@article{10902/31061,
year = {2023},
url = {https://hdl.handle.net/10902/31061},
abstract = {Background The complexity of the Chagas disease and its phases is impossible to have a unique test for both phases
and a lot of diferent epidemiological scenarios. Currently, serology is the reference standard technique; occasion‑
ally, results are inconclusive, and a diferent diagnostic technique is needed. Some guidelines recommend molecular
testing. A systematic review and meta-analysis of available molecular tools/techniques for the diagnosis of Chagas
disease was performed to measure their heterogeneity and efcacy in detecting Trypanosoma cruzi infection in blood
samples.
Methods A systematic review was conducted up to July 27, 2022, including studies published in international
databases. Inclusion and exclusion criteria were defned to select eligible studies. Data were extracted and presented
according to PRISMA 2020 guidelines. Study quality was assessed using Quality Assessment of Diagnostic Accuracy
Studies-2 (QUADAS-2). A random-efects model was used to calculate pooled sensitivity, specifcity, and diagnostic
odds ratio (DOR). Forest plots and a summary of the receiving operating characteristics (SROC) curves displayed
the outcomes. Heterogeneity was determined by I2
 and Tau2
 statistics and P values. Funnel plots and Deek’s test were
used to assess publication bias. A quantitative meta-analysis of the diferent outcomes in the two diferent clinical
phases was performed.
Results We identifed 858 records and selected 32 papers. Studies pertained to endemic countries and nonendemic
areas with adult and paediatric populations. The sample sizes ranged from 17 to 708 patients. There were no concerns
regarding the risk of bias and applicability of all included studies. A positive and nonsignifcant correlation coefcient
(S=0.020; P=0.992) was obtained in the set of studies that evaluated diagnostic tests in the acute phase population
(ACD). A positive and signifcant correlation coefcient (S=0.597; P<0.000) was obtained in the case of studies per‑
formed in the chronic phase population (CCD). This resulted in high heterogeneity between studies, with the master
mix origin and guanidine addition representing signifcant sources.
Interpretation/Conclusions and relevance The results described in this meta-analysis (qualitative and quantita‑
tive analyses) do not allow the selection of the optimal protocol of molecular method for the study of Trypanosoma
cruzi infection in any of its phases, among other reasons due to the complexity of this infection. Continuous analysis
and optimization of the diferent molecular techniques is crucial to implement this eficient diagnosis in endemic
areas.},
organization = {Funding: This work was supported by the Institute of Health Carlos III, ISCIII, Spain (www.isciii.es) grant number PI22/01721 (P.F.-S.) and European Union cofnanc  ing by FEDER funds (Fondo Europeo de Desarrollo Regional “Una manera de hacer Europa”) and partially granted by Gerencia Regional de Salud de Castilla y Leon (Consejería de Sanidad, Junta de Castilla y Leon, Spain). Research Project GRS 2555/A/22.},
publisher = {Springer Nature},
publisher = {Infectious Diseases of Poverty, 2023, 12, 95},
title = {Molecular diagnosis of Chagas disease: a systematic review and meta-analysis},
author = {Pascual-Vázquez, Guillermo and Alonso-Sardón, Montserrat and Rodríguez-Alonso, Beatriz and Pardo Lledías, Javier and Romero Alegría, Ángela and Fernández-Soto, Pedro and Muñoz Bellido, Juan Luis and Muro, Antonio and Belhassen García, Moncef},
}