Diagnostic Accuracy of Real Time Reverse Transcriptase Polymerase Chain Reaction for Chikungunya Virus Detection: A Systematic Review and Meta-Analysis.

Publication date: Jul 15, 2026

Chikungunya virus (CHIKV) is an arbovirus that causes an acute febrile illness with intense muscle and joint pain, with the possibility of progressing to a chronic or neurological stage. We conducted a systematic review and meta-analysis with the aim of evaluating the accuracy of real-time reverse transcriptase polymerase chain reaction (RT-qPCR) protocols for detecting CHIKV during the acute phase of symptoms. We searched the literature until December 5, 2024, including English, Portuguese, and Spanish, with no time restriction in PubMed, LILACS, and Web of Science. Studies that evaluated RT-qPCR protocols compared to reference techniques such as viral isolation or validated RT-qPCRs were included in the study. We collected data on sensitivity, specificity, accuracy, study design and methodological characteristics of RT-qPCR. Quadas-2 tool was used to assess the risk of bias and applicability. Subsequently, a meta-analysis and meta-regression were performed. Twenty-eight protocols were included in this systematic review, 28 index tests were extracted and 24 were included in quantitative analysis. According to meta-analysis, RT-qPCR for CHIKV detection had a combined accuracy of 96% (95% CI: 94 to 99%) and a summary sensitivity and specificity of 99. 7% and 99. 7%, respectively; however, the results need to be interpreted considering the high heterogeneity (78. 1%) and publication bias (p = 0. 002). RT-qPCR is a highly accurate technique for detecting the Chikungunya virus during the acute phase of symptoms. Despite the high heterogeneity observed, all subgroup analyses demonstrated high overall performance.

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