SynthesisPLoS neglected tropical diseases2024
Accuracy of rapid lateral flow immunoassays for human leptospirosis diagnosis: A systematic review and meta-analysis.
Synthesis in PLoS neglected tropical diseases, 2024. 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.
- A Label-Free Graphene Quantum Dot-Based Fluorescent Aptasensor for Rapid and Sensitive Detection of Leptospira interrogans.Journal of fluorescence · 2026Article
- Leptospirosis in Southeast Asia: Investigating Seroprevalence, Transmission Patterns, and Diagnostic Challenges.Tropical medicine and infectious disease · 2026Review
- Laboratory Diagnosis of Leptospirosis.Methods in molecular biology (Clifton, N.J.) · 2026Review
- A Guidance for Diagnosis, Control Measures, and Surveillance of Leptospirosis in Non-Human Primates From a Veterinary Perspective in a One-Health Approach.Journal of medical primatology · 2025Review
- Nanoparticle-based biosensors coupled with loop-mediated isothermal amplification for rapid, visual, and in-field identification of pathogenic Leptospira.BMC infectious diseases · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundIn the last two decades, several rapid lateral flow immunoassays (LFIs) for the diagnosis of human leptospirosis were developed and commercialized. However, the accuracy and reliability of these LFIs are not well understood. In this study, we aimed to evaluate the accuracy of leptospirosis LFIs as well as the factors affecting the test efficiency using systematic review and meta-analysis. METHODS AND
resultsOriginal articles reporting the accuracy of human leptospirosis LFIs against microagglutination tests (MAT) or immunofluorescent assays (IFA) were searched from PubMed, Embase, and Scopus, and selected as per pre-set inclusion and exclusion criteria. A total of 49 data entries extracted from 24 eligible records published between 2003 and 2023 were included for meta-analysis. A meta-analysis was performed using STATA. The quality of the included studies was assessed according to the revised QUADAS-2. Only nine studies (32.1%) were considered to have a low risk of bias and no concern for applicability. Pooled sensitivity and specificity were calculated to be 68% (95% confidence interval, CI: 57-78) and 93% (95% CI: 90-95), respectively. However, the ranges of sensitivity (3.6 - 100%) and specificity (53.5 - 100%) of individual entries are dramatically broad, possibly due to the heterogeneity found in both study designs and LFIs themselves. Subgroup analysis demonstrated that IgM detection has better sensitivity than detection of IgG alone. Moreover, the test performance seems to be unaffected by samples from different phases of infection.
conclusionsThe pooled specificity of LFIs observed is somewhat acceptable, but the pooled sensitivity is low. These results, however, must be interpreted with caution because of substantial heterogeneity. Further evaluations of the LFIs with well-standardized design and reference test will be needed for a greater understanding of the test performance. Additionally, IgM detection type should be employed when leptospirosis LFIs are developed in the future.
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