Tourniquet Test for Dengue Diagnosis: Systematic Review and Meta-analysis of Diagnostic Test Accuracy

摘要: BACKGROUND: Dengue fever is a ubiquitous arboviral infection in tropical and sub-tropical regions, whose incidence has increased over recent decades. In the absence of rapid point care test, clinical diagnosis dengue complex. The World Health Organisation outlined diagnostic criteria for making infection, which includes use tourniquet test (TT). PURPOSE: To assess quality evidence supporting TT perform accuracy meta-analysis comparing to antibody response measured by ELISA. DATA SOURCES: A comprehensive literature search was conducted following databases April, 2016: MEDLINE (PubMed), EMBASE, Cochrane Central Register Controlled Trials, BIOSIS, Web Science, SCOPUS. STUDY SELECTION: Studies with ELISA were included. EXTRACTION: Two independent authors extracted data using standardized form. SYNTHESIS: total 16 studies 28,739 participants included meta-analysis. Pooled sensitivity 58% (95% Confidence Interval (CI), 43%-71%) specificity 71% CI, 60%-80%). subgroup analysis non-severe 55% 52%-59%) 63% 60%-66%), whilst hemorrhagic 62% 53%-71%) 60% 48%-70%). Receiver-operator characteristics demonstrated (AUC) 0.70 0.66-0.74). CONCLUSION: widely used resource poor settings despite currently available demonstrating only marginal benefit alone. REGISTRATION: protocol this systematic review registered at PROSPERO: CRD42015020323.