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https://www.arca.fiocruz.br/handle/icict/56076
DIAGNOSIS OF VISCERAL AND CUTANEOUS LEISHMANIASIS USING LOOP-MEDIATED ISOTHERMAL AMPLIFICATION (LAMP) PROTOCOLS: A SYSTEMATIC REVIEW AND META-ANALYSIS
In vitro diagnostics
Leishmaniasis
Loop-mediated isothermal amplification
Meta-analysis
Neglected tropical disease
Visceral leishmaniasis
Author
Affilliation
Department of Epidemiology. Center for Public Health. Medical University of Vienna. Vienna, Austria / Nuffield Department of Medicine. Centre for Tropical Medicine and Global Health. University of Oxford. Oxford, OX3 7LG, UK.
Department of Applied Life Sciences. FH Campus Wien University of Applied Sciences. Vienna, Austria.
Fundação Oswaldo Cruz. Instituto René Rachou. Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias. Belo Horizonte, MG, Brazil.
Department of Applied Life Sciences. FH Campus Wien University of Applied Sciences. Vienna, Austria.
Fundação Oswaldo Cruz. Instituto René Rachou. Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias. Belo Horizonte, MG, Brazil.
Institute of Specific Prophylaxis and Tropical Medicine. Medical University of Vienna. Vienna, Austria.
Department of Applied Life Sciences. FH Campus Wien University of Applied Sciences. Vienna, Austria.
Fundação Oswaldo Cruz. Instituto René Rachou. Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias. Belo Horizonte, MG, Brazil.
Department of Applied Life Sciences. FH Campus Wien University of Applied Sciences. Vienna, Austria.
Fundação Oswaldo Cruz. Instituto René Rachou. Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias. Belo Horizonte, MG, Brazil.
Institute of Specific Prophylaxis and Tropical Medicine. Medical University of Vienna. Vienna, Austria.
Abstract
Sensitive, reliable and fast diagnostic tools that are applicable in low-resource settings, at the point of care (PoC), are seen as crucial in the fight against visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL). Addressing the need for a PoC test, several diagnostic tests, including serological and molecular methods, have been developed and evaluated in the past. One promising molecular method, already implemented for diagnosis of a range of diseases, is the loop-mediated isothermal amplification (LAMP) protocol. In this systematic review and meta-analysis, using a comprehensive search strategy, we focus on studies evaluating the performance of LAMP for the diagnosis of leishmaniasis in humans and other mammals such as dogs, compared with microscopy and/or any other molecular diagnostic method. A meta-analysis, pooling sensitivity and specificity rates and calculating areas under the curve (AUCs) in summary receiver operating characteristic (SROC) plots, was conducted on datasets extracted from studies, grouped by clinical condition and sample type. We found high sensitivity and specificity for LAMP when compared with microscopy and PCR using blood samples, with pooled estimate values of > 90% for all subgroups, corresponding to calculated AUC values > 0.96, except for LAMP compared to microscopy for diagnosis of CL. However, only a limited number of studies were truly comparable. Most of the observed heterogeneity is likely based on true differences between the studies rather than sampling error only. Due to simple readout methods and low laboratory equipment requirements for sample preparation compared to other molecular methods, LAMP is a promising candidate for a molecular (near-)PoC diagnostic method for VL and CL.
Keywords
Cutaneous leishmaniasisIn vitro diagnostics
Leishmaniasis
Loop-mediated isothermal amplification
Meta-analysis
Neglected tropical disease
Visceral leishmaniasis
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