Science Journal of Microbiology

October 2013, Volume 2013, ISSN: 2276-626X

Author(s) 2013. This work is distributed under the Creative Commons Attribution 3.0 License.

Research Article


Noninvasive Sampling of Saliva as an Alternative Way for Malaria Diagnosis: A Systematic Review

Yin Jian-hai1, Xia Zhi-gui2, Liu Cong-shan3, Zhou Shui-sen4

1,2,3,4National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, MOH, China; WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, No. 207, Ruijin Er Lu, Shanghai 200025, China

Accepted 4 October, 2013; Available Online 21 October, 2013

doi: 10.7237/sjmb/180


To describe and evaluate the efficacy of different methods based on human saliva for malaria diagnosis compared with methods based on blood. A comprehensive search about malaria diagnosis based on saliva was undertaken from PubMed, China National Knowledge Infrastructure (CNKI), VIP and Wanfang databases with strict inclusion and exclusion criteria. Methodological quality was assessed by using the quality assessment of diagnostic studies (QUADAS) tool. Meta-Disc version 1.4 was used to analyze the studies and methods for sensitivity, specificity, and area under the summary receiver operating characteristic (sROC) curves. In result, nine studies (n=9) were enrolled from 150 studies retrieved only in the PubMed. Methodological quality was moderate. The pooled sensitivity and specificity with corresponding 95% confidence interval (CI) of all enrolled studies were 0.68 (0.65 to 0.71) and 0.91 (0.89 to 0.93) respectively. AUC of sROC was 0.8303. In ELISA subgroup of studies, pooled sensitivity and specificity were 0.61 (0.55 to 0.65) and 0.87 (0.84 to 0.90), and AUC was 0.7227 respectively. And 0.75 (0.71 to 0.80), 0.94 (0.92 to 0.95) and 0.9012 were corresponding in PCR subgroup of studies. The methods based on saliva displayed good prospects to be an alternative ways for malaria diagnosis and, attributing to their noninvasive sampling, will be welcome worldwide particularly in the large epidemiological surveillance of community populations or asymptomatic people as malaria declined significantly. However, the techniques with much better efficacy and a standardized procedure of sampling and concentration are encouraged to be developed.

Keyword:Noninvasive; saliva; malaria diagnosis; PCR; ELISA; systematic review