Accuracy of real-time PCR for the detection of paratuberculosis in actual samples: A systematic review and meta-analysis

Paratuberculosis, an infectious and chronic ailment that affects ruminants, causes significant annual economic losses to the livestock industry. Early diagnosis and prompt culling are the primary measures for controlling this disease, highlighting the need for accurate and rapid diagnostic methods. This systematic review and meta-analysis aimed to evaluate the efficacy of quantitative PCR (qPCR) in the diagnosis of paratuberculosis. We searched for and selected articles from databases including PubMed, Web of Science, Elsevier ScienceDirect, Wiley-Blackwell, Springerlink, AGRICOLA, and CAB Abstracts, with VETQUADAS (VQ) employed to assess the quality of the literature. Meta-analysis and heterogeneity investigation were conducted using the “Meta4diag” package in “R” software, Meta-Disc 2.0, and Meta-Disc, while the Deeks’ test was utilized to detect publication bias. The studies included in the systematic review displayed a moderate level of heterogeneity (I² = 48.6 %) with no significant publication bias (p = 0.998). The pooled sensitivity was determined to be 0.92 [95 % confidence interval [CI], 0.85–0.96], and the specificity was 0.85 [95 % CI, 0.77–0.91], with a summary receiver operating characteristic area under the curve (SROCAUC) of 0.95 [95 % CI, 0.91–0.98]. These findings indicate that the qPCR method has high diagnostic value for identifying paratuberculosis in animals. Subgroup analysis revealed satisfactory stability in these studies; however, the current single-target qPCR detection strategy still has limitations, as it fails to simultaneously ensure both sensitivity and specificity. Future developments should focus on multi-target detection strategies to provide more reliable qPCR testing methods for controlling paratuberculosis.