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All Journal Jurnal Kesehatan Andalas Universa Medicina Majalah Kedokteran Andalas Bioscientia Medicina : Journal of Biomedicine and Translational Research Sumatera Medical Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) Berita Kedokteran Masyarakat Jurnal Penyakit Dalam Indonesia JUKEJ: Jurnal Kesehatan Jompa Jurnal Riset Ilmiah Jurnal Sains, Teknologi dan Kesehatan
Fadrian, Fadrian
Department Of Internal Medicine, Faculty Of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Economics, Econometrics & Finance Engineering Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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The Diagnostic Accuracy of IgG Avidity Testing for Differentiating Acute from Chronic Toxoplasmosis in Pregnant Women: A Meta-Analysis Hermalina Sherli Utami; Rohayat Bilmahdi; Fadrian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1467

Abstract

Background: Differentiating acute from chronic Toxoplasma gondii infection during pregnancy is a critical diagnostic challenge. Persistent Immunoglobulin M (IgM) antibodies create ambiguity, complicating clinical management. The IgG avidity test serves as a key tool to estimate infection timing. This meta-analysis aimed to systematically evaluate and quantify the diagnostic accuracy of the IgG avidity test for identifying acute toxoplasmosis in pregnant women. Methods: A systematic literature search was conducted across PubMed, Scopus, Web of Science, EMBASE, and LILACS for studies published between January 2015 and December 2025 evaluating the IgG avidity test's diagnostic accuracy in pregnant women. Included studies required data for a 2x2 contingency table. The QUADAS-2 tool was used for bias assessment. A bivariate random-effects model was used to pool sensitivity, specificity, likelihood ratios (PLR, NLR), and the diagnostic odds ratio (DOR). Results: Seven studies, comprising 1,250 pregnant women, were included. The pooled sensitivity was 0.96 (95% Confidence Interval [CI]: 0.92–0.98), and the pooled specificity was 0.97 (95% CI: 0.94–0.99). The pooled PLR was 32.5 (95% CI: 15.1–69.8), the NLR was 0.04 (95% CI: 0.02–0.08), and the DOR was 785 (95% CI: 289–2134). The area under the SROC curve was 0.99 (95% CI: 0.97–1.00). Substantial heterogeneity was observed across studies. A sensitivity analysis excluding one study with a high risk of bias did not significantly alter the results, and Deeks' test showed no evidence of publication bias (p=0.21). Conclusion: The IgG avidity test demonstrated excellent pooled diagnostic accuracy for differentiating acute from chronic toxoplasmosis in pregnancy. However, significant heterogeneity across studies underscores that a single performance estimate is not universally applicable. The test is a powerful tool for resolving diagnostic uncertainty, but results must be interpreted based on assay-specific performance and in the context of the complete clinical picture.
Co-Authors Abdiana Abdiana, Abdiana Adefri Wahyudi Ahmad, Armen Amelia F. Dewi Anggrainy, Fenty Armen Ahmad Armen Ahmad Armen Ahmad Astiena, Adila Kasni Daan Khambri Desmawati Desmawati Desmawati Desmawati Dessy Arisanty Dwi Yulia Dwitya Elvira, Dwitya Elvia Fataya Eva Decroli Fika Tri Anggraini Genta Pradana, Genta Hardisman Harvindra, Astrid Hasmiwati Hasnah Hasnah Hasnah, Hidayatul Hermalina Sherli Utami Hilary Priscilla Ikhsan Amanda Putra, Ikhsan Amanda Kam, Alexander Khairat, Khairat Lili Irawati Lydia Sarah Shabrina Muharramah, Disa Hijratul Mustafa Noer Netti Suharti Nice Rachmawati Masnadi Oktalina, Dyanti Prasetio, Ade Putri Nirmala Dewi Putri, Vidola Yasena Putri, Viona Salsabila Rifa, Farras Zahra Rima Semiarty Rita Hamdani Rizki Amelia Rohayat Bilmahdi Rosfita Rasyid Rudy Afriant Saptino Miro, Saptino Selfi Renita Rusjdi Vitresia, Havriza Vivi Triana Yulia, Dwi Yuliarni Syafrita Yuniar Lestari Yustini Alioes Zaki Mahmudi Dasril