-
Journal of Medical Virology May 2016In this meta-analysis, we evaluated the diagnostic role of Epstein-Barr virus deoxyribonucleic acid detection and quantitation in the serum of pediatric and young adult... (Meta-Analysis)
Meta-Analysis Review
In this meta-analysis, we evaluated the diagnostic role of Epstein-Barr virus deoxyribonucleic acid detection and quantitation in the serum of pediatric and young adult patients with infectious mononucleosis. The primary outcome of this meta-analysis was the sensitivity and specificity of Epstein-Barr virus (EBV) deoxyribonucleic acid (DNA) detection and quantitation using polymerase chain reaction (PCR). A systematic review and meta-analysis was performed by searching for articles that were published through September 24, 2014 in the following databases: Medline, Cochrane, EMBASE, and Google Scholar. The following keywords were used for the search: "Epstein-Barr virus," "infectious mononucleosis," "children/young adults/infant/pediatric," and "polymerase chain reaction or PCR." Three were included in this analysis. We found that for detection by PCR, the pooled sensitivity for detecting EBV DNA was 77% (95%CI, 66-86%) and the pooled specificity for was 98% (95%CI, 93-100%). Our findings indicate that this PCR-based assay has high specificity and good sensitivity for detecting of EBV DNA, indicating it may useful for identifying patients with infectious mononucleosis. This assay may also be helpful to identify young athletic patients or highly physically active pediatric patients who are at risk for a splenic rupture due to acute infectious mononucleosis.
Topics: Adolescent; Adult; Child; Child, Preschool; DNA, Viral; Female; Herpesvirus 4, Human; Humans; Infant; Infectious Mononucleosis; Male; Molecular Diagnostic Techniques; Real-Time Polymerase Chain Reaction; Sensitivity and Specificity; Viral Load; Young Adult
PubMed: 26455510
DOI: 10.1002/jmv.24402 -
International Journal of Public Health 2023We aimed to assess the association between rapid antigen detection tests and real-time reverse transcription-polymerase chain reaction assay for severe acute... (Meta-Analysis)
Meta-Analysis Review
Association Between Rapid Antigen Detection Tests and Real-Time Reverse Transcription-Polymerase Chain Reaction Assay for SARS-CoV-2: A Systematic Review and Meta-Analyses.
We aimed to assess the association between rapid antigen detection tests and real-time reverse transcription-polymerase chain reaction assay for severe acute respiratory syndrome coronavirus 2. We searched PubMed, Cochrane Library, EMBASE, and the Web of Science from their inception to 31 May 2023. A random-effects meta-analysis was used to estimate false positives in the RADTs group, relative to those in the RT-PCR group, and subgroup analyses were conducted based on the different Ct value cut-offs (<40 or ≥40). We performed this study in accordance with the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Fifty-one studies were included and considered to be of moderate quality. We found a satisfactory overall false positive rate (0.01, 95% CI: 0.00-0.01) for the RADTs compared to RT-PCR. In the stratified analysis, we also found that the false positive rates of the RADTs did not increase when Ct values of RT-PCR (Ct < 40, 0.01, 95% CI: 0.00-0.01; Ct ≥ 40, 0.01, 95% CI: 0.00-0.01). In conclusion, the best available evidence supports an association between RADTs and RT-PCR. When Ct-values were analyzed using cut-off <40 or ≥40, this resulted in an estimated false positive rate of only 1%.
Topics: Humans; Reverse Transcriptase Polymerase Chain Reaction; Reverse Transcription; SARS-CoV-2; COVID-19; COVID-19 Testing
PubMed: 37588042
DOI: 10.3389/ijph.2023.1605452 -
International Journal of Antimicrobial... Aug 2023There are currently some differences in the research results of molnupiravir. This study aimed to evaluate the efficacy and safety of molnupiravir in the treatment of... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
There are currently some differences in the research results of molnupiravir. This study aimed to evaluate the efficacy and safety of molnupiravir in the treatment of COVID-19.
METHODS
PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), ClinicalTrials.gov, ICTRP (International Clinical Trials Registry Platform) and medRxiv were searched to identify relevant randomised controlled trials (RCTs) from inception to 1 January 2023. The Cochrane risk of bias tool for randomised trials was used to assess the bias risk of the included studies. Revman 5.4 software was used for meta-analysis.
RESULTS
Nine RCTs were included, including 31 573 COVID-19 patients, of whom 15 846 received molnupiravir. The meta-analysis results showed that the molnupiravir group had a higher proportion in terms of clinical improvement (Day 5 RR 2.41, 95% CI 1.18-4.92; Day 10 RR 1.45, 95% CI 1.04-2.01) and real-time polymerase chain reaction negativity (Day 5 RR 2.78, 95% CI 1.38-5.62; Day 10 RR 1.18, 95% CI 1.07-1.31). However, no significant difference was observed between the two groups in terms of mortality, hospitalisation, adverse events and serious adverse events.
CONCLUSIONS
Molnupiravir can accelerate the rehabilitation of COVID-19 patients, but it does not significantly reduce mortality and hospitalisation.
Topics: Humans; COVID-19; Randomized Controlled Trials as Topic; Bias
PubMed: 37245600
DOI: 10.1016/j.ijantimicag.2023.106870 -
International Journal of Infectious... Oct 2022The aim of this study was to evaluate the time in days between symptom onset and first positive real-time reverse transcriptase polymerase chain reaction (RT-PCR) result... (Review)
Review
OBJECTIVES
The aim of this study was to evaluate the time in days between symptom onset and first positive real-time reverse transcriptase polymerase chain reaction (RT-PCR) result for COVID-19.
METHODS
This systematic review was conducted in the MEDLINE (PubMed), Embase, and Scopus databases using the following descriptors: "COVID-19", "SARS-CoV-2", "coronavirus", "RT-PCR", "real time PCR", and "diagnosis".
RESULTS
The included studies were conducted in 31 different countries and reported on a total of 6831 patients. The median age of the participants was 49.95 years. The three most common symptoms were fever, cough, and dyspnea, which affected 4012 (58.68%), 3192 (46.69%), and 2009 patients (29.38%), respectively. Among the 90 included studies, 13 were prospective cohorts, 15 were retrospective cohorts, 36 were case reports, 20 were case series, and six were cross-sectional studies. The overall mean time between symptom onset and positive test result was 6.72 days. Fourteen articles were analyzed separately for the temporal profile of RT-PCR test results; the best performance was on days 22-24, when 98% of test results were positive.
CONCLUSION
These findings corroborate the RT-PCR COVID-19 testing practices of some health units. In addition, the most frequently described symptoms of these patients can be considered the initial symptoms of infection and used in decision-making about RT-PCR testing.
Topics: COVID-19; COVID-19 Testing; Clinical Laboratory Techniques; Humans; Middle Aged; Prospective Studies; RNA-Directed DNA Polymerase; Real-Time Polymerase Chain Reaction; Retrospective Studies; Reverse Transcriptase Polymerase Chain Reaction
PubMed: 35760382
DOI: 10.1016/j.ijid.2022.06.037 -
Surgical Infections 2018We aim to update a meta-analysis to evaluate the efficiency of polymerase chain reaction (PCR) for diagnosis of periprosthetic joint infection (PJI) because different... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
We aim to update a meta-analysis to evaluate the efficiency of polymerase chain reaction (PCR) for diagnosis of periprosthetic joint infection (PJI) because different types of PCR assays have yielded variable diagnostic efficiency from 2013.
METHODS
We conducted our systematic review by searching for keywords in online databases from 2013 to May 2017. Studies were chosen based on inclusion and exclusion criteria and the quality of included studies was assessed. Pooled sensitivity and specificity were compared with other synovial fluid biomarkers. A total of 20 studies, comprising 2,526 participants were assessed.
RESULTS
The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were 0.76 (95% confidence interval [CI]: 0.65-0.85), 0.94 (95% CI: 0.92-0.95), and 0.94 (95% CI: 0.92-0.96), respectively. Meta-regression analysis indicated that use of specific genes, fresh samples, and more than one sample per patient may improve sensitivity.
CONCLUSIONS
Although novel PCR assays have been developed, the sensitivity of PCR for the diagnosis of PJI had decreased compared with the previous meta-analysis (0.86, 95% CI: 0.77-0.92), whereas the high specificity is reliable for excluding PJI. Novel synovial fluid biomarker such as α-defensin, which possesses pooled sensitivity between 0.96 and 1.00, might be more efficient than PCR in PJI diagnosis.
Topics: Biomarkers; Humans; Joint Prosthesis; Polymerase Chain Reaction; Prosthesis-Related Infections; Reproducibility of Results; Sensitivity and Specificity; Synovial Fluid
PubMed: 29920159
DOI: 10.1089/sur.2018.014 -
American Journal of Orthopedics (Belle... 2017Prosthetic joint infection (PJI) may be underreported because of difficulty in making a diagnosis, especially in infections with low-virulence organisms. Reports of PJI... (Review)
Review
Prosthetic joint infection (PJI) may be underreported because of difficulty in making a diagnosis, especially in infections with low-virulence organisms. Reports of PJI cases misdiagnosed as aseptic loosening suggest that current screening and diagnostic tools are not sensitive enough to detect all infections and that PJI likely is underdiagnosed. We reviewed the literature on recently developed novel synovial biomarkers and polymerase chain reaction (PCR) technologies, of which several have proved promising as highly sensitive and specific tools for detecting PJI. We followed the recommendations of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Of 90 papers screened by title or abstract and then by full text, 15 met our inclusion criteria. Sensitivities reported in the included studies ranged from 63% to 100% for α-defensin, from 46.8% to 90.9% for interleukin 6, from 28.6% to 100% for leukocyte esterase, and from 67.10% to 95.7% for PCR. Specificities ranged from 95% to 100% for α-defensin, from 85.7% to 97.6% for interleukin 6, from 63.6% to 96.5% for leukocyte esterase, and from 12.3% to 97.8% for PCR. α-Defensin is a highly sensitive and specific screening tool that may help improve the accuracy of PJI detection, particularly in low-grade infections.
Topics: Biomarkers; Humans; Joint Prosthesis; Polymerase Chain Reaction; Prosthesis-Related Infections; Synovial Fluid; alpha-Defensins
PubMed: 28856346
DOI: No ID Found -
Infectious Diseases of Poverty Oct 2023The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases and a lot of different epidemiological scenarios. Currently,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases and a lot of different epidemiological scenarios. Currently, serology is the reference standard technique; occasionally, results are inconclusive, and a different diagnostic technique is needed. Some guidelines recommend molecular testing. A systematic review and meta-analysis of available molecular tools/techniques for the diagnosis of Chagas disease was performed to measure their heterogeneity and efficacy in detecting Trypanosoma cruzi infection in blood samples.
METHODS
A systematic review was conducted up to July 27, 2022, including studies published in international databases. Inclusion and exclusion criteria were defined to select eligible studies. Data were extracted and presented according to PRISMA 2020 guidelines. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). A random-effects model was used to calculate pooled sensitivity, specificity, and diagnostic odds ratio (DOR). Forest plots and a summary of the receiving operating characteristics (SROC) curves displayed the outcomes. Heterogeneity was determined by I and Tau statistics and P values. Funnel plots and Deek's test were used to assess publication bias. A quantitative meta-analysis of the different outcomes in the two different clinical phases was performed.
RESULTS
We identified 858 records and selected 32 papers. Studies pertained to endemic countries and nonendemic areas with adult and paediatric populations. The sample sizes ranged from 17 to 708 patients. There were no concerns regarding the risk of bias and applicability of all included studies. A positive and nonsignificant correlation coefficient (S = 0.020; P = 0.992) was obtained in the set of studies that evaluated diagnostic tests in the acute phase population (ACD). A positive and significant correlation coefficient (S = 0.597; P < 0.000) was obtained in the case of studies performed in the chronic phase population (CCD). This resulted in high heterogeneity between studies, with the master mix origin and guanidine addition representing significant sources.
INTERPRETATION/CONCLUSIONS AND RELEVANCE
The results described in this meta-analysis (qualitative and quantitative analyses) do not allow the selection of the optimal protocol of molecular method for the study of Trypanosoma cruzi infection in any of its phases, among other reasons due to the complexity of this infection. Continuous analysis and optimization of the different molecular techniques is crucial to implement this efficient diagnosis in endemic areas.
Topics: Adult; Child; Humans; Sensitivity and Specificity; Chagas Disease
PubMed: 37845734
DOI: 10.1186/s40249-023-01143-7 -
Indian Journal of Otolaryngology and... Jun 2023Thyroid tuberculosis has non-specific clinical presentation, difficult diagnosis and specific medical management. The aim of this article is to present and share a...
OBJECTIVE
Thyroid tuberculosis has non-specific clinical presentation, difficult diagnosis and specific medical management. The aim of this article is to present and share a review of the English-language literature on thyroid tuberculosis in order to gain a better understanding of diagnostic methods and provide guidelines for its management and to present our experience of three cases.
METHODS
The systematic search of the literature was performed on Pubmed and Medline from 1950 to 2019 according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement.
RESULTS
We retrieved 13 manuscripts meeting our criteria from the search. There were 7 case series, and 6 manuscripts with review of the literature.
CONCLUSION
Direct histopathological demonstration is the best diagnostic modality. FNAC is the study of choice and PCR assay increases its sensitivity. The standard short course ATT for 6 months is recommended for isolated thyroid TB and for widespread disease, 12 months therapy is recommended. Surgery is reserved for failure of medical therapy and abscess formation.
PubMed: 37275094
DOI: 10.1007/s12070-022-03275-y -
Revista Brasileira de Enfermagem 2021Analyze available evidence related to SARS-CoV-2 infection and vertical transmission. (Review)
Review
OBJECTIVE
Analyze available evidence related to SARS-CoV-2 infection and vertical transmission.
METHODS
Scoping review, according to the Joanna Briggs Institute and PRISMA-ScR. Searches were conducted in five electronic databases to find publications about coronavirus infection and vertical transmission. Data were extracted, analyzed and synthesized by three independent researchers using a descriptive approach.
RESULTS
The search resulted in 76 publications. After selective steps, 15 articles - retrospective descriptive or case studies - were analyzed, all in English. In order to track the infection, specimens were collected from neonates through nasal swabs and C-reactive protein from breast milk, cord blood, amniotic fluid, placenta and vaginal secretion was analyzed. A small percentage of neonates tested positive for COVID-19, but these cases were not attributed to vertical transmission.
CONCLUSION
Vertical transmission could not be demonstrated. Research protocol registered with the Open Science Framework (https://osf.io/fawmv).
Topics: C-Reactive Protein; COVID-19; DNA, Viral; Female; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Pandemics; Pregnancy; Pregnancy Complications, Infectious; Real-Time Polymerase Chain Reaction; SARS-CoV-2
PubMed: 34037165
DOI: 10.1590/0034-7167-2020-0849 -
Travel Medicine and Infectious Disease 2023Southeast Asia is attractive for tourism. Unfortunately, travelers to this region are at risk of becoming infected with Shigella. We conducted a meta-analysis to provide... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Southeast Asia is attractive for tourism. Unfortunately, travelers to this region are at risk of becoming infected with Shigella. We conducted a meta-analysis to provide updates on Shigella prevalence in Southeast Asia, along with their serogroups and serotypes.
METHODS
We conducted a systematic search using PubMed, EMBASE, and Web of Science for peer-reviewed studies from 2000 to November 2022. We selected studies that detected Shigella in stools by culture or polymerase chain reaction (PCR). Two reviewers extracted the data using a standardized form and performed quality assessments using the Joanna Briggs Institute checklist. The random effects model was used to estimate the pooled prevalence of Shigella.
RESULTS
During our search, we identified 4376 studies. 29 studies (from six Southeast Asian countries) were included in the systematic review, 21 each in the meta-analysis of the prevalence of Shigella (Sample size: 109545) and the prevalence of Shigella serogroups. The pooled prevalence of Shigella was 4% (95% CI: 4-5%) among diarrhea cases. Shigella sonnei was the most abundant serogroup in Thailand (74%) and Vietnam (57%), whereas Shigella flexneri was dominant in Indonesia (72%) and Cambodia (71%). Shigella dysenteriae and Shigella boydii were uncommon (pooled prevalence of 1% each). The pooled prevalence of Shigella was 5% (95% CI: 4-6%) in children aged <5 years. The pooled prevalence showed a decreasing trend comparing data collected between 2000-2013 (5%; 95% CI: 4-6%) and between 2014-2022 (3%; 95% CI: 2-4%). Shigella prevalence was 6% in studies that included participants with mixed pathogens versus 3% in those without. Shigella flexneri serotype 2a was the most frequently isolated (33%), followed by 3a (21%), 1b (10%), 2b (3%), and 6 (3%).
CONCLUSIONS
This study provides compelling evidence for the development of effective Shigella vaccines for residents of endemic regions and travellers to these areas.
Topics: Child; Humans; Dysentery, Bacillary; Shigella; Shigella dysenteriae; Shigella flexneri; Indonesia
PubMed: 36792021
DOI: 10.1016/j.tmaid.2023.102554