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Published on: January 28, 2019
Diagnostic accuracy of rotavirus antigen tests in children: A systematic review and meta-analysis
Pei-Jung Hung1, Cheng-Chieh Chen1
1Department of Pathology and Laboratory Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Insights
Rotavirus antigen tests accurately diagnose rotavirus infection in children with acute gastroenteritis. These rapid diagnostic tests aid in early identification, management, and prevention of rotavirus disease progression.
Area of Science:
- Pediatric Infectious Diseases
- Diagnostic Accuracy Studies
- Gastroenterology
Background:
- Rotavirus is a primary cause of acute gastroenteritis (AGE) in children globally.
- Clinical symptoms of rotavirus gastroenteritis are indistinguishable from other enteric pathogens, necessitating reliable diagnostic methods.
- Accurate and timely diagnosis of rotavirus infection is crucial for effective patient management and public health interventions.
Approach:
- A systematic literature search was conducted across major databases (PubMed, Embase, Cochrane Library, Google Scholar) to identify relevant diagnostic accuracy studies.
- Studies were included if they provided sufficient data for constructing 2x2 tables on a per-patient basis.
- A bivariate random-effects model was employed to pool sensitivity and specificity estimates for rotavirus antigen tests.
Key Points:
- The meta-analysis included 12 studies encompassing 4407 participants.
- Pooled sensitivity for rotavirus antigen tests was 89.2% (95% CI: 77.4%-95.3%) and pooled specificity was 93.2% (95% CI: 83.8%-97.3%).
- Subgroup analyses demonstrated high accuracy in children aged ≤5 years (sensitivity 87.1%, specificity 91.8%) and in high-quality studies (sensitivity 92.3%, specificity 95.2%).
Conclusions:
- Rotavirus antigen tests exhibit high sensitivity and specificity for diagnosing rotavirus infection in pediatric AGE cases.
- These tests are valuable tools for the early identification and clinical management of rotavirus infections in children.
- Effective utilization of rotavirus antigen tests can contribute to preventing disease progression and controlling outbreaks.
Objectives:
Rotavirus infection is the leading cause of acute gastroenteritis (AGE) in children. Children with rotavirus infection may have symptoms such as diarrhoea or vomiting. Diarrheal diseases caused by rotavirus and other enteric pathogens cannot be differentiated on the basis of clinical symptoms. Therefore, diagnostic testing is essential to confirm a diagnosis of rotavirus infection. The aim of the meta-analysis is to evaluate the diagnostic accuracy of immunochromatographic rotavirus antigen tests in children.
Methods:
We searched the PubMed, Embase, Cochrane Library and Google Scholar databases for studies evaluating the diagnostic accuracy of antigen tests for rotavirus in children. We included studies that provided sufficient data to construct a 2 × 2 table on a per patient basis. The overall sensitivity and specificity of the antigen tests were determined using a bivariate random-effects model.
Results:
In total, 12 studies with 4407 participants were included in the study. The meta-analysis yielded a pooled sensitivity of 89.2% (95% confidence interval [CI]: 77.4%-95.3%) and pooled specificity of 93.2% (95% CI: 83.8%-97.3%). A subgroup analysis of such tests in children aged ≤5 years yielded a pooled sensitivity of 87.1% and pooled specificity of 91.8%. Another subgroup analysis of high-quality studies involving 820 participants yielded a pooled sensitivity of 92.3% and pooled specificity of 95.2%.
Conclusions:
Rotavirus antigen tests have high sensitivity for the diagnosis of rotavirus infection in children with AGE. In addition, such tests may be effective for the identification and clinical management of rotavirus infection in children and the prevention of disease progression.
