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

Autor: Franco PS; Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil., Scussel ACMO; Universidade Federal do Triângulo Mineiro, Rua Frei Paulino, 30, Nossa Sra. da Abadia 38025-180, Uberaba, MG, Brazil., Silva RJ; Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil., Araújo TE; Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil.; Instituto René Rachou, Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Barro Preto 30190-002, Belo Horizonte, MG, Brazil., Gonzaga HT; Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil., Marcon CF; Universidade Federal do Triângulo Mineiro, Rua Frei Paulino, 30, Nossa Sra. da Abadia 38025-180, Uberaba, MG, Brazil., Brito-de-Sousa JP; Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil.; Instituto René Rachou, Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Barro Preto 30190-002, Belo Horizonte, MG, Brazil., Diniz ALD; Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil., Paschoini MC; Universidade Federal do Triângulo Mineiro, Rua Frei Paulino, 30, Nossa Sra. da Abadia 38025-180, Uberaba, MG, Brazil., Barbosa BF; Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil., Martins-Filho OA; Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil.; Instituto René Rachou, Fundação Oswaldo Cruz, Avenida Augusto de Lima, 1715, Barro Preto 30190-002, Belo Horizonte, MG, Brazil., Mineo JR; Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil., Ferro EAV; Universidade Federal de Uberlândia, Avenida João Naves de Ávila 2121, Uberlândia, Santa Mônica 38408-100, MG, Brazil., Gomes AO; Universidade Federal do Triângulo Mineiro, Rua Frei Paulino, 30, Nossa Sra. da Abadia 38025-180, Uberaba, MG, Brazil.
Jazyk: angličtina
Zdroj: Journal of tropical medicine [J Trop Med] 2024 Feb 21; Vol. 2024, pp. 1514178. Date of Electronic Publication: 2024 Feb 21 (Print Publication: 2024).
DOI: 10.1155/2024/1514178
Abstrakt: 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.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2024 Priscila Silva Franco et al.)
Databáze: MEDLINE
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