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Diagnostic accuracy of molecular amplification tests for human African trypanosomiasis-systematic review

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dc.contributor.author Mugasa, C. M.
dc.contributor.author Adams, E. R.
dc.contributor.author Boer, K. R.
dc.contributor.author Dyserinck, H. C.
dc.contributor.author Büscher, P.
dc.contributor.author Schallig, H. D.
dc.contributor.author Leeflang, M. M.
dc.date.accessioned 2012-03-01T11:06:01Z
dc.date.available 2012-03-01T11:06:01Z
dc.date.issued 2012
dc.identifier.issn 1935-2727
dc.identifier.doi http://dx.doi.org/10.1371/journal.pntd.0001438
dc.identifier.other ITG-B5A
dc.identifier.other DBM
dc.identifier.other U-PARDIA
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other UPD43
dc.identifier.other FTA
dc.identifier.uri http://hdl.handle.net/10390/6853
dc.description.abstract BACKGROUND: A range of molecular amplification techniques have been developed for the diagnosis of Human African Trypanosomiasis (HAT); however, careful evaluation of these tests must precede implementation to ensure their high clinical accuracy. Here, we investigated the diagnostic accuracy of molecular amplification tests for HAT, the quality of articles and reasons for variation in accuracy. METHODOLOGY: Data from studies assessing diagnostic molecular amplification tests were extracted and pooled to calculate accuracy. Articles were included if they reported sensitivity and specificity or data whereby values could be calculated. Study quality was assessed using QUADAS and selected studies were analysed using the bivariate random effects model. RESULTS: 16 articles evaluating molecular amplification tests fulfilled the inclusion criteria: PCR (n = 12), NASBA (n = 2), LAMP (n = 1) and a study comparing PCR and NASBA (n = 1). Fourteen articles, including 19 different studies were included in the meta-analysis. Summary sensitivity for PCR on blood was 99.0% (95% CI 92.8 to 99.9) and the specificity was 97.7% (95% CI 93.0 to 99.3). Differences in study design and readout method did not significantly change estimates although use of satellite DNA as a target significantly lowers specificity. Sensitivity and specificity of PCR on CSF for staging varied from 87.6% to 100%, and 55.6% to 82.9% respectively. CONCLUSION: Here, PCR seems to have sufficient accuracy to replace microscopy where facilities allow, although this conclusion is based on multiple reference standards and a patient population that was not always representative. Future studies should, therefore, include patients for which PCR may become the test of choice and consider well designed diagnostic accuracy studies to provide extra evidence on the value of PCR in practice. Another use of PCR for control of disease could be to screen samples collected from rural areas and test in reference laboratories, to spot epidemics quickly and direct resources appropriately. en
dc.language English en
dc.subject Protozoal diseases en
dc.subject Trypanosomiasis, African en
dc.subject Sleeping sickness en
dc.subject Vectors en
dc.subject Glossina en
dc.subject Tsetse flies en
dc.subject Laboratory diagnosis en
dc.subject Molecular en
dc.subject Amplification en
dc.subject Polymerase chain reaction en
dc.subject PCR en
dc.subject Sensitivity en
dc.subject Specificity en
dc.subject Systematic review en
dc.subject Review of the literature en
dc.title Diagnostic accuracy of molecular amplification tests for human African trypanosomiasis-systematic review en
dc.type Article-E en
dc.citation.issue 1 en
dc.citation.jtitle PLoS Neglected Tropical Diseases en
dc.citation.volume 6 en
dc.citation.pages e1438 en
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/22253934
dc.citation.jabbreviation PLoS Negl Trop Dis en


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