Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature

Autores
Signorini Porchietto, Marcelo Lisandro; Lottersberger, Javier; Tarabla, Hector Dante; Vanasco, Norma Bibiana
Año de publicación
2013
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
We report an evaluation of the accuracy of ELISA for the detection of Leptospira-specific antibodies in humans. Eighty-eight studies published in 35 articles met all inclusion criteria and were submitted to meta-analysis. Pooled sensitivity and specificity were 0·779 (95% CI 0·770-0·789) and 0·913 (95% CI 0·908-0·917), respectively, and the area under the curve was 0·964. Heterogeneity across studies was statistically significant, but none of the sources of heterogeneity (disease stage, antigen used, antibody detected) could fully explain this finding. Although the convalescent stage of disease was significantly associated with higher diagnostic accuracy, IgM ELISA was the best choice, regardless of the stage of disease. Negative ELISAs (IgG or IgM) applied in the acute phase do not rule out leptospirosis due to the possibility of false-negative results. In this case it is advisable to request a second blood sample or to apply a direct method for leptospiral DNA.
Fil: Signorini Porchietto, Marcelo Lisandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; Argentina
Fil: Lottersberger, Javier. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas; Argentina
Fil: Tarabla, Hector Dante. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; Argentina
Fil: Vanasco, Norma Bibiana. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorios e Instituto de Salud "Dr. C. G. Malbran". Instituto Nacional de Enfermedades Respiratorias; Argentina
Materia
Diagnostic Accuracy
Human Leptospirosis
Sensitivity
Specificity
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/18088
Acceder
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network_name_str CONICET Digital (CONICET)
spelling Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literatureSignorini Porchietto, Marcelo LisandroLottersberger, JavierTarabla, Hector DanteVanasco, Norma BibianaDiagnostic AccuracyHuman LeptospirosisSensitivitySpecificityhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3We report an evaluation of the accuracy of ELISA for the detection of Leptospira-specific antibodies in humans. Eighty-eight studies published in 35 articles met all inclusion criteria and were submitted to meta-analysis. Pooled sensitivity and specificity were 0·779 (95% CI 0·770-0·789) and 0·913 (95% CI 0·908-0·917), respectively, and the area under the curve was 0·964. Heterogeneity across studies was statistically significant, but none of the sources of heterogeneity (disease stage, antigen used, antibody detected) could fully explain this finding. Although the convalescent stage of disease was significantly associated with higher diagnostic accuracy, IgM ELISA was the best choice, regardless of the stage of disease. Negative ELISAs (IgG or IgM) applied in the acute phase do not rule out leptospirosis due to the possibility of false-negative results. In this case it is advisable to request a second blood sample or to apply a direct method for leptospiral DNA.Fil: Signorini Porchietto, Marcelo Lisandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; ArgentinaFil: Lottersberger, Javier. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas; ArgentinaFil: Tarabla, Hector Dante. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; ArgentinaFil: Vanasco, Norma Bibiana. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorios e Instituto de Salud "Dr. C. G. Malbran". Instituto Nacional de Enfermedades Respiratorias; ArgentinaCambridge University Press2013-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/18088Signorini Porchietto, Marcelo Lisandro; Lottersberger, Javier; Tarabla, Hector Dante; Vanasco, Norma Bibiana; Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature; Cambridge University Press; Epidemiology and Infection; 141; 1; 1-2013; 22-320950-2688enginfo:eu-repo/semantics/altIdentifier/url/http://dx.doi.org/10.1017/S0950268812001951info:eu-repo/semantics/altIdentifier/ark/https://www.cambridge.org/core/journals/epidemiology-and-infection/article/enzymelinked-immunosorbent-assay-to-diagnose-human-leptospirosis-a-metaanalysis-of-the-published-literature/DD18EBF9867DA17E7BEDBD6F7AE8FCE0info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:31:52Zoai:ri.conicet.gov.ar:11336/18088instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:31:52.824CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature
title Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature
spellingShingle Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature
Signorini Porchietto, Marcelo Lisandro
Diagnostic Accuracy
Human Leptospirosis
Sensitivity
Specificity
title_short Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature
title_full Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature
title_fullStr Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature
title_full_unstemmed Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature
title_sort Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature
dc.creator.none.fl_str_mv Signorini Porchietto, Marcelo Lisandro
Lottersberger, Javier
Tarabla, Hector Dante
Vanasco, Norma Bibiana
author Signorini Porchietto, Marcelo Lisandro
author_facet Signorini Porchietto, Marcelo Lisandro
Lottersberger, Javier
Tarabla, Hector Dante
Vanasco, Norma Bibiana
author_role author
author2 Lottersberger, Javier
Tarabla, Hector Dante
Vanasco, Norma Bibiana
author2_role author
author
author
dc.subject.none.fl_str_mv Diagnostic Accuracy
Human Leptospirosis
Sensitivity
Specificity
topic Diagnostic Accuracy
Human Leptospirosis
Sensitivity
Specificity
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv We report an evaluation of the accuracy of ELISA for the detection of Leptospira-specific antibodies in humans. Eighty-eight studies published in 35 articles met all inclusion criteria and were submitted to meta-analysis. Pooled sensitivity and specificity were 0·779 (95% CI 0·770-0·789) and 0·913 (95% CI 0·908-0·917), respectively, and the area under the curve was 0·964. Heterogeneity across studies was statistically significant, but none of the sources of heterogeneity (disease stage, antigen used, antibody detected) could fully explain this finding. Although the convalescent stage of disease was significantly associated with higher diagnostic accuracy, IgM ELISA was the best choice, regardless of the stage of disease. Negative ELISAs (IgG or IgM) applied in the acute phase do not rule out leptospirosis due to the possibility of false-negative results. In this case it is advisable to request a second blood sample or to apply a direct method for leptospiral DNA.
Fil: Signorini Porchietto, Marcelo Lisandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; Argentina
Fil: Lottersberger, Javier. Universidad Nacional del Litoral. Facultad de Bioquímica y Ciencias Biológicas; Argentina
Fil: Tarabla, Hector Dante. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Santa Fe. Estación Experimental Agropecuaria Rafaela; Argentina
Fil: Vanasco, Norma Bibiana. Dirección Nacional de Instituto de Investigación. Administración Nacional de Laboratorios e Instituto de Salud "Dr. C. G. Malbran". Instituto Nacional de Enfermedades Respiratorias; Argentina
description We report an evaluation of the accuracy of ELISA for the detection of Leptospira-specific antibodies in humans. Eighty-eight studies published in 35 articles met all inclusion criteria and were submitted to meta-analysis. Pooled sensitivity and specificity were 0·779 (95% CI 0·770-0·789) and 0·913 (95% CI 0·908-0·917), respectively, and the area under the curve was 0·964. Heterogeneity across studies was statistically significant, but none of the sources of heterogeneity (disease stage, antigen used, antibody detected) could fully explain this finding. Although the convalescent stage of disease was significantly associated with higher diagnostic accuracy, IgM ELISA was the best choice, regardless of the stage of disease. Negative ELISAs (IgG or IgM) applied in the acute phase do not rule out leptospirosis due to the possibility of false-negative results. In this case it is advisable to request a second blood sample or to apply a direct method for leptospiral DNA.
publishDate 2013
dc.date.none.fl_str_mv 2013-01
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/18088
Signorini Porchietto, Marcelo Lisandro; Lottersberger, Javier; Tarabla, Hector Dante; Vanasco, Norma Bibiana; Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature; Cambridge University Press; Epidemiology and Infection; 141; 1; 1-2013; 22-32
0950-2688
url http://hdl.handle.net/11336/18088
identifier_str_mv Signorini Porchietto, Marcelo Lisandro; Lottersberger, Javier; Tarabla, Hector Dante; Vanasco, Norma Bibiana; Enzyme-linked immunosorbent assay to diagnose human leptospirosis: a meta-analysis of the published literature; Cambridge University Press; Epidemiology and Infection; 141; 1; 1-2013; 22-32
0950-2688
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/http://dx.doi.org/10.1017/S0950268812001951
info:eu-repo/semantics/altIdentifier/ark/https://www.cambridge.org/core/journals/epidemiology-and-infection/article/enzymelinked-immunosorbent-assay-to-diagnose-human-leptospirosis-a-metaanalysis-of-the-published-literature/DD18EBF9867DA17E7BEDBD6F7AE8FCE0
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Cambridge University Press
publisher.none.fl_str_mv Cambridge University Press
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.070432

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