. Author manuscript; available in PMC: 2020 Aug 1.

Published in final edited form as: Lancet Infect Dis. 2020 Feb;20(2):e27–e37. doi: 10.1016/S1473-3099(19)30629-2

Table 2:

Inclusion and exclusion criteria for full text review

Outcome	Criterion
Inclusion:	• Febrile population (≥ 2 people with a fever, defined as body temperature ≥ 38·0°C) • Diagnosis of one or more zoonotic pathogens from pre-defined reference list of eligible aetiological agents (table 1) • Diagnostic test criteria: i) Culture of the pathogen from sample(s) collected from a febrile person ii) Direct detection of the pathogen (e.g., by PCR based techniques) from sample(s) collected from a febrile person iii) Serological diagnosis of acute infection based on testing of both acute and convalescent phase serum samples and demonstration of seroconversion iv) Diagnosis of acute infection based on detection of pathogen-specific antibody or antigens in a single serum sample only for selected pathogens, for which widely accepted case definitions deemed pathogen-specific antibody or antigen detection sufficiently accurate¹ v) IgM detection in cerebrospinal fluid (CSF) for selected pathogens for which widely accepted case definitions include IgM detection in CSF²
Exclusion:	• Failure to meet inclusion criteria described above • Lack of study detail e.g., number of people tested for each pathogen • Negative diagnostic test results in all patients • Study designed to evaluate diagnostic test and/or vaccine performance without presenting novel data on number or proportion of patients diagnosed with a study pathogen from a previously described population of febrile people. • Study described as a group of ≥ 2 people principally classified based on a shared (100% frequency) aetiological diagnosis. • Review

Outcome

Criterion

Inclusion:

• Febrile population (≥ 2 people with a fever, defined as body temperature ≥ 38·0°C)
• Diagnosis of one or more zoonotic pathogens from pre-defined reference list of eligible aetiological agents (table 1)
• Diagnostic test criteria:
i) Culture of the pathogen from sample(s) collected from a febrile person
ii) Direct detection of the pathogen (e.g., by PCR based techniques) from sample(s) collected from a febrile person
iii) Serological diagnosis of acute infection based on testing of both acute and convalescent phase serum samples and demonstration of seroconversion
iv) Diagnosis of acute infection based on detection of pathogen-specific antibody or antigens in a single serum sample only for selected pathogens, for which widely accepted case definitions deemed pathogen-specific antibody or antigen detection sufficiently accurate¹
v) IgM detection in cerebrospinal fluid (CSF) for selected pathogens for which widely accepted case definitions include IgM detection in CSF²

Exclusion:

• Failure to meet inclusion criteria described above
• Lack of study detail e.g., number of people tested for each pathogen
• Negative diagnostic test results in all patients
• Study designed to evaluate diagnostic test and/or vaccine performance without presenting novel data on number or proportion of patients diagnosed with a study pathogen from a previously described population of febrile people.
• Study described as a group of ≥ 2 people principally classified based on a shared (100% frequency) aetiological diagnosis.
• Review

The following met study criteria for valid diagnostics for pathogen detection based on single sera only: Leptospira spp. agglutination titer of ≥ 800 by microscopic agglutination test in one serum specimen ²⁶; detection of Hantavirus-specific IgM in a serum sample ²⁷; detection of virus-specific IgM antibodies in serum with confirmatory virus-specific neutralizing antibodies for Eastern equine encephalitis virus (EEEV), West Nile virus (WNV), Western equine encephalitis virus (WEEV), and Venezuelan equine encephalitis virus (VEEV) ²⁸; identification of lyssavirus specific antibody by indirect fluorescent antibody test or complete rabies virus neutralization at 1:5 dilution in the serum of an unvaccinated person ²⁹; detection of viral antigens in blood by enzyme-linked immunosorbent assay for Ebola ^30,31, Marburg ^31,32, Lassa ^31,33, and Crimean-Congo haemorrhagic fever viruses ³¹; detection of Rift Valley fever antigens or IgM in blood by enzyme-linked Immunosorbent assay ³⁴; and

IgM detection in CSF was considered a valid diagnostic for EEEV, Japanese encephalitis virus (JEV), rabies virus, WEEV, WNV and VEEV ^28,29,35.