| Autor: |
Barreto, Ana V M S, Domingues, Ana L C, Diniz, George T N, Cavalcanti, Ana M S, Lopes, Edmundo P, Montenegro, Silvia M L, Morais, Clarice N L |
| Předmět: |
|
| Zdroj: |
Transactions of the Royal Society of Tropical Medicine & Hygiene; Jan2022, Vol. 116 Issue 1, p19-25, 7p |
| Abstrakt: |
Background Periportal fibrosis (PPF) is the major pathological consequence of Schistosoma mansoni infection. The Coutinho index—the alkaline phosphatase (ALP) to platelet ratio ([ALP/upper limit of normality {ULN}]/platelet count [106/L] x 100)—was validated. Validation consisted of modest laboratory tests to predict advanced PPF. Methods A total of 378 individuals from an endemic area of Brazil with a previous history of the disease and/or a positive parasitological examination were evaluated. We used ultrasound examination as the gold standard for classification of the PPF pattern and measured the biological markers of the index. Results Forty-one individuals (10.8%) without PPF, 291 (77%) with moderate PPF and 46 (12.2%) with advanced PPF, were identified. ALP and platelet count were used for the index. The cut-off point ≥0.228 predicted the presence of fibrosis with an area under the receiver operating characteristic curve (AUROC) of 0.56, sensitivity of 68.6% and specificity of 46.3%. There was an absence of PPF in 46.3% of individuals without fibrosis and the presence of PPF in 68.5% of cases with moderate and advanced ultrasound fibrosis. The identification of advanced fibrosis with a cut-off point ≥0.316 revealed an AUROC curve of 0.70, sensitivity of 67.4% and specificity of 68.3%, thus confirming the advanced phase in 65.2% of cases compared with ultrasound. Conclusion The Coutinho index was able to predict advanced PPF in most individuals. It is valid as a new tool, uses routine laboratory tests and therefore is more accessible for screening patients with a severe form of the disease in endemic areas. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
|
