Systematic Review and Meta-Analysis of Congenital Toxoplasmosis Diagnosis: Advances and Challenges

IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Tropical Medicine Pub Date : 2024-02-21 DOI:10.1155/2024/1514178
Priscila Silva Franco, Ana Carolina Morais Oliveira Scussel, Rafaela José Silva, Thadia Evelyn Araújo, Henrique Tomaz Gonzaga, Camila Ferreira Marcon, Joaquim Pedro Brito-de-Sousa, Angélica Lemos Debs Diniz, Marina Carvalho Paschoini, Bellisa Freitas Barbosa, Olindo Assis Martins-Filho, José Roberto Mineo, Eloisa Amália Vieira Ferro, Angelica Oliveira Gomes
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引用次数: 0

Abstract

Objective. To understand how congenital toxoplasmosis (CT) diagnosis has evolved over the years, we performed a systematic review and meta-analysis to summarize the kind of analysis that has been employed for CT diagnosis. Methods. PubMed and Lilacs databases were used in order to access the kind of analysis that has been employed for CT diagnosis in several samples. Our search combined the following combining terms: “congenital toxoplasmosis” or “gestational toxoplasmosis” and “diagnosis” and “blood,” “serum,” “amniotic fluid,” “placenta,” or “colostrum.” We extracted data on true positive, true negative, false positive, and false negative to generate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Random-effects models using MetaDTA were used for analysis. Results. Sixty-five articles were included in the study aiming for comparisons (75.4%), diagnosis performance (52.3%), diagnosis improvement (32.3%), or to distinguish acute/chronic infection phases (36.9%). Amniotic fluid (AF) and placenta were used in 36.9% and 10.8% of articles, respectively, targeting parasites and/or T. gondii DNA. Blood was used in 86% of articles for enzymatic assays. Colostrum was used in one article to search for antibodies. In meta-analysis, PCR in AF showed the best performance for CT diagnosis based on the highest summary sensitivity (85.1%) and specificity (99.7%) added to lower magnitude heterogeneity. Conclusion. Most of the assays being researched to diagnose CT are basically the same traditional approaches available for clinical purposes. The range in diagnostic performance and the challenges imposed by CT diagnosis indicate the need to better explore pregnancy samples in search of new possibilities for diagnostic tools. Exploring immunological markers and using bioinformatics tools and T. gondii recombinant antigens should address the research needed for a new generation of diagnostic tools to face these challenges.
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先天性弓形虫病诊断的系统回顾和元分析:进展与挑战
目的。为了解先天性弓形虫病(CT)诊断多年来的发展情况,我们进行了一项系统回顾和荟萃分析,总结了 CT 诊断所采用的分析方法。方法:PubMed 和 Lilacs我们使用了 PubMed 和 Lilacs 数据库,以获取多个样本中用于 CT 诊断的分析方法。我们的搜索结合了以下组合词:"先天性弓形虫病 "或 "妊娠弓形虫病"、"诊断"、"血液"、"血清"、"羊水"、"胎盘 "或 "初乳"。我们提取了真阳性、真阴性、假阳性和假阴性的数据,以生成集合灵敏度、特异性和诊断几率比(DOR)。使用 MetaDTA 随机效应模型进行分析。结果。研究共纳入 65 篇文章,目的是进行比较(75.4%)、诊断性能(52.3%)、诊断改进(32.3%)或区分急性/慢性感染阶段(36.9%)。分别有 36.9% 和 10.8% 的文章使用羊水和胎盘检测寄生虫和/或淋球菌 DNA。86%的文章使用血液进行酶测定。一篇文章使用牛初乳来寻找抗体。在荟萃分析中,AF 中的 PCR 在 CT 诊断中表现最佳,灵敏度(85.1%)和特异度(99.7%)均最高,异质性较低。结论目前研究的大多数 CT 诊断方法基本上都是用于临床的传统方法。CT 诊断所带来的诊断性能差异和挑战表明,有必要更好地探索妊娠样本,寻找新的诊断工具。探索免疫标记物、使用生物信息学工具和淋病双球菌重组抗原应能解决新一代诊断工具所需的研究,以应对这些挑战。
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来源期刊
Journal of Tropical Medicine
Journal of Tropical Medicine Immunology and Microbiology-Parasitology
CiteScore
3.90
自引率
4.50%
发文量
0
审稿时长
14 weeks
期刊介绍: Journal of Tropical Medicine is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies on all aspects of tropical diseases. Articles on the pathology, diagnosis, and treatment of tropical diseases, parasites and their hosts, epidemiology, and public health issues will be considered. Journal of Tropical Medicine aims to facilitate the communication of advances addressing global health and mortality relating to tropical diseases.
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