SynthesisBMJ global health2021
Accuracy of malaria diagnostic tests performed on non-invasively collected samples: a systematic review and meta-analysis.
Synthesis in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 15 citations in OpenAlex.
- Diagnostic methods for protozoan diseases: a review focused on leishmaniasis, Chagas disease and malaria.Frontiers in microbiology · 2026Review
- Voices from the Amazon: exploring implementor and user perceptions of non-invasive malaria diagnostics in Peru.Malaria journal · 2025Article
- Limited Reliability of the Molecular Detection ofMicroorganisms · 2022Article
- Acceptance and perceived value of non-invasive malaria diagnostic tests in malaria-endemic countries.Malaria journal · 2021Article
- Comparative Performance of Blood and Urine Malaria Rapid Diagnostic Tests in Detecting Malaria in Febrile Children: A Cross-Sectional Analysis.Sage open pediatricsArticle
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Authors and funding
6 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDuring the last decade, many studies have assessed the performance of malaria tests on non-invasively collected specimens, but no systematic review has hitherto estimated the overall performance of these tests. We report here the first meta-analysis estimating the diagnostic performance of malaria diagnostic tests performed on saliva, urine, faeces, skin odour ('sniff and tell') and hair, using either microscopy or PCR on blood sample as reference test.
methodsWe searched on PubMed, EMBASE, African Journals Online and Cochrane Infectious Diseases from inception until 19 January 2021 for relevant primary studies. A random effects model was used to estimate the overall performance of various diagnostic methods on different types of specimen.
resultsEighteen studies providing 30 data sets were included in the meta-analysis. The overall sensitivity, specificity and diagnostic OR (DOR) of PCR were 84.5% (95% CI 79.3% to 88.6%), 97.3% (95% CI 95.3% to 98.5%) and 184.9 (95% CI 95.8 to 356.9) in saliva, respectively; 57.4% (95% CI 41.4% to 72.1%), 98.6% (95% CI 97.3% to 99.3%) and 47.2 (95% CI 22.1 to 101.1) in urine, respectively. The overall sensitivity, specificity and DOR of rapid diagnostic test for malaria in urine was 59.8% (95% CI 40.0% to 76.9%), 96.9% (95% CI 91.0% to 99.0%) and 30.8 (95% CI:23.5 to 40.4).
conclusionIn settings where PCR is available, saliva and urine samples should be considered for PCR-based malaria diagnosis only if blood samples cannot be collected. The performance of rapid diagnostic testing in the urine is limited, especially its sensitivity. Malaria testing on non-invasively collected specimen still needs substantial improvement.
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