Evaluation of truenat assays for the diagnosis of pulmonary and extrapulmonary tuberculosis: a systematic review and meta-analysis.

ABSTRACT

BACKGROUND: Tuberculosis (TB) remains a significant global health concern, necessitating accurate and timely diagnostic methods. This study aimed to conduct a systematic review and meta-analysis to assess the diagnostic accuracy of Truenat assays for both pulmonary TB (PTB) and extrapulmonary TB (EPTB). METHOD: PubMed, Scopus, and Web of Science were systematically searched for studies comparing Truenat assays to Mycobacterium tuberculosis confirmation methods. RESULTS: Comparing Truenat MTB assay with the Lowenstein-Jensen (LJ) culture, the pooled sensitivity and specificity were 86% (95% CI 79-91%) and 86% (95% CI 82-90%), respectively. For Mycobacterial Growth Indicator Tube (MGIT) culture comparison, pooled sensitivity was 88% (95% CI 82-92%) with a specificity of 79% (95% CI 57-92%). Compared to smear microscopy, Truenat assays displayed pooled sensitivity and specificity of 92% (95% CI 78-98%) and 86% (95% CI 64-95%). In comparison to Xpert MTB/RIF, Truenat assays exhibited a pooled sensitivity of 92% (95% CI 80-97%) and a pooled specificity of 92% (95% CI 56-99%) for PTB detection, and a pooled sensitivity of 94% (95% CI 81-98%) and a specificity of 77% (95% CI 32-96%) for the diagnosis of EPTB. CONCLUSION: This study underscores the potential of Truenat assays as valuable tools for diagnosing both PTB and EPTB. PROSPERO ID CRD42024526686.