Evaluation of Diagnostic Tests for Visceral Leishmaniasis in Iran: A Meta-Analysis

Objective: There exist various diagnostic tests to detect visceral leishmaniasis, but the most efficient ones have not been demonstrated yet. Herein, we evaluated the accuracy of these diagnostic tests in Iran. Methodology: English and Persian database searching was done from 1993 to 2016. According to heterogeneity of the studies, estimations of the study were pooled by random-effects model. Totally, twenty investigations were eligible for current review with 2115 patients as pooled sample size. Results: The overall pooled estimate of sensitivity and specificity for all diagnostic tests were 0.92 ([95% CI = 0.90–0.95]) and 0.92 ([95% CI = 0.89–0.94]), respectively. Also, the separate sensitivity and specificity of each test were as follow: PCR: 1.00 ([95% CI = 0.99–1.01]) and 0.37 ([95% CI = 0.25–0.49]); DAT: 0.93 ([95% CI = 0.89–0.96]) and 0.92 ([95% CI = 0.89–0.94]); ELISA: 0.78 ([95% CI = 0.47–1.09]) and 1.00 ([95% CI = 0.99–1.01]) as well as IFA: 0.50 ([95% CI = 0.29–0.72]) and 0.96 ([95% CI = 0.95–0.97]). Conclusions: The specificity and sensitivity of PCR and DAT as molecular and serological tests, respectively, are remarkable to detect visceral leishmaniasis; hence, it is highly recommended to simultaneously employ these diagnostic tests for this widespread infection. J Microbiol Infect Dis 2019; 9(1): 16-22