Diagnostic Accuracy of Real Time Reverse Transcriptase Polymerase Chain Reaction for Chikungunya Virus Detection: A Systematic Review and Meta-Analysis.
Róger J Costa, Cleyde S C Marconi, Gleice K Jesus et al.
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In 30 seconds
This systematic review and meta-analysis assessed real-time reverse transcriptase polymerase chain reaction (RT-qPCR) protocols for detecting chikungunya virus during acute symptoms, comparing them with reference methods such as viral isolation or validated RT-qPCR assays. Twenty-eight protocols were reviewed, with 24 included in quantitative analysis. Pooled accuracy was 96% (95% CI: 94 to 99%), and summary sensitivity and specificity were each 99.7%. These estimates indicate high diagnostic performance, but should be interpreted in light of substantial heterogeneity and evidence of publication bias.
Key findings
- Across 24 protocols in the quantitative analysis, pooled RT-qPCR accuracy was 96% (95% CI: 94 to 99%).
- Summary sensitivity and specificity were each 99.7%.
- Heterogeneity was high (78.1%), and publication bias was detected (p = 0.002).
- All subgroup analyses showed high overall performance.
Why it matters
Accurate detection during the acute phase can support identification of chikungunya virus infection when symptoms are present. The pooled estimates suggest RT-qPCR performs well across the evaluated protocols, while the substantial heterogeneity and publication bias mean that performance may vary and the summary estimates warrant cautious interpretation.
What to keep in mind
The analysis showed high heterogeneity (78.1%) and publication bias (p = 0.002), which may limit how broadly the pooled accuracy estimates apply.