Diagnostic accuracy of urinary latex agglutination test (KAtex) for the diagnosis of visceral leishmaniasis: A meta-analysis. 2018

Mohammad Fararouei, and Bahador Sarkari, and Samaneh Abdolahi Khabisi, and Zahra Rezaei
Shiraz University of Medical Sciences, Shiraz, Iran. fararooei@yahoo.com.

Latex agglutination test (KAtex) has been used in the last two decades for the diagnosis of visceral leishmaniasis (VL) in different VL-endemic areas. Here, we present a meta-analysis of studies which evaluated the KAtex for the diagnosis of VL to find out its overall diagnostic performance. A database search was performed on PubMed, Scopus, ISI Web of Science, Iranmedex and Google Scholar. The search of databases found 57 papers, of which 17 articles fulfilled our eligibility criteria. Meta-analysis of diagnostic accuracy (MADA) and Hierarchical Summary Receiver Operating Curve (HSROC) packages were used to do the meta-analysis and to obtain pooled estimates of sensitivity and specificity. Fixed effect bivariate analysis was conducted, using Mantel-Haenszel estimator, to measure the performance and diagnosis odds ratio (DOR) of the test. Heterogeneity of the test results was assessed by Chi-squared test. The sensitivity of individual studies ranged from 39.8 to 100%, and the specificity ranged from 64 to100%. The combined sensitivity and specificity estimates of KAtex were 77% (95% CI, 70-83%), and 97% (95% CI, 93-97%), respectively. Comparing the performance of the test by region suggests a significant difference where the lowest and highest sensitivities are reported from Nepal/Tunisia and Europe/Middle East respectively (p < 0.05). On the other hand, the lowest and highest rates of specificity were reported from Sudan and America/Middle East respectively. The overall specificity of KAtex is satisfactory. However, KAtex suffers from low sensitivity and this shortcoming should be improved. The test provides a rapid and simple diagnosis of VL and improvement of its sensitivity deserve further studies.

UI MeSH Term Description Entries
D007841 Latex Fixation Tests Passive agglutination tests in which antigen is adsorbed onto latex particles which then clump in the presence of antibody specific for the adsorbed antigen. (From Stedman, 26th ed) Latex Agglutination Tests,Agglutination Test, Latex,Agglutination Tests, Latex,Fixation Test, Latex,Fixation Tests, Latex,Latex Agglutination Test,Latex Fixation Test,Test, Latex Agglutination,Test, Latex Fixation,Tests, Latex Agglutination,Tests, Latex Fixation
D007898 Leishmaniasis, Visceral A chronic disease caused by LEISHMANIA DONOVANI and transmitted by the bite of several sandflies of the genera Phlebotomus and Lutzomyia. It is commonly characterized by fever, chills, vomiting, anemia, hepatosplenomegaly, leukopenia, hypergammaglobulinemia, emaciation, and an earth-gray color of the skin. The disease is classified into three main types according to geographic distribution: Indian, Mediterranean (or infantile), and African. Black Fever,Kala-Azar,Fever, Black,Kala Azar,Visceral Leishmaniasis
D008877 Middle East The region of southwest Asia and northeastern Africa usually considered as extending from Libya on the west to Afghanistan on the east. (From Webster's New Geographical Dictionary, 1988) Gaza Strip,Near East,West Bank,Gaza Strip (Palestine)
D009390 Nepal Country located in southern Asia, between China and India. The capital is Kathmandu. Federal Democratic Republic of Nepal
D005060 Europe The continent north of AFRICA, west of ASIA and east of the ATLANTIC OCEAN. Northern Europe,Southern Europe,Western Europe
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity
D013397 Sudan A country in northeastern Africa. The capital is Khartoum. Republic of the Sudan
D014416 Tunisia A country in northern Africa between ALGERIA and LIBYA. Its capital is Tunis.
D016017 Odds Ratio The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. Cross-Product Ratio,Risk Ratio,Relative Odds,Cross Product Ratio,Cross-Product Ratios,Odds Ratios,Odds, Relative,Ratio, Cross-Product,Ratio, Risk,Ratios, Cross-Product,Ratios, Risk,Risk Ratios

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