DIAGNOSTIC ACCURACY FOR ACUTE FEBRILE ILLNESSES IN WEST AFRICA: A LITERATURE REVIEW

Abstract

In West Africa, prompt diagnosis is important in the management of acute febrile illnesses (AFI). This study aims to review the existing diagnostic methods for AFIs in the West African region. A review search was performed on PubMed and Google Scholar to identify relevant peer-reviewed articles on AFIs carried out and published in the past 10 years. Studies were also manually searched from references of selected studies for relevance. Information on the diagnostic performance of AFI diagnostic tools was retrieved from all selected articles and synthesized. A total of 51 articles met the inclusion criteria and were selected for the review. The majority of the rapid diagnostic tests (RDT) and surface-enhanced ramam scattering (SERS) assay for malaria produced sensitivity, specificity, and diagnostic accuracy of >80%. Widal agglutination test and other RDTs had at least one diagnostic indicator of <80% when compared with their respective gold standards. All RDTs for Lassa fever had a diagnostic accuracy of >80% while enzyme-linked immunosorbent assay (ELISA) had a sensitivity of 26% when compared to polymerase chain reaction (PCR) as the gold standard. Gene Xpert test and other RDTs except for eZySCREEN RDT compared to PCR had sensitivities and specificities of >80% for Ebola virus disease (EVD). Diagnostics parameters for loop-mediated amplification test compared to PaCR for chikungunya was >80%. The specificity of RDTs for COVID-19 was >80% and sensitivity was <80%. This review shows that RDTs and SERS are cost-effective diagnostic tools for the diagnosis of AFIs and can be useful tools for effective disease management, and address the challenges with the misdiagnosis of AFIs in West African countries.