Accuracy of Gram-stained Smears as Screening Tests for Neisseria gonorrhoeae: A Systematic Review and Meta-analysis

Background and Objective: A total of 86.9 million persons worldwide are infected with Neisseria gonorrhoeae (Ng). Although Gram-stained smears (GSS) provide a timeand cost-saving alternative to conventional laboratory tests, their global uptake partly depends on performance. This study aimed meta-analyze the diagnostic accuracy GSS screen for Ng. Materials Methods: literature search was conducted using MEDLINE (1980 2020). Studies were included if they employed detect Ng in humans compared results reference tests. Results: Eleven studies reviewed meta-analyzed stratified by specimen type (Gram-stained urethral endocervical, swabs urine smears.) test (culture method or NAAT). Sensitivity similarly high versus NAAT (93% [CI, 64% 99 %]) culture methods (87% 74% 94%]), followed (97% [95% CI, 86% 100%]) (81% 67% 90%]). Specificity also (98% 95% (94% 73% 99%]), 93% 99%]) (96% 78% 99%]). Conclusions: Data suggest that have highest when investigated against methods, accuracy, smears. Given convenience, quick turnaround time, may be useful expanding first-line screening