Accuracy of mucocutaneous leishmaniasis diagnosis using polymerase chain reaction: systematic literature review and meta-analysis.

Autor:	Gomes CM; Programa de Pós-Graduação em Clínica Médica., Mazin SC; Departamento de Neurociências e Ciências do Comportamento., Santos ER; Serviço de Dermatologia., Cesetti MV; Serviço de Dermatologia., Bächtold GA; Departamento de Clínica Médica., Cordeiro JH; Departamento de Clínica Médica., Theodoro FC; Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil., Damasco Fdos S; Hospital Regional da Asa Norte, Brasília, DF, Brasil., Carranza SA; Programa de Pós-Graduação em Clínica Médica., Santos Ade O; Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil., Roselino AM; Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil., Sampaio RN; Departamento de Clínica Médica.
Jazyk:	angličtina
Zdroj:	Memorias do Instituto Oswaldo Cruz [Mem Inst Oswaldo Cruz] 2015 Apr; Vol. 110 (2), pp. 157-65. Date of Electronic Publication: 2015 Mar 31.
DOI:	10.1590/0074-02760140280
Abstrakt:	The diagnosis of mucocutaneous leishmaniasis (MCL) is hampered by the absence of a gold standard. An accurate diagnosis is essential because of the high toxicity of the medications for the disease. This study aimed to assess the ability of polymerase chain reaction (PCR) to identify MCL and to compare these results with clinical research recently published by the authors. A systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement was performed using comprehensive search criteria and communication with the authors. A meta-analysis considering the estimates of the univariate and bivariate models was performed. Specificity near 100% was common among the papers. The primary reason for accuracy differences was sensitivity. The meta-analysis, which was only possible for PCR samples of lesion fragments, revealed a sensitivity of 71% [95% confidence interval (CI) = 0.59; 0.81] and a specificity of 93% (95% CI = 0.83; 0.98) in the bivariate model. The search for measures that could increase the sensitivity of PCR should be encouraged. The quality of the collected material and the optimisation of the amplification of genetic material should be prioritised.
Databáze:	MEDLINE
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