Accuracy of rapid and near-patient diagnostics for detection of rift valley fever and Crimean-Congo haemorrhagic Fever infections: A systematic review and meta-analysis.

Abstract

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) and Rift Valley fever (RVF) are severe zoonotic viral diseases with overlapping clinical features, often leading to misdiagnosis. Rapid and near-patient diagnostics are vital for timely outbreak detection and response, especially in endemic and resource-limited settings. METHODS: A systematic review and meta-analysis followed PRISMA-DTA guidelines. Peer-reviewed and grey literature from 2008 to 2025 evaluating rapid diagnostics for CCHF and RVF were included. Data on sensitivity, specificity, analyte type, validation site, study population, and reference standards were extracted. Pooled estimates used a bivariate random-effects model. Protocol registered in PROSPERO (CRD420251148818). RESULTS: Seventeen studies were included; fourteen entered meta-analysis. RVFV diagnostics showed consistently high accuracy, while CCHFV assays had variable sensitivity. Most studies occurred outside endemic regions. CONCLUSION: Rapid and near-patient diagnostics demonstrate strong analytical accuracy, but limited field validation highlights the need for studies in endemic settings to guide implementation and outbreak detection.