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Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever

机译:伤寒和副伤寒(肠)热的快速诊断检测

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摘要

Background\udDifferentiating both typhoid (Salmonella Typhi) and paratyphoid (Salmonella Paratyphi A) infection from other causes of fever in endemic areas is a diagnostic challenge. Although commercial point-of-care rapid diagnostic tests (RDTs) for enteric fever are available as alternatives to the current reference standard test of blood or bone marrow culture, or to the widely used Widal Test, their diagnostic accuracy is unclear. If accurate, they could potentially replace blood culture as the World Health Organization (WHO)-recommended main diagnostic test for enteric fever.\ud\ud\udObjectives\udTo assess the diagnostic accuracy of commercially available rapid diagnostic tests (RDTs) and prototypes for detecting Salmonella Typhi or Paratyphi A infection in symptomatic persons living in endemic areas.\ud\ud\udSearch methods\udWe searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, IndMED, African Index Medicus, LILACS, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to 4 March 2016. We manually searched WHO reports, and papers from international conferences on Salmonella infections. We also contacted test manufacturers to identify studies.\ud\ud\udSelection criteria\udWe included diagnostic accuracy studies of enteric fever RDTs in patients with fever or with symptoms suggestive of enteric fever living in endemic areas. We classified the reference standard used as either Grade 1 (result from a blood culture and a bone marrow culture) or Grade 2 (result from blood culture and blood polymerase chain reaction, or from blood culture alone).\ud\ud\udData collection and analysis\udTwo review authors independently extracted the test result data. We used a modified QUADAS-2 extraction form to assess methodological quality. We performed a meta-analysis when there were sufficient studies for the test and heterogeneity was reasonable.
机译:背景\ udd将伤寒(伤寒沙门氏菌)和副伤寒(沙门氏菌副伤寒A)感染与流行地区其他发烧原因区分开来是一项诊断挑战。尽管可以使用商业上的针对肠热的即时诊断快速诊断测试(RDT)作为当前血液或骨髓培养物参考标准测试或广泛使用的维达尔测试的替代方法,但其诊断准确性尚不清楚。如果准确的话,它们有可能替代血液培养,成为世界卫生组织(WHO)推荐的肠热主要诊断测试。\ ud \ ud \ ud目标\ ud评估商用快速诊断测试(RDT)和原型的诊断准确性在居住在流行地区的有症状患者中检测伤寒沙门氏菌或副伤寒A型感染。\ ud \ ud \ ud搜索方法\ ud我们搜索了Cochrane传染病组专门注册机构,MEDLINE,Embase,科学引文索引,IndMED,非洲索引Medicus,LILACS,ClinicalTrials .gov和世界卫生组织(WHO)国际临床试验注册平台(ICTRP)截止到2016年3月4日。我们手动搜索了WHO的报告以及国际沙门氏菌感染大会的论文。我们还与测试制造商联系,以确定研究。我们将参考标准分类为1级(来自血液培养和骨髓培养的结果)或2级(来自血液培养和血液聚合酶链反应的结果,或者仅来自血液培养的结果)。\ ud \ ud \ ud数据收集和分析\ ud两名评论作者独立提取了测试结果数据。我们使用了改良的QUADAS-2提取形式来评估方法学质量。当有足够的研究进行测试并且异质性合理时,我们进行了荟萃分析。

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