| Title: |
Diagnosis of human leptospirosis: systematic review and meta-analysis of the diagnostic accuracy of the Leptospira microscopic agglutination test, PCR targeting Lfb1, and IgM ELISA to Leptospira fainei serovar Hurstbridge |
| Authors: |
Valente, Marta; Bramugy, Justina; Keddie, Suzanne, H; Hopkins, Heidi; Bassat, Quique; Baerenbold, Oliver; Bradley, John; Falconer, Jane; Keogh, Ruth, H; Newton, Paul, N; Picardeau, Mathieu; Crump, John, A |
| Contributors: |
Universitat de Barcelona (UB); Centro de Investigação em Saúde de Manhiça Maputo, Mozambique (CISM); London School of Hygiene and Tropical Medicine (LSHTM); Hospital Sant Joan de Déu Barcelona; Institució Catalana de Recerca i Estudis Avançats = Catalan Institution for Research and Advanced Studies (ICREA); Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública = Consortium for Biomedical Research of Epidemiology and Public Health (CIBERESP); Centre for Tropical Medicine and Global Health Oxford, UK; Nuffield Department of Medicine Oxford, UK (Big Data Institute); University of Oxford-University of Oxford; Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU); Mahidol University Bangkok -Mahosot Hospital; Biologie des Spirochètes / Biology of Spirochetes; Université Paris Cité (UPCité)-Microbiologie Intégrative et Moléculaire (UMR6047); Institut Pasteur Paris (IP)-Centre National de la Recherche Scientifique (CNRS)-Institut Pasteur Paris (IP)-Centre National de la Recherche Scientifique (CNRS); University of Otago Dunedin, Nouvelle-Zélande; This review was conducted as part of the FIEBRE study, which is funded by UK aid from the UK government; the views expressed, however, do not necessarily reflect the UK government’s official policies. MV is supported by Severo Ochoa Scholarship (Reference PRE2019-088336, Project CEX2018-000806-S-19-1). JB is supported by EDCTP fellowship grant (EDCTP2 programme Project Code TMA2019SFP2836TF). SK is supported by the Medical Research Council London Intercollegiate Doctoral Training Partnership Studentship (MR/N013638/1). JAC received support from US National Institutes of Health grants R01TW009237 and R01 AI121378.; We thank Prof David Mabey at LSHTM for general support to this review. MV, JB, HH and QB conceived the study. MV and JB assessed the eligibility of the studies, extracted the data, and assessed the methodological quality of the included studies. JF developed the search strategy and conducted the literature search. SK carried out the statistical analysis. JB, RK and OB advised on the statistical analysis. MV, JB and SK prepared the original draft of the manuscript, with considerable input from HH, QB, JAC, PN and MP. All authors contributed to the interpretations of results and all authors reviewed, edited and approved the final manuscript. |
| Source: |
ISSN: 1471-2334 ; BMC Infectious Diseases ; https://pasteur.hal.science/pasteur-05076896 ; BMC Infectious Diseases, 2024, 24 (1), pp.168. ⟨10.1186/s12879-023-08935-0⟩. |
| Publisher Information: |
CCSD; BioMed Central |
| Publication Year: |
2024 |
| Subject Terms: |
Leptospirosis; Meta-analysis; Agglutinations tests; Polymerase chain reaction; Enzyme-linked immunosorbent assay; Systematic review; Sensitivity and specificity; [SDV]Life Sciences [q-bio] |
| Description: |
International audience ; Background : Leptospirosis is an underdiagnosed infectious disease with non-specific clinical presentation that requires laboratory confirmation for diagnosis. The serologic reference standard remains the microscopic agglutination test (MAT) on paired serum samples. However, reported estimates of MAT's sensitivity vary. We evaluated the accuracy of four index tests, MAT on paired samples as well as alternative standards for leptospirosis diagnosis: MAT on single acute-phase samples, polymerase chain reaction (PCR) with the target gene Lfb1, and ELISA IgM with Leptospira fainei serovar Hurstbridge as an antigen.Methods : We performed a systematic review of studies reporting results of leptospirosis diagnostic tests. We searched eight electronic databases and selected studies that tested human blood samples and compared index tests with blood culture and/or PCR and/or MAT (comparator tests). For MAT selection criteria we defined a threshold for single acute-phase samples according to a national classification of leptospirosis endemicity. We used a Bayesian random-effect meta-analysis to estimate the sensitivity and specificity of MAT in single acute-phase and paired samples separately, and assessed risk of bias using the Quality Assessment of Studies of Diagnostic Accuracy Approach-2 (QUADAS-2) tool.Result : For the MAT accuracy evaluation, 15 studies were included, 11 with single acute-phase serum, and 12 with paired sera. Two included studies used PCR targeting the Lfb1 gene, and one included study used IgM ELISA with Leptospira fainei serovar Hurstbridge as antigen. For MAT in single acute-phase samples, the pooled sensitivity and specificity were 14% (95% credible interval [CrI] 3-38%) and 86% (95% CrI 59-96%), respectively, and the predicted sensitivity and specificity were 14% (95% CrI 0-90%) and 86% (95% CrI 9-100%). Among paired MAT samples, the pooled sensitivity and specificity were 68% (95% CrI 32–92%) and 75% (95% CrI 45–93%) respectively, and the pre-dicted sensitivity and ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/38326762; PUBMED: 38326762; PUBMEDCENTRAL: PMC10848445 |
| DOI: |
10.1186/s12879-023-08935-0 |
| Availability: |
https://pasteur.hal.science/pasteur-05076896; https://pasteur.hal.science/pasteur-05076896v1/document; https://pasteur.hal.science/pasteur-05076896v1/file/PMID%2038326762.pdf; https://doi.org/10.1186/s12879-023-08935-0 |
| Rights: |
http://creativecommons.org/licenses/by/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.DB11369E |
| Database: |
BASE |