Evaluating Rabies Test Accuracy: A Systematic Review and Meta-Analysis of Human and Canine Diagnostic Methods

<b>Background/Objectives:</b> Rabies is almost invariably fatal once clinical symptoms manifest. Timely and accurate diagnosis is essential for effective treatment and prevention. Dogs are the principal reservoirs of the virus, particularly in developing nations, highlighting the importa...

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Main Authors: Mayron Antonio Candia-Puma, Leydi Pola-Romero, Haruna Luz Barazorda-Ccahuana, Luis Daniel Goyzueta-Mamani, Alexsandro Sobreira Galdino, Ricardo Andrez Machado-de-Ávila, Rodolfo Cordeiro Giunchetti, Eduardo Antonio Ferraz Coelho, Miguel Angel Chávez-Fumagalli
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/4/412
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author Mayron Antonio Candia-Puma
Leydi Pola-Romero
Haruna Luz Barazorda-Ccahuana
Luis Daniel Goyzueta-Mamani
Alexsandro Sobreira Galdino
Ricardo Andrez Machado-de-Ávila
Rodolfo Cordeiro Giunchetti
Eduardo Antonio Ferraz Coelho
Miguel Angel Chávez-Fumagalli
author_facet Mayron Antonio Candia-Puma
Leydi Pola-Romero
Haruna Luz Barazorda-Ccahuana
Luis Daniel Goyzueta-Mamani
Alexsandro Sobreira Galdino
Ricardo Andrez Machado-de-Ávila
Rodolfo Cordeiro Giunchetti
Eduardo Antonio Ferraz Coelho
Miguel Angel Chávez-Fumagalli
author_sort Mayron Antonio Candia-Puma
collection DOAJ
description <b>Background/Objectives:</b> Rabies is almost invariably fatal once clinical symptoms manifest. Timely and accurate diagnosis is essential for effective treatment and prevention. Dogs are the principal reservoirs of the virus, particularly in developing nations, highlighting the importance of precise diagnostic and control measures to prevent human cases. This systematic review and meta-analysis assessed the accuracy of laboratory tests for diagnosing rabies in humans and dogs. <b>Methods:</b> The PubMed database was searched for published studies on rabies diagnosis between 1990 and 2024. Following PRISMA statement recommendations, we included 60 studies that met the selection criteria. <b>Results:</b> The results demonstrated the effectiveness of immunological tests like the Enzyme-Linked Immunosorbent Assay (ELISA) and molecular tests such as Reverse Transcription Polymerase Chain Reaction (RT-PCR) for both humans and dogs. In this study, the Direct Fluorescent Antibody Test (DFAT) exhibited lower diagnostic performance, with an area under the curve for false positive rates (AUC<sub>FPR</sub> = 0.887). In contrast, ELISA (AUC<sub>FPR</sub> = 0.909) and RT-PCR (AUC<sub>FPR</sub> = 0.905) provided more consistent results. Notably, the Rapid Immunochromatographic Test (RIT) showed the best performance (AUC<sub>FPR</sub> = 0.949), highlighting its superior diagnostic capabilities compared to DFAT. <b>Conclusions:</b> These findings underscore the need to modernize rabies diagnostic protocols by incorporating advanced methodologies to improve diagnostic accuracy, reduce transmission, and decrease mortality rates.
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spelling doaj-art-259f2dba1d2e4b5c801903aecad0bbf12025-08-20T02:44:35ZengMDPI AGDiagnostics2075-44182025-02-0115441210.3390/diagnostics15040412Evaluating Rabies Test Accuracy: A Systematic Review and Meta-Analysis of Human and Canine Diagnostic MethodsMayron Antonio Candia-Puma0Leydi Pola-Romero1Haruna Luz Barazorda-Ccahuana2Luis Daniel Goyzueta-Mamani3Alexsandro Sobreira Galdino4Ricardo Andrez Machado-de-Ávila5Rodolfo Cordeiro Giunchetti6Eduardo Antonio Ferraz Coelho7Miguel Angel Chávez-Fumagalli8Computational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, PeruComputational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, PeruComputational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, PeruComputational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, PeruLaboratório de Biotecnologia de Microrganismos, Universidade Federal São João Del-Rei, Divinópolis 35501-296, BrazilPrograma de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, Criciúma 88806-000, BrazilLaboratório de Biologia das Interações Celulares, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, BrazilInfectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, BrazilComputational Biology and Chemistry Research Group, Vicerrectorado de Investigación, Universidad Católica de Santa María, Arequipa 04000, Peru<b>Background/Objectives:</b> Rabies is almost invariably fatal once clinical symptoms manifest. Timely and accurate diagnosis is essential for effective treatment and prevention. Dogs are the principal reservoirs of the virus, particularly in developing nations, highlighting the importance of precise diagnostic and control measures to prevent human cases. This systematic review and meta-analysis assessed the accuracy of laboratory tests for diagnosing rabies in humans and dogs. <b>Methods:</b> The PubMed database was searched for published studies on rabies diagnosis between 1990 and 2024. Following PRISMA statement recommendations, we included 60 studies that met the selection criteria. <b>Results:</b> The results demonstrated the effectiveness of immunological tests like the Enzyme-Linked Immunosorbent Assay (ELISA) and molecular tests such as Reverse Transcription Polymerase Chain Reaction (RT-PCR) for both humans and dogs. In this study, the Direct Fluorescent Antibody Test (DFAT) exhibited lower diagnostic performance, with an area under the curve for false positive rates (AUC<sub>FPR</sub> = 0.887). In contrast, ELISA (AUC<sub>FPR</sub> = 0.909) and RT-PCR (AUC<sub>FPR</sub> = 0.905) provided more consistent results. Notably, the Rapid Immunochromatographic Test (RIT) showed the best performance (AUC<sub>FPR</sub> = 0.949), highlighting its superior diagnostic capabilities compared to DFAT. <b>Conclusions:</b> These findings underscore the need to modernize rabies diagnostic protocols by incorporating advanced methodologies to improve diagnostic accuracy, reduce transmission, and decrease mortality rates.https://www.mdpi.com/2075-4418/15/4/412rabiesdiagnostic testsmeta-analysissystematic reviewsensitivityspecificity
spellingShingle Mayron Antonio Candia-Puma
Leydi Pola-Romero
Haruna Luz Barazorda-Ccahuana
Luis Daniel Goyzueta-Mamani
Alexsandro Sobreira Galdino
Ricardo Andrez Machado-de-Ávila
Rodolfo Cordeiro Giunchetti
Eduardo Antonio Ferraz Coelho
Miguel Angel Chávez-Fumagalli
Evaluating Rabies Test Accuracy: A Systematic Review and Meta-Analysis of Human and Canine Diagnostic Methods
Diagnostics
rabies
diagnostic tests
meta-analysis
systematic review
sensitivity
specificity
title Evaluating Rabies Test Accuracy: A Systematic Review and Meta-Analysis of Human and Canine Diagnostic Methods
title_full Evaluating Rabies Test Accuracy: A Systematic Review and Meta-Analysis of Human and Canine Diagnostic Methods
title_fullStr Evaluating Rabies Test Accuracy: A Systematic Review and Meta-Analysis of Human and Canine Diagnostic Methods
title_full_unstemmed Evaluating Rabies Test Accuracy: A Systematic Review and Meta-Analysis of Human and Canine Diagnostic Methods
title_short Evaluating Rabies Test Accuracy: A Systematic Review and Meta-Analysis of Human and Canine Diagnostic Methods
title_sort evaluating rabies test accuracy a systematic review and meta analysis of human and canine diagnostic methods
topic rabies
diagnostic tests
meta-analysis
systematic review
sensitivity
specificity
url https://www.mdpi.com/2075-4418/15/4/412
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