Evaluating diagnostic indicators of urogenital Schistosoma haematobium infection in young women: A cross sectional study in rural South Africa
Autor: | Hashini Nilushika Galappaththi-Arachchige, Sigve Holmen, Patricia D. Ndhlovu, Artemis Koukounari, Lisette van Lieshout, Eyrun Floerecke Kjetland, Birgitte J. Vennervald, Motshedisi Sebitloane, Myra Taylor, Svein Gunnar Gundersen, Pavitra Pillay, Elisabeth Kleppa |
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Přispěvatelé: | Knight, Matty |
Rok vydání: | 2018 |
Předmět: |
Rural Population
Physiology Cross-sectional study lcsh:Medicine Artificial Gene Amplification and Extension Urine Polymerase Chain Reaction Gastroenterology Schistosomiasis haematobia South Africa 0302 clinical medicine Medicine and Health Sciences Schistosomiasis 030212 general & internal medicine lcsh:Science qy_185 Schistosoma haematobium Multidisciplinary biology Eukaryota wc_810 Latent class model Body Fluids 3. Good health Helminth Infections qx_355 Schistosoma Female Anatomy Research Article Neglected Tropical Diseases Adult medicine.medical_specialty Adolescent Urogenital Schistosomiasis Imaging Techniques Urology 030231 tropical medicine Image Analysis Research and Analysis Methods Sensitivity and Specificity Young Adult 03 medical and health sciences Diagnostic Medicine Helminths Internal medicine parasitic diseases Parasitic Diseases medicine Humans Animals Sex organ Molecular Biology Techniques Molecular Biology Incontinence business.industry Genitourinary system lcsh:R Organisms Biology and Life Sciences Gold standard (test) Tropical Diseases biology.organism_classification wj_20 Invertebrates Schistosoma Haematobium Cross-Sectional Studies lcsh:Q business |
Zdroj: | PLoS ONE PLoS ONE, Vol 13, Iss 2, p e0191459 (2018) 13:e0191459 PLoS ONE, 13(2) Galappaththi-Arachchige, H N, Holmen, S, Koukounari, A, Kleppa, E, Pillay, P, Sebitloane, M, Ndhlovu, P, van Lieshout, L, Vennervald, B J, Gundersen, S G, Taylor, M & Kjetland, E F 2018, ' Evaluating diagnostic indicators of urogenital Schistosoma haematobium infection in young women: A cross sectional study in rural South Africa ', PLOS ONE, vol. 13, no. 2, 0191459 . https://doi.org/10.1371/journal.pone.0191459 |
ISSN: | 1932-6203 |
DOI: | 10.1371/journal.pone.0191459 |
Popis: | BackgroundUrine microscopy is the standard diagnostic method for urogenital S. haematobium infection. However, this may lead to under-diagnosis of urogenital schistosomiasis, as the disease may present itself with genital symptoms in the absence of ova in the urine. Currently there is no single reliable and affordable diagnostic method to diagnose the full spectrum of urogenital S. haematobium infection. In this study we explore the classic indicators in the diagnosis of urogenital S. haematobium infection, with focus on young women.MethodsIn a cross-sectional study of 1237 sexually active young women in rural South Africa, we assessed four diagnostic indicators of urogenital S. haematobium infection: microscopy of urine, polymerase chain reaction (PCR) of cervicovaginal lavage (CVL), urogenital symptoms, and sandy patches detected clinically in combination with computerised image analysis of photocolposcopic images. We estimated the accuracy of these diagnostic indicators through the following analyses: 1) cross tabulation (assumed empirical gold standard) of the tests against the combined findings of sandy patches and/or computerized image analysis and 2) a latent class model of the four indicators without assuming any gold standard.ResultsThe empirical approach showed that urine microscopy had a sensitivity of 34.7% and specificity of 75.2% while the latent class analysis approach (LCA) suggested a sensitivity of 81.0% and specificity of 85.6%. The empirical approach and LCA showed that Schistosoma PCR in CVL had low sensitivity (14.1% and 52.4%, respectively) and high specificity (93.0% and 98.0, respectively). Using LCA, the presence of sandy patches showed a sensitivity of 81.6 and specificity of 42.4%. The empirical approach and LCA showed that urogenital symptoms had a high sensitivity (89.4% and 100.0%, respectively), whereas specificity was low (10.6% and 12.3%, respectively).ConclusionAll the diagnostic indicators used in the study had limited accuracy. Using urine microscopy or Schistosoma PCR in CVL would only confirm a fraction of the sandy patches found by colposcopic examination. |
Databáze: | OpenAIRE |
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