Evaluating Diagnostic Accuracy of Rapid Tests and PCR for Visceral LeishmaniasisComparing different testing methods for identifying visceral leishmaniasis in various patient groups

This meta-analysis evaluates the diagnostic accuracy of rapid diagnostic tests (RDTs), kDNA-PCR, and indirect immunofluorescence assays (IFA) compared to parasitological reference methods for visceral leishmaniasis. The study specifically examines performance in both immunocompetent individuals and patients with HIV infections.

In immunocompetent populations, RDTs and kDNA-PCR demonstrated high diagnostic accuracy compared to reference standards. RDTs showed a high diagnostic odds ratio, making them highly effective for initial screening in these patients. Similarly, kDNA-PCR provided robust results, supporting its use in clinical settings where rapid identification is necessary.

In contrast, serological tests like RDTs and IFA showed significantly reduced performance in patients with HIV. These results suggest that immune suppression may interfere with serological detection. Consequently, molecular methods like PCR performed significantly better than serological tests in the HIV-positive cohort.

Clinical implications suggest that while RDTs are supported as first-line diagnostic tools for immunocompetent patients, they may be insufficient for those with HIV. For patients with HIV, clinicians should prioritize molecular or parasitological methods to ensure accurate diagnosis and timely treatment of visceral leishmaniasis.