Diagnostic accuracy of polymerase chain reaction for detection of mpox in humans.

Objective: To evaluate diagnostic accuracy of polymerase chain reaction (PCR) in detecting mpox infection in humans by pooling the estimates of sensitivity and specificity across different study settings.

Methods: A systematic search was conducted in PubMed, Cochrane database, Scopus, and Google Scholar. Studies that evaluated the diagnostic accuracy of PCR test for the detection of monkeypox virus providing the sensitivity and specificity values and the total number of samples were included. The sensitivity and specificity values of PCR test were pooled for all the included studies. The meta-analysis was conducted in accordance with PRISMA guidelines using the metadta package in STATA software. A summary receiver operating characteristic (SROC) curve and forest plot were generated. The protocol was registered in PROSPERO (CRD-NIHR) database with Reference ID CRD42024590183.

Results: Twelve studies were included for meta-analysis. The pooled sensitivity and specificity estimate across all the studies using a random effects model was 0.99 (95% CI [0.95, 1.00]) and 1 (95% CI [0.96, 1.00]), respectively. The SROC curve confirmed high diagnostic accuracy of PCR. The quality assessment of diagnostic accuracy studies (QUADAS) tool depicted low risk of bias.

Conclusions: This systematic review and meta-analysis is the first study in the scientific literature to provide a pooling for diagnostic accuracy for PCR test for mpox and confirms it as an accurate tool in detecting the infection in humans.