ), Recife, Brasil.
Expert Rev Mol Diagn. 2021 May;21(5):493-504. doi: 10.1080/14737159.2021.1900736. Epub 2021 May 30.
Visceral leishmaniasis (VL) is a systemic and neglected parasitic disease. Its main symptoms are fever, splenomegaly with or without hepatomegaly, and anemia, however, most individuals remain asymptomatic. Due to the lack of a gold standard and the limitations of current diagnostic techniques, where parasitology is ethically unfeasible for individuals without symptoms and serological tests do not differentiate between past and present disease, molecular methodologies are the most suitable.
We performed a systematic review analyzing the molecular techniques based on PCR used, so far, to detect asymptomatic cases of VL in humans. Structured searches were carried out on PubMed, LILACS, Scopus, and Web of Science databases without time and language restrictions. Two reviewers evaluated the studies, performed data extraction, and quality assessment by assigning scores.
qPCR using RNA targets can be used in the diagnosis of asymptomatic cases of human VL, due to its characteristics. We recommend further studies to analyze the methodology, mainly observing the use of different rRNA targets. Therefore, we hope that this technique contributed to the construction of public policies that address the diagnosis and handling of asymptomatic patients.
内脏利什曼病(VL)是一种系统性的被忽视的寄生虫病。其主要症状为发热、脾肿大伴或不伴肝肿大以及贫血,但大多数患者无症状。由于缺乏金标准,且当前诊断技术存在局限性,对于无症状个体而言寄生虫学检查不切实际,而血清学检查无法区分既往和现患疾病,因此分子方法是最合适的。
我们进行了一项系统评价,分析了迄今为止用于检测人类无症状 VL 病例的基于 PCR 的分子技术。在没有时间和语言限制的情况下,在 PubMed、LILACS、Scopus 和 Web of Science 数据库中进行了结构化搜索。两名评审员评估了研究,并通过评分进行数据提取和质量评估。
使用 RNA 靶标的 qPCR 可用于诊断无症状的人类 VL 病例,这是由于其特性决定的。我们建议进一步研究该方法,主要观察不同 rRNA 靶标的使用。因此,我们希望该技术有助于制定公共政策,以解决无症状患者的诊断和处理问题。