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上呼吸道样本的准确性来诊断Mycobacterium结核病:一个系统的审查和元分析
Helen R Savage1, Hannah M Rickman2, Rachael M Burke2
1Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
The Lancet. Microbe
|September 15, 2023
概括
在没有唾液的情况下诊断肺结核是具有挑战性的. 上呼吸道采样,就像鼻吸入剂一样,对准确的结核病诊断有希望,特别是在儿童和老年人中.
科学领域:
- 医学微生物学 医学微生物学
- 诊断的准确性 诊断的准确性
- 公共卫生 公共卫生
背景情况:
- 没有唾液样本,肺结核的诊断是困难的,特别是对于儿童和老年人等弱势群体.
- 替代诊断方法对于提高结核病检测率至关重要.
- 上呼吸道采样提供了一个潜在的解决方案,用于在唾液无法获得时获取诊断样本.
研究的目的:
- 系统地评估上呼吸道采样活动性肺结核的性能特征和诊断准确性.
- 将各种上呼吸道采样方法的有效性与既定参考标准进行比较.
- 为扩大结核病诊断的可访问性提供证据.
主要方法:
- 系统审查和对2022年12月之前发表的研究进行元分析.
- 搜索了多个数据库,包括MEDLINE,Cinahl,科学网,全球卫生.
- 包括评估喉拭子,鼻吸液,口腔拭子,唾液,口水,鼻,斑块样本和鼻拭子与唾液或胃吸液参考标准的研究.
主要成果:
- 分析了71项研究,其中有119项测试对比.
- 鼻吸附剂显示出高诊断准确性,综合灵敏度为65.2%,特异性为97.9%.
- 喉拭子和口腔拭子也显示出潜力,尽管灵敏度和特异性不同.
结论:
- 上呼吸道采样为改善结核病诊断的可访问性提供了一个有希望的途径.
- 需要进一步的研究和前性研究来优化这些方法用于临床实践.
- 将历史采样技术与现代诊断技术相结合,可以增强替代样本类型的选择.
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