Back to search
Publication

Diagnostic accuracy of tests for leprosy: a systematic review and meta-analysis.

Abstract

BACKGROUND: Due to difficulties in the clinical diagnosis of leprosy, several complementary tests have been developed and used.

OBJECTIVES: To systematically summarize the accuracy of diagnostic tests for leprosy.

DATA SOURCES: We searched for relevant articles in Embase, Medline, and Global Health databases, until June 2017. Study eligibility criteria and participants: Studies evaluating the accuracy of any diagnostic techniques for differentiating between people with and without leprosy were included. Studies solely focusing on differentiating between the separate forms of leprosy were excluded.

METHODS: Our protocol was registered on PROSPERO (CRD42017071803). We assessed study quality using the QUADAS-2 checklist. A bivariate random effects regression model was used for the meta-analyses.

RESULTS: We included 78 studies, most of those evaluating the detection of IgM antibodies against phenolic glycolipid I using ELISA. Sensitivity of the 39 studies evaluating ELISA was 63.8% (95% CI 55.0 to 71.8); specificity 91.0% (95% CI 86.9 to 93.9). The lateral flow test (9 studies) and the agglutination test (5 studies) had a slightly higher sensitivity and a slightly lower specificity. Sensitivity of qPCR was (5 studies) 78.5% (95% CI 61.9 to 89.2) and specificity 89.3% (95% CI 61.4 to 97.8). Sensitivity of conventional PCR was (17 studies) 75.3% (95% CI 67.9 to 81.5) and specificity 94.5% (95% CI 91.4 to 96.5).

CONCLUSIONS: Although the test accuracy looks reasonable, the studies suffered from heterogeneity and low methodological quality.

More information

Type
Journal Article
Author
Gurung P
Gomes CM
Vernal S
Leeflang M