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
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