Pouryousef Ali, Fararouei Mohammad, Sarkari Bahador
Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
HIV/AIDS Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran J Parasitol. 2023 Apr-Jun;18(2):140-154. doi: 10.18502/ijpa.v18i2.13180.
We aimed to present a systematic review and meta-analysis of studies that used antigen-based assays for the diagnosis of human giardiasis.
All the related published literature cited within PubMed, ISI web of science, Google Scholar, Embase, and Scopus, were searched up to December 2021. The search terms, both as MeSH terms and text words, were "", "", "", "giardiasis", combined with "diagnosis", "antigen detection", serodiagnosis, or serological diagnosis. The required data was extracted from the papers. Pooled estimates of sensitivity and specificity were obtained and forest plots and summary receiver operating characteristics (SROC) plots were used to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
The search of databases found 1683 papers, of which 46 articles fulfilled our eligibility criteria. The sensitivity of antigen-based methods for the diagnosis of human giardiasis ranged from 45% (95% CI: 31-59%) to 100% (95% CI: 100-100%) and the pooled estimate of sensitivity was 92% (95% CI: 90-93%). The pooled estimated specificity was 97% (95% CI: 96-98%), ranged from 81% (95% CI: 68-89%) to 100% (95% CI: 98-100%). The summary estimate of PPV and NPV were 92 % (95% CI: 90-93%) and 97% (95% CI: 96-98%) respectively. Comparing the performance of the antigen detection assays by region revealed a significant difference in the assay's performances in different regions of the world.
The antigen-based detection methods have acceptable and satisfactory performance in the diagnosis of human giardiasis. The task ahead is to identify more specific target antigens and design simpler, cheaper, and more sensitive methods for the diagnosis of this common worldwide-distributed parasitic infection.
我们旨在对使用基于抗原的检测方法诊断人类贾第虫病的研究进行系统评价和荟萃分析。
检索截至2021年12月在PubMed、科学网（ISI）、谷歌学术、Embase和Scopus中引用的所有相关已发表文献。检索词包括医学主题词（MeSH）和文本词“”“”“”“贾第虫病”，并与“诊断”“抗原检测”“血清学诊断”或“血清诊断”相结合。所需数据从论文中提取。获得敏感性和特异性的合并估计值，并使用森林图和汇总接受者操作特征（SROC）图来计算敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
数据库检索发现1683篇论文，其中46篇符合我们的纳入标准。基于抗原的方法诊断人类贾第虫病的敏感性范围为45%（95%置信区间：31 - 59%）至100%（95%置信区间：100 - 100%），敏感性的合并估计值为92%（95%置信区间：90 - 93%）。合并估计的特异性为97%（95%置信区间：96 - 98%），范围为81%（95%置信区间：68 - 89%）至100%（95%置信区间：98 - 100%）。PPV和NPV的汇总估计值分别为92%（95%置信区间：90 - 93%）和97%（95%置信区间：96 - 98%）。按地区比较抗原检测试验的性能发现，该试验在世界不同地区的性能存在显著差异。
基于抗原的检测方法在诊断人类贾第虫病方面具有可接受且令人满意的性能。未来的任务是识别更具特异性的靶抗原，并设计更简单、更便宜且更敏感的方法来诊断这种在全球广泛分布的常见寄生虫感染。
