Assessing the diagnostic accuracy of immunodiagnostic techniques in the diagnosis of schistosomiasis japonica: a meta-analysis.

Immunodiagnostic tests are commonly used in the diagnosis for schistosomiasis japonica in field situation. Their diagnostic effect, however, has never been evaluated in a systematic way. We set out to review the value of tests including enzyme-linked immunosorbent assay (ELISA) and indirect hemagglutination assay (IHA) in the diagnosis of schistosomiasis japonica. A comprehensive search was conducted in order to identify all possible studies achieving the inclusion criteria. We undertook a meta-analysis of diagnostic ability that compared ELISA with IHA for the diagnosis of schistosomiasis japonica. Original articles were searched in Pubmed, Science Citation Index Expanded, Cochrane Library, Proquest and China National Knowledge Infrastructure. Data extractions were conducted independently by two reviewers. Summary receiver operating characteristic curves were used to summarize overall test performance. Funnel plot was used to analyze publication bias. Finally, 16 studies met inclusion criteria. In all studies combined, the diagnostic odds ratio (DOR) for IHA was 8.689 (95%CI 7.671 to 9.842) and ELISA was 3.691 (95%CI 3.018 to 4.515). The DOR for IHA was better than that for ELISA. IHA demonstrated TPR* = 0.721 and ELISA showed TPR* = 0.633. IHA performance was superior to that of ELISA. Nevertheless, difference of the accuracy between the two methods for diagnosis of schistosomiasis japonica has no statistical significance as shown by the result of Z test. We found that both IHA and ELISA can be used to rule in or rule out the diagnosis.