title: Accuracy of mucocutaneous leishmaniasis diagnosis using polymerase chain reaction: systematic literature review and meta-analysis.
abstract: The diagnosis of mucocutaneous leishmaniasis (MCL) is hampered by the absence of a gold standard. An accurate diagnosis is essential because of the high toxicity of the medications for the disease. This study aimed to assess the ability of polymerase chain reaction (PCR) to identify MCL and to compare these results with clinical research recently published by the authors. A systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement was performed using comprehensive search criteria and communication with the authors. A meta-analysis considering the estimates of the univariate and bivariate models was performed. Specificity near 100% was common among the papers. The primary reason for accuracy differences was sensitivity. The meta-analysis, which was only possible for PCR samples of lesion fragments, revealed a sensitivity of 71% [95% confidence interval (CI) = 0.59; 0.81] and a specificity of 93% (95% CI = 0.83; 0.98) in the bivariate model. The search for measures that could increase the sensitivity of PCR should be encouraged. The quality of the collected material and the optimisation of the amplification of genetic material should be prioritised.
authors.affiliation: Programa de Pós-Graduação em Clínica Médica.
authors.forename: Ciro Martins
authors.initials: CM
authors.lastname: Gomes
authors.affiliation: Departamento de Neurociências e Ciências do Comportamento.
authors.forename: Suleimy Cristina
authors.initials: SC
authors.lastname: Mazin
authors.affiliation: Serviço de Dermatologia.
authors.forename: Elisa Raphael dos
authors.initials: ER
authors.lastname: Santos
authors.affiliation: Serviço de Dermatologia.
authors.forename: Mariana Vicente
authors.initials: MV
authors.lastname: Cesetti
authors.affiliation: Departamento de Clínica Médica.
authors.forename: Guilherme Albergaria Brízida
authors.initials: GA
authors.lastname: Bächtold
authors.affiliation: Departamento de Clínica Médica.
authors.forename: João Henrique de Freitas
authors.initials: JH
authors.lastname: Cordeiro
authors.affiliation: Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil.
authors.forename: Fabrício Claudino Estrela Terra
authors.initials: FC
authors.lastname: Theodoro
authors.affiliation: Hospital Regional da Asa Norte, Brasília, DF, Brasil.
authors.forename: Fabiana dos Santos
authors.initials: Fdos S
authors.lastname: Damasco
authors.affiliation: Programa de Pós-Graduação em Clínica Médica.
authors.forename: Sebastián Andrés Vernal
authors.initials: SA
authors.lastname: Carranza
authors.affiliation: Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil.
authors.forename: Adriana de Oliveira
authors.initials: Ade O
authors.lastname: Santos
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Roselino
authors.affiliation: Departamento de Clínica Médica.
authors.forename: Raimunda Nonata Ribeiro
authors.initials: RN
authors.lastname: Sampaio
mesh_terms: D001706:Biopsy; D002986:Clinical Trials as Topic; D016001:Confidence Intervals; D016054:DNA, Protozoan / Q000302:isolation & purification*; D006801:Humans; D007897:Leishmaniasis, Mucocutaneous / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D016133:Polymerase Chain Reaction / Q000592:standards*; D036301:Qualitative Research; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D016054:DNA, Protozoan