Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 May 17:2021:5527505.
doi: 10.1155/2021/5527505. eCollection 2021.

Pooled Analysis of the Accuracy of Xpert Ebola Assay for Diagnosing Ebola Virus Infection

Zhi-Yong Pan  1   2 , Yan-Jun Wu  1   3 , Ye-Xian Zeng  1   4 , Hao Lin  1   2 , Tian-Ao Xie  1   2 , Ya-Ping Li  1   3 , Ye-Ling Liu  1   2 , Zhi-Jian He  1   2 , Xu-Guang Guo  1   2   5   6
Affiliations
Review

Pooled Analysis of the Accuracy of Xpert Ebola Assay for Diagnosing Ebola Virus Infection

Zhi-Yong Pan et al. Biomed Res Int. .

Abstract

Background: West Africa has witnessed the unprecedented outbreak of Ebola virus disease (EVD). The Ebola virus (EBOV) can cause Ebola hemorrhagic fever, which is documented as the most deadly viral hemorrhagic fever in the world. RT-PCR had been suggested to be employed in the detection of Ebola virus; however, this method has high requirements for laboratory equipment and takes a long time to determine Ebola infection. Although Xpert Ebola is a fast and simple instrument for the detection of Ebola virus, its effect is still unclear. This study is aimed at evaluating the accuracy of Xpert Ebola in diagnosing Ebola virus infection.

Methods: Using the keywords "Xpert" and "Ebola virus", relevant studies were retrieved from the database of PubMed, Embase, Web of Science, and Cochrane. RT-PCR was employed as a reference standard to evaluate whether the study is eligible to be included in the meta-analysis. Data from these included studies were extracted by two independent assessors and were then analyzed by the Meta-DiSc 1.4 software to produce the heterogeneity of sensitivity (SEN), specificity (SP), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic advantage ratio (DOR) of the study. The results of pooled analysis were plotted, together with the summary receiver operating characteristic (SROC) curve plotted by calculating the area under the curve (AUC). Generated pooled summary estimates (95% CIs) were calculated for the evaluation of the overall accuracy of this study.

Results: Five fourfold tables were made from the four studies that were included in the meta-analysis. The pooled sensitivity of Xpert Ebola was 0.98 (95% confidence interval (CI) (0.95, 0.99)), and the pooled specificity was 0.98 (95% CI (0.97, 0.99)). The pooled values of positive likelihood ratio was 53.91 (95% CI (12.82, 226.79)), with negative likelihood ratio being 0.04 (95% CI (0.02, 0.08)) and diagnostic odds ratio being 2649.45 (95% CI (629.61, 11149.02)). The AUC was 0.9961.

Conclusions: Compared with RT-PCR, Xpert Ebola has high sensitivity and specificity. Therefore, it is a valued alternative method for the clinical diagnosis of Ebola virus infection. However, the Xpert Ebola test is a qualitative test that does not provide quantitative testing of EBOV concentration. Whether it can completely replace other methods or not calls for further evidences.

PubMed Disclaimer

Conflict of interest statement

The authors declare that there are no competing interests associated with the manuscript.

Figures

Figure 1
Figure 1
(a) Overall quality assessment of the included studies. (b) Quality assessment of the individual studies.
Figure 2
Figure 2
SROC curves of EVD detected by Xpert Ebola.
Figure 3
Figure 3
Forest plots for the pooled sensitivity of Xpert Ebola.
Figure 4
Figure 4
Forest plots for the pooled specificity of Xpert Ebola.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Jacob S. T., Crozier I., Fischer W. A., 2nd, et al. Ebola virus disease. Nature Reviews. Disease Primers. 2020;6(1):p. 13. doi: 10.1038/s41572-020-0147-3. - DOI - PMC - PubMed
    1. McCormick J. B., Bauer S. P., Elliott L. H., Webb P. A., Johnson K. M. Biologic differences between strains of Ebola virus from Zaire and Sudan. The Journal of Infectious Diseases. 1983;147(2):264–267. doi: 10.1093/infdis/147.2.264. - DOI - PubMed
    1. Agua-Agum J., Allegranzi B., Ariyarajah A. After Ebola in West Africa--unpredictable risks, preventable epidemics. The New England Journal of Medicine. 2016;375(6):587–596. doi: 10.1056/NEJMsr1513109. - DOI - PubMed
    1. WHO Ebola Response Team, Aylward B., Barboza P., et al. Ebola virus disease in West Africa--the first 9 months of the epidemic and forward projections. The New England Journal of Medicine. 2014;371(16):1481–1495. doi: 10.1056/NEJMoa1411100. - DOI - PMC - PubMed
    1. Baize S., Pannetier D., Oestereich L., et al. Emergence of Zaire Ebola virus disease in Guinea. The New England Journal of Medicine. 2014;371(15):1418–1425. doi: 10.1056/NEJMoa1404505. - DOI - PubMed

LinkOut - more resources