Candia-Puma Mayron Antonio, Machaca-Luque Laura Yesenia, Roque-Pumahuanca Brychs Milagros, Galdino Alexsandro Sobreira, Giunchetti Rodolfo Cordeiro, Coelho Eduardo Antonio Ferraz, Chávez-Fumagalli Miguel Angel
Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru.
Facultad de Ciencias Farmacéuticas, Bioquímicas y Biotecnológicas, Universidad Católica de Santa María, Arequipa 04000, Peru.
Diagnostics (Basel). 2022 Nov 10;12(11):2752. doi: 10.3390/diagnostics12112752.
The present systematic review and meta-analysis about the accuracy of diagnostic tests aim to describe the findings of literature over the last thirty years for the diagnosis of Chagas disease (CD). This work aimed to determine the accuracy of diagnostic techniques for CD in the disease's acute and chronic phases. The PubMed database was searched for studies published between 1990 and 2021 on CD diagnostics. Fifty-six published studies that met the criteria were analyzed and included in the meta-analysis, evaluating diagnostic accuracy through sensitivity and specificity. For Enzyme-Linked Immunosorbent Assay (ELISA), Fluorescent Antibody Technique (IFAT), Hemagglutination Test (HmT), Polymerase Chain Reaction (PCR), and Real-Time Polymerase Chain Reaction (qPCR) diagnosis methods, the sensitivity had a median of 99.0%, 78.0%, 75.0%, 76.0%, and 94.0%, respectively; while specificity presented a median of 99.0%, 99.0%, 99.0%, 98.0%, and 98.0%, respectively. This meta-analysis showed that ELISA and qPCR techniques had a higher performance compared to other methods of diagnosing CD in the chronic and acute phases, respectively. It was concluded utilizing the Area Under the Curve restricted to the false positive rates (AUC), that the ELISA diagnostic test presents the highest performance in diagnosing acute and chronic CD, compared to serological and molecular tests. Future studies focusing on new CD diagnostics approaches should be targeted.
本次关于诊断试验准确性的系统评价和荟萃分析旨在描述过去三十年中有关恰加斯病（CD）诊断的文献研究结果。这项工作旨在确定CD诊断技术在疾病急性期和慢性期的准确性。在PubMed数据库中检索了1990年至2021年间发表的关于CD诊断的研究。对56项符合标准的已发表研究进行了分析，并纳入荟萃分析，通过敏感性和特异性评估诊断准确性。对于酶联免疫吸附测定（ELISA）、荧光抗体技术（IFAT）、血凝试验（HmT）、聚合酶链反应（PCR）和实时聚合酶链反应（qPCR）诊断方法，敏感性中位数分别为99.0%、78.0%、75.0%、76.0%和94.0%；而特异性中位数分别为99.0%、99.0%、99.0%、98.0%和98.0%。该荟萃分析表明，ELISA和qPCR技术在慢性期和急性期诊断CD时分别比其他方法具有更高的性能。利用限于假阳性率的曲线下面积（AUC）得出结论，与血清学和分子检测相比，ELISA诊断试验在诊断急性和慢性CD方面表现出最高的性能。应针对聚焦于新的CD诊断方法的未来研究。
