{"title":"先天性弓形虫病诊断的系统回顾和元分析:进展与挑战","authors":"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","doi":"10.1155/2024/1514178","DOIUrl":null,"url":null,"abstract":"<i>Objective</i>. 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. <i>Methods</i>. 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. <i>Results</i>. 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 <i>T. gondii</i> 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. <i>Conclusion</i>. 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 <i>T. gondii</i> recombinant antigens should address the research needed for a new generation of diagnostic tools to face these challenges.","PeriodicalId":17527,"journal":{"name":"Journal of Tropical Medicine","volume":"1 1","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Systematic Review and Meta-Analysis of Congenital Toxoplasmosis Diagnosis: Advances and Challenges\",\"authors\":\"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\",\"doi\":\"10.1155/2024/1514178\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<i>Objective</i>. 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. <i>Methods</i>. 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. <i>Results</i>. 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 <i>T. gondii</i> 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. <i>Conclusion</i>. 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 <i>T. gondii</i> recombinant antigens should address the research needed for a new generation of diagnostic tools to face these challenges.\",\"PeriodicalId\":17527,\"journal\":{\"name\":\"Journal of Tropical Medicine\",\"volume\":\"1 1\",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-02-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Tropical Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2024/1514178\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Tropical Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2024/1514178","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Systematic Review and Meta-Analysis of Congenital Toxoplasmosis Diagnosis: Advances and Challenges
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.
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.