牛布鲁氏菌病的直接诊断方法有一些局限性,因此,血清学检查是诊断该疾病的基础。然而,尚未对全球范围内牛布氏杆菌病控制计划中使用的主要检测方法进行评估诊断敏感性(DSe)和诊断特异性(DSp)的荟萃分析.这项系统评价和荟萃分析旨在估计DSe,DSp以及单独用于诊断牛布鲁氏菌病的血清学测试的准确性。CABI数据库,科克伦图书馆,PubMed/MEDLINE,SciELO,Scopus和WebofScience被用来选择文章。搜索产生了5308项研究,其中71项采用质量评估工具进行系统评价,65项研究纳入meta分析.对于荟萃分析,考虑了178个测定和11个不同的血清学测试。要估计测试的DSe和DSp,研究根据研究的动物选择进行划分:(1)进行随机或连续选择参与者的研究(非病例对照研究)和(2)所有研究,包括病例对照研究。仅考虑非病例对照研究来估计DSe,表现最佳和最差的测试是iELISA测试(间接酶免疫分析-细菌悬浮液作为抗原-BS)(96.5%,95%CI:94.1-97.9%)和2ME(2-巯基乙醇测试)(85.0%,95%CI:79.6-89.1%),分别;而对于DSp,FPA(荧光偏振测定)(99%,7%,95%CI:99.5-99.8%)和PCFIA测试(蛋白质浓度荧光免疫测定)(78.5%,95%CI:70.0-85.1%)表现出更好和更差的表现,分别。总的来说,我们的结果表明,当病例对照研究纳入荟萃分析时,评估的11项血清学检查中的DSe和DSp有高估,考虑到它对与疾病的人口诊断相关的时间和成本的影响,这是一个令人担忧的问题,因为这些测试中的一些常规用于全世界牛布鲁氏菌病的控制和根除计划。此外,表现出最佳DSe和DSp的测试,iELISA(BS)和FPA,分别,相对容易执行和解释,并且显示最佳总体准确性的测试是FPA。
The direct methods for diagnosis of
bovine brucellosis have several limitations, therefore serological tests are the basis for the diagnosis of the disease. However, a meta-analysis estimating the diagnostic sensitivity (DSe) and diagnostic specificity (DSp) on the main tests used in
bovine brucellosis control programs worldwide has not been performed. This systematic
review and meta-analysis aimed to estimate the DSe, DSp and thereby accuracy of serological tests individually used in the diagnosis of
bovine brucellosis. The databases CABI, Cochrane Library, PubMed/MEDLINE, SciELO, Scopus and Web of Science were used to select articles. The search resulted in 5308 studies, of which 71 were selected for systematic
review using quality assessment tools and 65 studies were included in the meta-analysis. For the meta-analysis, 178 assays and 11 different serological tests were considered. To estimate DSe and DSp of the tests, studies were divided according to animal selection for the studies: (1) studies that carried out a random or consecutive selection of participants (noncasecontrol studies) and (2) all studies, including casecontrol studies. Considering only the non-case-control studies to estimate the DSe, the tests that exhibited the best and worst performance were the iELISA test (indirect enzyme immunoassay - bacterial suspension as antigen - BS) (96.5%, 95% CI: 94.1-97.9%) and 2ME (2- mercaptoethanol test) (85.0%, 95% CI: 79.6-89.1%), respectively; while for DSp, the FPA (fluorescence polarization assay) (99, 7%, 95% CI: 99.5-99.8%) and PCFIA tests (protein concentration fluorescence immunoassay) (78.5%, 95% CI: 70.0-85.1%) showed better and worse performance, respectively. Overall, our results showed an overestimation in the DSe and DSp of the eleven serological tests assessed when casecontrol studies were included in the meta-analysis, which is a concern considering its impacts on the time and costs associated with populational diagnosis of the diseases, since several of these tests are routinely used in the control and eradication programs of bovine brucellosis worldwide. Furthermore, the tests that exhibited the best DSe and DSp, iELISA (BS) and FPA, respectively, are relatively easy to perform and interpret and the test which showed the best overall accuracy was FPA.