Commercial enzyme-linked immunosorbent assay versus polymerase chain reaction for the diagnosis of chronic Chagas disease: a systematic review and meta-analysis

被引:20
|
作者
Alvarenga Americano do Brasil, Pedro Emmanuel [1 ]
Castro, Rodolfo [2 ,3 ]
de Castro, Liane [4 ]
机构
[1] Fundacao Oswaldo Cruz, Inst Nacl Infectol Evandro Chagas, Lab Pesquisa Clin Doenca Chagas, Rio De Janeiro, RJ, Brazil
[2] Fundacao Oswaldo Cruz, Inst Nacl Infectol Evandro Chagas, Lab Pesquisa Clin DST & AIDS, Rio De Janeiro, RJ, Brazil
[3] Univ Fed Estado Rio de Janeiro, Inst Saude Colet, Rio De Janeiro, RJ, Brazil
[4] Fundacao Oswaldo Cruz, Inst Nacl Infectol Evandro Chagas, Lab Farmacogenet, Rio De Janeiro, RJ, Brazil
来源
MEMORIAS DO INSTITUTO OSWALDO CRUZ | 2016年 / 111卷 / 01期
关键词
Chagas disease; Trypanosoma cruzi; diagnosis; polymerase chain reaction; enzyme-linked immunosorbent assay; REAL-TIME PCR; TRYPANOSOMA-CRUZI INFECTION; SEROLOGICAL TESTS; BLOOD-SAMPLES; ANTIBODY-ASSAY; OLIGOC-TEST; DNA; CHEMILUMINESCENCE; SERODIAGNOSIS; AMPLIFICATION;
D O I
10.1590/0074-02760150296
中图分类号
R38 [医学寄生虫学]; Q [生物科学];
学科分类号
07 ; 0710 ; 09 ; 100103 ;
摘要
Chronic Chagas disease diagnosis relies on laboratory tests due to its clinical characteristics. The aim of this research was to review commercial enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) diagnostic test performance. Performance of commercial ELISA or PCR for the diagnosis of chronic Chagas disease were systematically searched in PubMed, Scopus, Embase, ISI Web, and LILACS through the bibliography from 1980-2014 and by contact with the manufacturers. The risk of bias was assessed with QUADAS-2. Heterogeneity was estimated with the I-2 statistic. Accuracies provided by the manufacturers usually overestimate the accuracy provided by academia. The risk of bias is high in most tests and in most QUADAS dimensions. Heterogeneity is high in either sensitivity, specificity, or both. The evidence regarding commercial ELISA and ELISA-rec sensitivity and specificity indicates that there is overestimation. The current recommendation to use two simultaneous serological tests can be supported by the risk of bias analysis and the amount of heterogeneity but not by the observed accuracies. The usefulness of PCR tests are debatable and health care providers should not order them on a routine basis. PCR may be used in selected cases due to its potential to detect seronegative subjects.
引用
收藏
页码:1 / +
页数:21
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