{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:52:37Z","timestamp":1783039957290,"version":"3.54.6"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The diagnosis and detection of pathogens such as <jats:italic>Rickettsia<\/jats:italic> and <jats:italic>Orientia<\/jats:italic> is a cause of major concern among the public health community. Unavailability of rapid, cost-effective diagnostic assays contributes to delayed diagnosis and timely treatment. Using the methodology of systematic reviewing and meta-analysis, the study aimed to synthesize and compare the diagnostic performances of all the available isothermal assays for the detection of classical rickettsial diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Studies were retrieved from PubMed and Scopus, and selection and screening were conducted using pre-determined inclusion and exclusion criteria. Analysis was performed using Meta-DiSc 2.0 for the assessment and comparison of diagnostic performance of the isothermal assays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, six studies were selected as a part of this systematic review. All the selected studies (<jats:italic>n<\/jats:italic>\u202f=\u202f6) optimized LAMP as their index test to detect scrub typhus. The quality assessment of the selected studies revealed only (<jats:italic>n<\/jats:italic>\u202f=\u202f1) study to be of poor quality with a QUADAS-2 score of (&amp;lt;2). Meta-analysis revealed the pooled sensitivity of LAMP to be 66% [95% CI (0.40\u20130.85)] with a pooled specificity of 94% [95% CI (0.81\u20130.98)]. LAMP was estimated with a positive likelihood ratio of 8.3 [95% CI (3.8\u201318.1)] and a negative likelihood ratio of 0.3 [95% CI (0.2\u20130.7)] with a false positivity rate of 0.07 [95% CI (0.02\u20130.2)]. The diagnostic odds ratio was reported to be 21.96 [95% CI (10.2\u201347.3)]. Due to severe heterogeneity in the body of evidence (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u202f=\u202f0.77), a meta-regression was performed with certain covariates to explore the potential causes. A case\u2013control design was found to exaggerate the sensitivity {0.84 [95% CI (0.5\u20130.9)]} and specificity {0.73 [95% CI (0.6\u20130.8)]}.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The findings reveal subpar performance of LAMP for the detection of scrub typhus. Active research and development focused on optimization of novel molecular diagnosis that are efficient, rapid, and cost-effective shall foster timely diagnosis and aid in reduction of the overall burden of scrub typhus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Protocol and registration<\/jats:title><jats:p>A detailed protocol of this review is registered and available in Prospero at: <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>. (registration number CRD42024511706).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2024.1516921","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T07:00:57Z","timestamp":1736146857000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The diagnostic accuracy of point-of-care nucleic acid-based isothermal amplification assays for scrub typhus: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"15","author":[{"given":"Rashi","family":"Dixit","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Manikandan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Antony Jude","family":"Prakash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Biswal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharitri","family":"Mohapatra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natarajan","family":"Gopalan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Gnanamani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujit Kumar","family":"Behera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3156","DOI":"10.1099\/ijsem.0.001865","article-title":"Rickettsia gravesii sp. nov.: a novel spotted fever group rickettsia in Western Australian Amblyomma triguttatum triguttatum ticks","volume":"67","author":"Abdad","year":"2017","journal-title":"Int. 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