Tropical medicine & international health : TM & IH · 2026
Diagnostic Accuracy of Real Time Reverse Transcriptase Polymerase Chain Reaction for Chikungunya Virus Detection: A Systematic Review and Meta-Analysis.
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Costa Róger J, Marconi Cleyde S C, Jesus Gleice K, Franco Gabriel O, Silva Abevailton M, Arriaga Maria B, Soares Gúbio C, Sardi Silvia I, Netto Eduardo M
Аннотация
BACKGROUND: Chikungunya virus (CHIKV) is an arbovirus that causes an acute febrile illness with intense muscle and joint pain, with the possibility of progressing to a chronic or neurological stage. We conducted a systematic review and meta-analysis with the aim of evaluating the accuracy of real-time reverse transcriptase polymerase chain reaction (RT-qPCR) protocols for detecting CHIKV during the acute phase of symptoms.
METHODS: We searched the literature until December 5, 2024, including English, Portuguese, and Spanish, with no time restriction in PubMed, LILACS, and Web of Science. Studies that evaluated RT-qPCR protocols compared to reference techniques such as viral isolation or validated RT-qPCRs were included in the study. We collected data on sensitivity, specificity, accuracy, study design and methodological characteristics of RT-qPCR. Quadas-2 tool was used to assess the risk of bias and applicability. Subsequently, a meta-analysis and meta-regression were performed.
RESULTS: Twenty-eight protocols were included in this systematic review, 28 index tests were extracted and 24 were included in quantitative analysis. According to meta-analysis, RT-qPCR for CHIKV detection had a combined accuracy of 96% (95% CI: 94 to 99%) and a summary sensitivity and specificity of 99.7% and 99.7%, respectively; however, the results need to be interpreted considering the high heterogeneity (78.1%) and publication bias (p = 0.002).
CONCLUSION: RT-qPCR is a highly accurate technique for detecting the Chikungunya virus during the acute phase of symptoms. Despite the high heterogeneity observed, all subgroup analyses demonstrated high overall performance.
METHODS: We searched the literature until December 5, 2024, including English, Portuguese, and Spanish, with no time restriction in PubMed, LILACS, and Web of Science. Studies that evaluated RT-qPCR protocols compared to reference techniques such as viral isolation or validated RT-qPCRs were included in the study. We collected data on sensitivity, specificity, accuracy, study design and methodological characteristics of RT-qPCR. Quadas-2 tool was used to assess the risk of bias and applicability. Subsequently, a meta-analysis and meta-regression were performed.
RESULTS: Twenty-eight protocols were included in this systematic review, 28 index tests were extracted and 24 were included in quantitative analysis. According to meta-analysis, RT-qPCR for CHIKV detection had a combined accuracy of 96% (95% CI: 94 to 99%) and a summary sensitivity and specificity of 99.7% and 99.7%, respectively; however, the results need to be interpreted considering the high heterogeneity (78.1%) and publication bias (p = 0.002).
CONCLUSION: RT-qPCR is a highly accurate technique for detecting the Chikungunya virus during the acute phase of symptoms. Despite the high heterogeneity observed, all subgroup analyses demonstrated high overall performance.