Article type
Year
Abstract
Background: Leptospirosis is a neglected infectious disease caused by spirochetes from the genus Leptospira. It constitutes the most widespread zoonosis and is emerging as a major public health problem with outcomes ranging from subclinical infections to fatal pulmonary hemorrhage and Weil´s syndrome.
Objectives: A systematic review with meta-analysis was performed to estimate the accuracy of IgM ELISA for diagnosis of leptospirosis.
Methods: A search of MEDLINE, PubMed, LILACS, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and grey literature (Google Scholar and British Library) was conducted from January 1969 to July 2014. The medical subject headings (MeSHs) and the words 'leptospirosis', 'human leptospirosis' and 'IgM ELISA' were used. The methodological quality assessment for diagnostic accuracy was performed according to criteria from the Quality Assessment of Diagnostic Accuracy Studies (QUADAS 2). The statistical analysis was performed with the software Stata 11, Meta-DiSc (version 1.4) and Review Manager (RevMan) 5.2.
Results: Fifty-two studies were analyzed, which included 10,775 samples. The pooled sensitivity of all the studies was 86% (95% CI 85% to 87%) and specificity 90% (95% CI 89% to 91%; Figure 1). The diagnostic odds ratio (DOR) was 82, 06 (95% CI 89% to 91%; Figure 2). In studies the acute phase, the sensitivity and specificity was 84% (95% CI 82% to 85%) and 91% (95% CI 90% to 91%), respectively. The AUC was 0.957 in all studies and 0.953 in the acute phase (Figure 3).
Conclusions: We conclude that IgM ELISA is sufficiently sensitive for use as an initial screening test for leptospiral infections.
Objectives: A systematic review with meta-analysis was performed to estimate the accuracy of IgM ELISA for diagnosis of leptospirosis.
Methods: A search of MEDLINE, PubMed, LILACS, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and grey literature (Google Scholar and British Library) was conducted from January 1969 to July 2014. The medical subject headings (MeSHs) and the words 'leptospirosis', 'human leptospirosis' and 'IgM ELISA' were used. The methodological quality assessment for diagnostic accuracy was performed according to criteria from the Quality Assessment of Diagnostic Accuracy Studies (QUADAS 2). The statistical analysis was performed with the software Stata 11, Meta-DiSc (version 1.4) and Review Manager (RevMan) 5.2.
Results: Fifty-two studies were analyzed, which included 10,775 samples. The pooled sensitivity of all the studies was 86% (95% CI 85% to 87%) and specificity 90% (95% CI 89% to 91%; Figure 1). The diagnostic odds ratio (DOR) was 82, 06 (95% CI 89% to 91%; Figure 2). In studies the acute phase, the sensitivity and specificity was 84% (95% CI 82% to 85%) and 91% (95% CI 90% to 91%), respectively. The AUC was 0.957 in all studies and 0.953 in the acute phase (Figure 3).
Conclusions: We conclude that IgM ELISA is sufficiently sensitive for use as an initial screening test for leptospiral infections.