Screening for HIV-associated peripheral neuropathy in resource-limited settings
| Autor: | Cettomai, D, Kwasa, JK, Birbeck, GL, Price, RW, Cohen, CR, Bukusi, EA, Kendi, C, Meyer, ACL |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Health Personnel education HIV Infections Neurodegenerative Severity of Illness Index Sensitivity and Specificity Medical and Health Sciences Random Allocation Predictive Value of Tests Clinical Research Surveys and Questionnaires Humans Mass Screening Developing Countries Peripheral Neuropathy screening and diagnosis Neurology & Neurosurgery Prevention Pain Research Neurosciences Peripheral Nervous System Diseases HIV Middle Aged Health Services screening tools CD4 Lymphocyte Count Detection Infectious Diseases Anti-Retroviral Agents HIV/AIDS Female Chronic Pain Infection 4.2 Evaluation of markers and technologies |
| Zdroj: | Muscle & nerve, vol 48, iss 4 Cettomai, D; Kwasa, JK; Birbeck, GL; Price, RW; Cohen, CR; Bukusi, EA; et al.(2013). Screening for HIV-associated peripheral neuropathy in resource-limited settings. Muscle and Nerve, 48(4), 516-524. doi: 10.1002/mus.23795. UC San Francisco: Retrieved from: http://www.escholarship.org/uc/item/7n94m5zz |
| Popis: | Introduction: Peripheral neuropathy is the most common neurological complication of human immunodeficiency virus (HIV) infection but is widely under-diagnosed in resource-limited settings. We investigated the utility of screening tools administered by nonphysician healthcare workers (HCW) and quantitative sensory testing (QST) administered by trained individuals for identification of moderate/severe neuropathy. Methods: We enrolled 240 HIV-infected outpatients using 2-stage cluster randomized sampling. HCWs administered the several screening tools. Trained study staff performed QST. Tools were validated against a clinical diagnosis of neuropathy. Results: Participants were 65% women, mean age 36.4 years, median CD4 324 cells/μL. A total of 65% were taking antiretrovirals, and 18% had moderate/severe neuropathy. The screening tests were 76% sensitive in diagnosing moderate/severe neuropathy with negative predictive values of 84-92%. QST was less sensitive but more specific. Conclusions: Screening tests administered by HCW have excellent negative predictive values and are promising tools for scale-up in resource-limited settings. QST shows promise for research use. © 2013 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
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