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

• Autor(a) principal: Gomes,Ciro Martins
• Data de Publicação: 2015
• Outros Autores: Mazin,Suleimy Cristina, Santos,Elisa Raphael dos, Cesetti,Mariana Vicente, Bächtold,Guilherme Albergaria Brízida, Cordeiro,João Henrique de Freitas, Theodoro,Fabrício Claudino Estrela Terra, Damasco,Fabiana dos Santos, Carranza,Sebastián Andrés Vernal, Santos,Adriana de Oliveira, Roselino,Ana Maria, Sampaio,Raimunda Nonata Ribeiro
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Memórias do Instituto Oswaldo Cruz
• Texto Completo: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762015000200157
• topic: leishmaniasis, mucocutaneous; diagnosis; polymerase chain reaction

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.