Evaluación comparativa de la sensibilidad y especificidad de los métodos diagnósticos de toxoplasmosis en el Hospital Roberto Gilbert Elizalde, período 2016 – 2019.

Abstract

Background: Toxoplasmosis is a prevalent disease, especially in underdeveloped countries, which, since it does not manifest itself with obvious symptoms and signs, could be presented as a silent disease. That is why the diagnosis of toxoplasmosis is an issue of great importance due to the need to establish an early and timely treatment to prevent long-term sequelae. Objective: Determine the sensitivity and specificity of the diagnostic methods used for the detection of Toxoplasmosis at the Roberto Gilbert Elizalde Hospital during the period 2016 - 2019. Materials and methods: Cohort study, observational, descriptive, cross-sectional approach, retrospective collection, in which the sensitivity and specificity of the different diagnostic tests for toxoplasmosis used in 81 exposed patients, including serological tests (IgG / IgM) and DNA / PCR in biological fluid (blood / cerebrospinal fluid). Results: The initial serology showed a sensitivity of 65.67%, specificity 57.14%, PPV 88%, NPV 25.81%, accuracy 64.20%, Kappa not significant. DNA / PCR in blood presented sensitivity 70.83%, specificity 100%, PPV 100%, NPV 53.33%, accuracy 78.13%, significant Kappa p-value 0.001 with moderate agreement (0.55) . CSF DNA / PCR presented sensitivity 82.98%, specificity 100%, PPV 100%, NPV 46.67%, accuracy 85.19%, significant Kappa p-value 0.000 with moderate concordance (0.56) . The simultaneous study of DNA / CRP in blood and CSF showed no variation in diagnostic sufficiency (sensitivity 74.63%, specificity 100%). Conclusions: The diagnosis of Toxoplasmosis must not only be based on the initial serological study, but must be associated with studies of high diagnostic sufficiency such as DNA / PCR in biological fluid or serological follow-up until one year of life; the method with the highest sensitivity and specificity for the diagnosis of toxoplasmosis is the CSF DNA / PCR test.