Diagnostic accuracy of Opisthorchis viverrini antigen methods for human opisthorchiasis: Systematic review and Meta-analysis

Abstract

Opisthorchiasis relates to cholangiocarcinoma occurrences. Regular screening for Opisthorchis viverrini can prevent loss of human and economy; however, optimal screening techniques have not been identified. There are various methods to detect O. viverrini infections, and each method has its strengths and limitations. A common detection method, conventional fecal examinations are cheap but has high false-negative and cannot differentiate between O. viverrini and Minute intestinal fluke (MIF) eggs. Antigen detection can result in cross-reactivity with other helminths; nevertheless, it can detect O. viverrini at early stage of infection and uses non-invasive human samples. This systematic review and meta-analysis evaluated the diagnostic accuracy of antigen detection for O. viverrini. This research searched various databases: MEDLINE, EMBASE, Google scholar, PubMed, Scopus, Science direct, Cochrane, AMED, IPA, CINAHL, and Thai Thesis Database. Study selection and data extraction were done by two researchers independently. Of 142 published articles, 4 articles met the inclusion criteria. Quality assessment was done by QUADAS-2 and found a low risk of bias. Pooled sensitivity is 91 % (95% CI = 82% - 96%) and pooled specificity is 68% (95% CI = 65% - 72%). The high sensitivity of antigen detection for O. viverrini suggested its potential to be an optimal tool for early detection and treatment. However, the moderate specificity reflects lower effectiveness to apply the antigen test for surveillance in low endemic areas. The study's findings provide evidence of the precision of O. viverrini antigen detection. Public health decision-makers can employ antigen detection of O. viverrini as cost-effective screening tools in an epidemic area.