A systematic review and meta-analysis of the performance of two point of care typhoid fever tests, Tubex TF and Typhidot, in endemic countries

Kamala Ley-Thriemer, Benedikt Ley, Joris Menten, Jan Jacobs, Jef Van Den Ende

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: In the absence of well-equipped laboratory infrastructure in many developing countries the accurate diagnosis of typhoid fever is challenging. Rapid diagnostic tests (RDT) with good performance indicators would be helpful to improve clinical management of suspected cases. We performed a systematic literature review and meta- analysis to determine the performance of TUBEX TF and Typhidot for the diagnosis of typhoid fever using PRISMA guidelines.

Methods: Titles and abstracts were reviewed for relevance. Articles were screened for language, reference method and completeness. Studies were categorized according to control groups used. Meta-analysis was performed only for categories where enough data was available to combine sensitivity and specificity estimates. Sub-analysis was performed for the Typhidot test to determine the influence of indeterminate results on test performance.

Results: A total of seven studies per test were included. The sensitivity of TUBEX TF ranged between 56% and 95%, Specificity between 72% and 95%. Meta-analysis showed an average sensitivity of 69% (95%CI: 45–85) and an average specificity of 88% (CI95%:83–91). A formal meta-analysis for Typhidot was not possible due to limited data available. Across the extracted studies, sensitivity and specificity estimates ranged from 56% to 84% and 31% to 97% respectively.

Conclusion: The observed performance does not support the use of either rapid diagnostic test exclusively as the basis for diagnosis and treatment. There is a need to develop an RDT for typhoid fever that has a performance level comparable to malaria RDTs.
Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalPLoS One
Volume8
Issue number12
DOIs
Publication statusPublished - 2013

Fingerprint

Point-of-Care Systems
typhoid fever
Typhoid Fever
systematic review
meta-analysis
Meta-Analysis
Routine Diagnostic Tests
diagnostic techniques
testing
Developing countries
Sensitivity and Specificity
Case Management
infrastructure
malaria
Developing Countries
Malaria
developing countries
Language
Guidelines
Control Groups

Cite this

@article{b25d3c0481f24a7091a3f253a3a9d305,
title = "A systematic review and meta-analysis of the performance of two point of care typhoid fever tests, Tubex TF and Typhidot, in endemic countries",
abstract = "Background: In the absence of well-equipped laboratory infrastructure in many developing countries the accurate diagnosis of typhoid fever is challenging. Rapid diagnostic tests (RDT) with good performance indicators would be helpful to improve clinical management of suspected cases. We performed a systematic literature review and meta- analysis to determine the performance of TUBEX TF and Typhidot for the diagnosis of typhoid fever using PRISMA guidelines.Methods: Titles and abstracts were reviewed for relevance. Articles were screened for language, reference method and completeness. Studies were categorized according to control groups used. Meta-analysis was performed only for categories where enough data was available to combine sensitivity and specificity estimates. Sub-analysis was performed for the Typhidot test to determine the influence of indeterminate results on test performance.Results: A total of seven studies per test were included. The sensitivity of TUBEX TF ranged between 56{\%} and 95{\%}, Specificity between 72{\%} and 95{\%}. Meta-analysis showed an average sensitivity of 69{\%} (95{\%}CI: 45–85) and an average specificity of 88{\%} (CI95{\%}:83–91). A formal meta-analysis for Typhidot was not possible due to limited data available. Across the extracted studies, sensitivity and specificity estimates ranged from 56{\%} to 84{\%} and 31{\%} to 97{\%} respectively.Conclusion: The observed performance does not support the use of either rapid diagnostic test exclusively as the basis for diagnosis and treatment. There is a need to develop an RDT for typhoid fever that has a performance level comparable to malaria RDTs.",
author = "Kamala Ley-Thriemer and Benedikt Ley and Joris Menten and Jan Jacobs and {Van Den Ende}, Jef",
year = "2013",
doi = "10.1371/journal.pone.0081263",
language = "English",
volume = "8",
pages = "1--9",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science (PLoS)",
number = "12",

}

A systematic review and meta-analysis of the performance of two point of care typhoid fever tests, Tubex TF and Typhidot, in endemic countries. / Ley-Thriemer, Kamala; Ley, Benedikt; Menten, Joris; Jacobs, Jan; Van Den Ende, Jef.

In: PLoS One, Vol. 8, No. 12, 2013, p. 1-9.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - A systematic review and meta-analysis of the performance of two point of care typhoid fever tests, Tubex TF and Typhidot, in endemic countries

AU - Ley-Thriemer, Kamala

AU - Ley, Benedikt

AU - Menten, Joris

AU - Jacobs, Jan

AU - Van Den Ende, Jef

PY - 2013

Y1 - 2013

N2 - Background: In the absence of well-equipped laboratory infrastructure in many developing countries the accurate diagnosis of typhoid fever is challenging. Rapid diagnostic tests (RDT) with good performance indicators would be helpful to improve clinical management of suspected cases. We performed a systematic literature review and meta- analysis to determine the performance of TUBEX TF and Typhidot for the diagnosis of typhoid fever using PRISMA guidelines.Methods: Titles and abstracts were reviewed for relevance. Articles were screened for language, reference method and completeness. Studies were categorized according to control groups used. Meta-analysis was performed only for categories where enough data was available to combine sensitivity and specificity estimates. Sub-analysis was performed for the Typhidot test to determine the influence of indeterminate results on test performance.Results: A total of seven studies per test were included. The sensitivity of TUBEX TF ranged between 56% and 95%, Specificity between 72% and 95%. Meta-analysis showed an average sensitivity of 69% (95%CI: 45–85) and an average specificity of 88% (CI95%:83–91). A formal meta-analysis for Typhidot was not possible due to limited data available. Across the extracted studies, sensitivity and specificity estimates ranged from 56% to 84% and 31% to 97% respectively.Conclusion: The observed performance does not support the use of either rapid diagnostic test exclusively as the basis for diagnosis and treatment. There is a need to develop an RDT for typhoid fever that has a performance level comparable to malaria RDTs.

AB - Background: In the absence of well-equipped laboratory infrastructure in many developing countries the accurate diagnosis of typhoid fever is challenging. Rapid diagnostic tests (RDT) with good performance indicators would be helpful to improve clinical management of suspected cases. We performed a systematic literature review and meta- analysis to determine the performance of TUBEX TF and Typhidot for the diagnosis of typhoid fever using PRISMA guidelines.Methods: Titles and abstracts were reviewed for relevance. Articles were screened for language, reference method and completeness. Studies were categorized according to control groups used. Meta-analysis was performed only for categories where enough data was available to combine sensitivity and specificity estimates. Sub-analysis was performed for the Typhidot test to determine the influence of indeterminate results on test performance.Results: A total of seven studies per test were included. The sensitivity of TUBEX TF ranged between 56% and 95%, Specificity between 72% and 95%. Meta-analysis showed an average sensitivity of 69% (95%CI: 45–85) and an average specificity of 88% (CI95%:83–91). A formal meta-analysis for Typhidot was not possible due to limited data available. Across the extracted studies, sensitivity and specificity estimates ranged from 56% to 84% and 31% to 97% respectively.Conclusion: The observed performance does not support the use of either rapid diagnostic test exclusively as the basis for diagnosis and treatment. There is a need to develop an RDT for typhoid fever that has a performance level comparable to malaria RDTs.

U2 - 10.1371/journal.pone.0081263

DO - 10.1371/journal.pone.0081263

M3 - Article

VL - 8

SP - 1

EP - 9

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 12

ER -