Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-Analysis

Background: We aimed to present a systematic review and meta-analysis of studies that used antigen-based assays for the diagnosis of human giardiasis. Methods: All the related published literature cited within PubMed, ISI web of science, Google Scholar, Embase, and Scopus, were searched up to De...

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Main Authors: Ali Pouryousef, Mohammad Fararooei, Bahador Sarkari
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2023-06-01
Series:Iranian Journal of Parasitology
Subjects:
Online Access:https://ijpa.tums.ac.ir/index.php/ijpa/article/view/3639
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author Ali Pouryousef
Mohammad Fararooei
Bahador Sarkari
author_facet Ali Pouryousef
Mohammad Fararooei
Bahador Sarkari
author_sort Ali Pouryousef
collection DOAJ
description Background: We aimed to present a systematic review and meta-analysis of studies that used antigen-based assays for the diagnosis of human giardiasis. Methods: All the related published literature cited within PubMed, ISI web of science, Google Scholar, Embase, and Scopus, were searched up to December 2021. The search terms, both as MeSH terms and text words, were “Giardia”, “Giardia lamblia”, “Giardia intestinalis", "giardiasis", combined with "diagnosis", "antigen detection", serodiagnosis, or serological diagnosis.  The required data was extracted from the papers. Pooled estimates of sensitivity and specificity were obtained and forest plots and summary receiver operating characteristics (SROC) plots were used to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).  Results: The search of databases found 1683 papers, of which 46 articles fulfilled our eligibility criteria. The sensitivity of antigen-based methods for the diagnosis of human giardiasis ranged from 45% (95% CI: 31-59%) to 100% (95% CI: 100-100%) and the pooled estimate of sensitivity was 92% (95% CI: 90-93%). The pooled estimated specificity was 97% (95% CI: 96-98%), ranged from 81% (95% CI: 68-89%) to 100% (95% CI: 98-100%). The summary estimate of PPV and NPV were 92 % (95% CI: 90-93%) and 97% (95% CI: 96-98%) respectively. Comparing the performance of the antigen detection assays by region revealed a significant difference in the assay's performances in different regions of the world. Conclusion: The antigen-based detection methods have acceptable and satisfactory performance in the diagnosis of human giardiasis.  The task ahead is to identify more specific target antigens and design simpler, cheaper, and more sensitive methods for the diagnosis of this common worldwide-distributed parasitic infection.
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spelling doaj.art-f264bf185b6548a4ab1cd5b3ba95e2ba2023-08-16T06:06:36ZengTehran University of Medical SciencesIranian Journal of Parasitology1735-70202008-238X2023-06-0118210.18502/ijpa.v18i2.13180Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-AnalysisAli Pouryousef0Mohammad Fararooei1Bahador Sarkari2Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranHIV/AIDS Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran1. Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran 2. Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Background: We aimed to present a systematic review and meta-analysis of studies that used antigen-based assays for the diagnosis of human giardiasis. Methods: All the related published literature cited within PubMed, ISI web of science, Google Scholar, Embase, and Scopus, were searched up to December 2021. The search terms, both as MeSH terms and text words, were “Giardia”, “Giardia lamblia”, “Giardia intestinalis", "giardiasis", combined with "diagnosis", "antigen detection", serodiagnosis, or serological diagnosis.  The required data was extracted from the papers. Pooled estimates of sensitivity and specificity were obtained and forest plots and summary receiver operating characteristics (SROC) plots were used to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).  Results: The search of databases found 1683 papers, of which 46 articles fulfilled our eligibility criteria. The sensitivity of antigen-based methods for the diagnosis of human giardiasis ranged from 45% (95% CI: 31-59%) to 100% (95% CI: 100-100%) and the pooled estimate of sensitivity was 92% (95% CI: 90-93%). The pooled estimated specificity was 97% (95% CI: 96-98%), ranged from 81% (95% CI: 68-89%) to 100% (95% CI: 98-100%). The summary estimate of PPV and NPV were 92 % (95% CI: 90-93%) and 97% (95% CI: 96-98%) respectively. Comparing the performance of the antigen detection assays by region revealed a significant difference in the assay's performances in different regions of the world. Conclusion: The antigen-based detection methods have acceptable and satisfactory performance in the diagnosis of human giardiasis.  The task ahead is to identify more specific target antigens and design simpler, cheaper, and more sensitive methods for the diagnosis of this common worldwide-distributed parasitic infection. https://ijpa.tums.ac.ir/index.php/ijpa/article/view/3639GiardiasisDiagnosisAntigen-basedMeta-analysis
spellingShingle Ali Pouryousef
Mohammad Fararooei
Bahador Sarkari
Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-Analysis
Iranian Journal of Parasitology
Giardiasis
Diagnosis
Antigen-based
Meta-analysis
title Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-Analysis
title_full Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-Analysis
title_fullStr Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-Analysis
title_full_unstemmed Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-Analysis
title_short Antigen-Based Diagnosis of Human Giardiasis: A Systematic Review and Meta-Analysis
title_sort antigen based diagnosis of human giardiasis a systematic review and meta analysis
topic Giardiasis
Diagnosis
Antigen-based
Meta-analysis
url https://ijpa.tums.ac.ir/index.php/ijpa/article/view/3639
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AT mohammadfararooei antigenbaseddiagnosisofhumangiardiasisasystematicreviewandmetaanalysis
AT bahadorsarkari antigenbaseddiagnosisofhumangiardiasisasystematicreviewandmetaanalysis