Department of Pathology and Laboratory Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Trop Med Int Health. 2023 Feb;28(2):72-79. doi: 10.1111/tmi.13846. Epub 2023 Jan 6.
Rotavirus infection is the leading cause of acute gastroenteritis (AGE) in children. Children with rotavirus infection may have symptoms such as diarrhoea or vomiting. Diarrheal diseases caused by rotavirus and other enteric pathogens cannot be differentiated on the basis of clinical symptoms. Therefore, diagnostic testing is essential to confirm a diagnosis of rotavirus infection. The aim of the meta-analysis is to evaluate the diagnostic accuracy of immunochromatographic rotavirus antigen tests in children.
We searched the PubMed, Embase, Cochrane Library and Google Scholar databases for studies evaluating the diagnostic accuracy of antigen tests for rotavirus in children. We included studies that provided sufficient data to construct a 2 × 2 table on a per patient basis. The overall sensitivity and specificity of the antigen tests were determined using a bivariate random-effects model.
In total, 12 studies with 4407 participants were included in the study. The meta-analysis yielded a pooled sensitivity of 89.2% (95% confidence interval [CI]: 77.4%-95.3%) and pooled specificity of 93.2% (95% CI: 83.8%-97.3%). A subgroup analysis of such tests in children aged ≤5 years yielded a pooled sensitivity of 87.1% and pooled specificity of 91.8%. Another subgroup analysis of high-quality studies involving 820 participants yielded a pooled sensitivity of 92.3% and pooled specificity of 95.2%.
Rotavirus antigen tests have high sensitivity for the diagnosis of rotavirus infection in children with AGE. In addition, such tests may be effective for the identification and clinical management of rotavirus infection in children and the prevention of disease progression.
轮状病毒感染是导致儿童急性肠胃炎（AGE）的主要原因。感染轮状病毒的儿童可能出现腹泻或呕吐等症状。轮状病毒和其他肠道病原体引起的腹泻性疾病不能仅根据临床症状进行区分。因此，诊断性检测对于确诊轮状病毒感染至关重要。本荟萃分析旨在评估免疫层析法轮状病毒抗原检测在儿童中的诊断准确性。
我们检索了 PubMed、Embase、Cochrane 图书馆和 Google Scholar 数据库，以评估针对儿童轮状病毒抗原检测的诊断准确性的研究。我们纳入了提供了足够数据以按每位患者为基础构建 2×2 表格的研究。使用双变量随机效应模型确定抗原检测的总体敏感性和特异性。
共有 12 项研究，涉及 4407 名参与者，被纳入本研究。荟萃分析得出的抗原检测的合并敏感性为 89.2%（95%置信区间[CI]：77.4%-95.3%），合并特异性为 93.2%（95% CI：83.8%-97.3%）。对年龄≤5 岁的此类检测的亚组分析得出的合并敏感性为 87.1%，合并特异性为 91.8%。另一项涉及 820 名参与者的高质量研究的亚组分析得出的合并敏感性为 92.3%，合并特异性为 95.2%。
轮状病毒抗原检测对于诊断患有 AGE 的儿童的轮状病毒感染具有较高的敏感性。此外，此类检测可能有助于识别和临床管理儿童的轮状病毒感染，并预防疾病进展。
