Accuracy of malaria diagnostic tests performed on non-invasively collected samples: a systematic review and meta-analysis
Background During the last decade, many studies have assessed the performance of malaria tests on non-invasively collected specimens, but no systematic review has hitherto estimated the overall performance of these tests. We report here the first meta-analysis estimating the diagnostic performance o...
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doaj-8d119e328ee648ce8c493a2a5aff67902021-08-01T09:30:07ZengBMJ Publishing GroupBMJ Global Health2059-79082021-06-016610.1136/bmjgh-2021-005634Accuracy of malaria diagnostic tests performed on non-invasively collected samples: a systematic review and meta-analysisJean Jacques Noubiap0Celestin Danwang1Jean Gaudart2Jean Cyr Yombi3Annie Robert4Jacob Souopgui5Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia's, AustraliaEpidemiology and Biostatistics Unit, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, BelgiumAix Marseille Univ, IRD, INSERM, SESSTIM, ISSPAM, Marseille, FranceDepartment of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Brussels, BelgiumEpidemiology and Biostatistics Unit, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, BelgiumDepartment of Molecular Biology, Universite Libre de Bruxelles, Gosselies, BelgiumBackground During the last decade, many studies have assessed the performance of malaria tests on non-invasively collected specimens, but no systematic review has hitherto estimated the overall performance of these tests. We report here the first meta-analysis estimating the diagnostic performance of malaria diagnostic tests performed on saliva, urine, faeces, skin odour (‘sniff and tell’) and hair, using either microscopy or PCR on blood sample as reference test.Methods We searched on PubMed, EMBASE, African Journals Online and Cochrane Infectious Diseases from inception until 19 January 2021 for relevant primary studies. A random effects model was used to estimate the overall performance of various diagnostic methods on different types of specimen.Results Eighteen studies providing 30 data sets were included in the meta-analysis. The overall sensitivity, specificity and diagnostic OR (DOR) of PCR were 84.5% (95% CI 79.3% to 88.6%), 97.3% (95% CI 95.3% to 98.5%) and 184.9 (95% CI 95.8 to 356.9) in saliva, respectively; 57.4% (95% CI 41.4% to 72.1%), 98.6% (95% CI 97.3% to 99.3%) and 47.2 (95% CI 22.1 to 101.1) in urine, respectively. The overall sensitivity, specificity and DOR of rapid diagnostic test for malaria in urine was 59.8% (95% CI 40.0% to 76.9%), 96.9% (95% CI 91.0% to 99.0%) and 30.8 (95% CI:23.5 to 40.4).Conclusion In settings where PCR is available, saliva and urine samples should be considered for PCR-based malaria diagnosis only if blood samples cannot be collected. The performance of rapid diagnostic testing in the urine is limited, especially its sensitivity. Malaria testing on non-invasively collected specimen still needs substantial improvement.https://gh.bmj.com/content/6/6/e005634.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jean Jacques Noubiap Celestin Danwang Jean Gaudart Jean Cyr Yombi Annie Robert Jacob Souopgui |
spellingShingle |
Jean Jacques Noubiap Celestin Danwang Jean Gaudart Jean Cyr Yombi Annie Robert Jacob Souopgui Accuracy of malaria diagnostic tests performed on non-invasively collected samples: a systematic review and meta-analysis BMJ Global Health |
author_facet |
Jean Jacques Noubiap Celestin Danwang Jean Gaudart Jean Cyr Yombi Annie Robert Jacob Souopgui |
author_sort |
Jean Jacques Noubiap |
title |
Accuracy of malaria diagnostic tests performed on non-invasively collected samples: a systematic review and meta-analysis |
title_short |
Accuracy of malaria diagnostic tests performed on non-invasively collected samples: a systematic review and meta-analysis |
title_full |
Accuracy of malaria diagnostic tests performed on non-invasively collected samples: a systematic review and meta-analysis |
title_fullStr |
Accuracy of malaria diagnostic tests performed on non-invasively collected samples: a systematic review and meta-analysis |
title_full_unstemmed |
Accuracy of malaria diagnostic tests performed on non-invasively collected samples: a systematic review and meta-analysis |
title_sort |
accuracy of malaria diagnostic tests performed on non-invasively collected samples: a systematic review and meta-analysis |
publisher |
BMJ Publishing Group |
series |
BMJ Global Health |
issn |
2059-7908 |
publishDate |
2021-06-01 |
description |
Background During the last decade, many studies have assessed the performance of malaria tests on non-invasively collected specimens, but no systematic review has hitherto estimated the overall performance of these tests. We report here the first meta-analysis estimating the diagnostic performance of malaria diagnostic tests performed on saliva, urine, faeces, skin odour (‘sniff and tell’) and hair, using either microscopy or PCR on blood sample as reference test.Methods We searched on PubMed, EMBASE, African Journals Online and Cochrane Infectious Diseases from inception until 19 January 2021 for relevant primary studies. A random effects model was used to estimate the overall performance of various diagnostic methods on different types of specimen.Results Eighteen studies providing 30 data sets were included in the meta-analysis. The overall sensitivity, specificity and diagnostic OR (DOR) of PCR were 84.5% (95% CI 79.3% to 88.6%), 97.3% (95% CI 95.3% to 98.5%) and 184.9 (95% CI 95.8 to 356.9) in saliva, respectively; 57.4% (95% CI 41.4% to 72.1%), 98.6% (95% CI 97.3% to 99.3%) and 47.2 (95% CI 22.1 to 101.1) in urine, respectively. The overall sensitivity, specificity and DOR of rapid diagnostic test for malaria in urine was 59.8% (95% CI 40.0% to 76.9%), 96.9% (95% CI 91.0% to 99.0%) and 30.8 (95% CI:23.5 to 40.4).Conclusion In settings where PCR is available, saliva and urine samples should be considered for PCR-based malaria diagnosis only if blood samples cannot be collected. The performance of rapid diagnostic testing in the urine is limited, especially its sensitivity. Malaria testing on non-invasively collected specimen still needs substantial improvement. |
url |
https://gh.bmj.com/content/6/6/e005634.full |
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