IgM ELISA for leptospirosis diagnosis: a systematic review and meta-analysis

Rosa, Maria Ines; Reis, Maria Fernandes dos; Simon, Carla; Dondossola, Eduardo; Alexandre, Maria Cecília; Colonetti, Tamy; Meller, Fernanda Oliveira

doi:10.1590/1413-812320172212.14112016

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Sumário

Review • Ciênc. saúde colet. 22 (12) • Dec 2017 • https://doi.org/10.1590/1413-812320172212.14112016 linkcopy

IgM ELISA for leptospirosis diagnosis: a systematic review and meta-analysis

ELISA IgM para diagnóstico de leptospirose: revisão sistemática e meta-análise

Authorship SCIMAGO INSTITUTIONS RANKINGS

A systematic review with meta-analysis was performed to estimate the accuracy of IgM ELISA for Leptospirosis diagnosis. A search of Medline, Lilacs, Embase, Cochrane Central Register of Controlled Trials and Grey literature (Google Scholar and British Library) was conducted. The medical subject headings (MeSHs) and the words “leptospirosis”, “human leptospirosis” and “IgM ELISA” were used. Fifty-two studies were analyzed, which included 10,775 samples. The pooled sensitivity of all the studies was 86% (CI 95%, 85%-87%) and specificity was 90% (CI 95%, 89%-91%). In studies of the acute phase, the sensitivity and specificity were 84% (CI 95%, 82%-85%) and 91% (CI 95%, 90%-91%), respectively. In conclusion, IgM ELISA is sensitive for use as an initial screen for leptospiral infections.

Key words
Human leptospirosis; IgM ELISA; Leptospirosis diagnosis; Meta-analysis

Author/year	Country	N (samples)	Mean Age	Cut-of	Stage	TP	FP	FN	TN
Aviat et al. 2009	France	48	NR	0.5	Acute	12	3	26	7
Bajani et al. 2003	EUA	775	NR	NR	Unspecific	115	38	18	604
Bharadwaj et al. 2002	India	169	NR	NR	Acute	67	11	7	84
Blacksell et al. 2006	Laos	70	NR	NR	Acute	7	18	3	42
Blanco et al. 2008	Brazil	138	NR	NR	Acute	27	0.5	3	108
Bourhy et al. 2013	France	197	45,05	0,4	Unspecific	141	0.5	8	48
Brandão et al. 1998	Brazil	353	32(6-67)	NR	Acute	107	1	1	244
Céspedes et al. 2002	Perú	120	NR	0.6	Acute	39	1	1	79
Cinco et al. 1992	Italy	260	NR	0.245	Acute	110	08	25	117
Cumberland et al. 1999	United Kingdon	638	45.9(14-85)	NR	Acute	167	19	154	298
Da Silva et al. 1988	Brazil	142	NR	0.589	Acute	41	21	9	71
Da Silva et al. 1990	Brazil	71	NR	0.382	Acute	21	0.5	9	41
Da Silva et al. 1992	Brazil	57	30.9	0.630	Acute	26	0.5	0.5	31
Da Silva et al. 1997	Brazil	114	30.5(12-52)	NR	Acute	65	0.5	1	48
Desakorn et al. 2012	Thailand	214	NR	NR	Acute	56	36	51	71
Dey et al. 2008	India	136	NR	0.8	Unspecific	77	0.5	3	51
Effler et al. 2002	Hawaii	217	NR	NR	Acute	16	18	17	166
Fonseca et al. 2006	Brazil	124	34.4	NR	Acute	47	07	13	57
Honarmand et al. 2008	Iran	152	NR	NR	Unspecific	88	1	10	53
Kucerova et al. 2011	Czech Republic	45	44.24(19-82		Acute	10	4	0.5	31
Kumar et al. 2012	India	319	NR	NR	Acute	130	2	2	185
Levett et al. 2002	Barbados	48	NR	NR	Unspecific	24	9	4	11
Levett et al. 2001	Barbados	51	NR	NR	Acute	25	9	3	14
Mc Bride et al. 2007	Brazil	204	NR	NR	Acute	41	36	0.5	127
Mc Bride et al. 2007b	Brazil	72	NR	NR	Acute	25	0.5	4	38
Nakarin et al. 2004	Thailand	282	NR	0.9	Acute	79	0.5	6	197
Obregón et al. 2004	Cuba	71	NR	NR	Unspecific	37	2	1	31
Ooteman et al. 2006	Brazil	158	NR	NR	Unspecific	44	12	3	99
Pappas et al. 1985	EUA	172	NR	NR	Unspecific	93	14	4	61
Pol and Bharadwaj 2009	India	50	NR	0.41	Unspecific	17	2	3	28
Polanco et al. 1997	Venezuela	181	NR	NR	Unspecific	44	63	5	69
PremLtha et al. 2013	India	328	(3-75)	NR	Unspecific	32	50	31	215
Ribeiro et al. 1995	Brazil	89	NR	NR	Acute	23	24	3	39
Ribeiro et al. 1996	Brazil	89	NR	NR	Unspecific	23	28	1	37
Sehgal et al. 2003	India	117	NR	NR	Acute	35	10	35	37
Sekhar et al. 2000	Malaysia	70	NR	0.5	Acute	26	01	12	31
Shekathar et al. 2010a	India	110	NR	0.5	Acute	15	26	25	44
Shekatkar et al. 2010b	India	150	40.5(15-84)	NR	Acute	29	0.9	9	103
Silpasakorn et al. 2011	Thailand	161	NR	NR	Acute	54	0.5	35	72
Smits et al. 2000	Hawaii	686	NR	0.4	Acute	286	7	48	345
Smits et al. 2001	Hawaii	420	NR	0.1	Acute	120	17	15	268
Srimanote et al. 2007	Thailand	75	NR	0,75	Acute	32	04	14	25
Tanganuchitcharnchai et al. 2012	Laos	70	30(12-50)	NR	Acute	09	17	01	43
Tansuphasiri et al. 2005	Thailand	343	NR	NR	Acute	95	15	01	232
Terpstra et al. 1980	The Netherlands	313	NR	0,45	Unspecific	91	01	05	216
Trombert-Paolantoni et al. 2010	France	79	NR	NR	Acute	27	09	03	40
Vedhagiri et al. 2013	India	1289	NR	NR	Acute	1137	10	43	99
Velineni et al. 2006	India	32	NR	0,45	Unspecific	26	04	02	0,5
Vitale et al. 2003	Italy	71	NR	0,45	Acute	19	02	0,5	50
Winslow et al. 1997	Australia	274	NR	NR	Acute	41	16	0,5	217
Yersin et al. 1999	The Netherlands	161	NR	NR	Acute	36	03	01	121
Zochowski et al. 2001	UK	200	NR	0,40	Unspecific	96	07	04	93
TOTAL		10775				4050	605	682	5438

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[TFN1] NR, not reported; TP, true-positive; FP, false-positive, FN, false-negative, TN, true-negative.