Muzembo Basilua Andre, Kitahara Kei, Ohno Ayumu, Debnath Anusuya, Okamoto Keinosuke, Miyoshi Shin-Ichi
Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan.
Collaborative Research Center, Okayama University for Infectious Diseases in India, Kolkata 700010, India.
Diagnostics (Basel). 2021 Nov 13;11(11):2095. doi: 10.3390/diagnostics11112095.
The rapid diagnosis of cholera contributes to adequate outbreak management. This meta-analysis assesses the diagnostic accuracy of cholera rapid tests (RDTs) to detect O1.
Systematic review and meta-analysis. We searched four databases (Medline, EMBASE, Google Scholar, and Web of Science up to 8 September 2021) for studies that evaluated cholera RDTs for the detection of O1 compared with either stool culture or polymerase chain reaction (PCR). We assessed the studies' quality using the QUADAS-2 criteria. In addition, in this update, GRADE approach was used to rate the overall certainty of the evidence. We performed a bivariate random-effects meta-analysis to calculate the pooled sensitivity and specificity of cholera RDTs.
Overall, 20 studies were included in this meta-analysis. Studies were from Africa ( = 11), Asia ( = 7), and America (Haiti; = 2). They evaluated eight RDTs (Crystal VC-O1, Crystal VC, Cholkit, Institut Pasteur cholera dipstick, SD Bioline, Artron, Cholera Smart O1, and Smart II Cholera O1). Using direct specimen testing, sensitivity and specificity of RDTs were 90% (95% CI, 86 to 93) and 86% (95% CI, 81 to 90), respectively. Cholera Sensitivity was higher in studies conducted in Africa [92% (95% CI, 89 to 94)] compared with Asia [82% (95% CI, 77 to 87)]. However, specificity [83% (95% CI, 71 to 91)] was lower in Africa compared with Asia [90% (95% CI, 84 to 94)]. GRADE quality of evidence was estimated as moderate.
Against culture or PCR, current cholera RDTs have moderate sensitivity and specificity for detecting O1.
霍乱的快速诊断有助于进行充分的疫情管理。本荟萃分析评估霍乱快速检测（RDT）对检测O1群霍乱弧菌的诊断准确性。
系统评价和荟萃分析。我们检索了四个数据库（截至2021年9月8日的Medline、EMBASE、谷歌学术和科学网），以查找评估霍乱RDT检测O1群霍乱弧菌并与粪便培养或聚合酶链反应（PCR）进行比较的研究。我们使用QUADAS - 2标准评估研究质量。此外，在本次更新中，采用GRADE方法对证据的总体确定性进行评级。我们进行了双变量随机效应荟萃分析，以计算霍乱RDT的合并敏感性和特异性。
总体而言，本荟萃分析纳入了20项研究。这些研究来自非洲（n = 11）、亚洲（n = 7）和美洲（海地；n = 2）。它们评估了8种RDT（Crystal VC - O1、Crystal VC、Cholkit、巴斯德研究所霍乱试纸、SD Bioline、Artron、Cholera Smart O1和Smart II Cholera O1）。采用直接样本检测时，RDT的敏感性和特异性分别为90%（95%CI，86至93）和86%（95%CI，81至90）。与亚洲[82%（95%CI，77至87）]相比，非洲开展的研究中霍乱的敏感性更高[92%（95%CI，89至94）]。然而，非洲的特异性[83%（95%CI，71至91）]低于亚洲[90%（95%CI，84至94）]。证据的GRADE质量估计为中等。
与培养或PCR相比，目前的霍乱RDT检测O1群霍乱弧菌具有中等的敏感性和特异性。
