Does nerve examination improve diagnostic efficacy of the WHO classification of leprosy?
| Autor: | Aurpit Patnaik, Oommen John, P S S Rao, Ruchika Chandna Mehndiratta |
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| Rok vydání: | 2008 |
| Předmět: |
Slit skin smear
Adult Male medicine.medical_specialty Adolescent Physical examination Dermatology World Health Organization Sensitivity and Specificity Young Adult Leprosy lcsh:Dermatology medicine Humans Nerve Tissue Child Aged Skin Diagnosis of leprosy Aged 80 and over World Health Organization criteria medicine.diagnostic_test business.industry Nerve enlargement Reproducibility of Results lcsh:RL1-803 Middle Aged medicine.disease Slit Surgery Mycobacterium leprae Infectious Diseases PB leprosy Who criteria Female Radiology business Who classification Skin lesion |
| Zdroj: | Indian Journal of Dermatology, Venereology and Leprology, Vol 74, Iss 4, Pp 327-330 (2008) |
| ISSN: | 0973-3922 |
| Popis: | Background: In the year 1998 WHO proposed that the clinical criteria of counting skin lesions alone should decide whether a patient receives Multibacillary (MB) or Paucibacillary (PB) MDT. There is a concern that a significant number of patients may be incorrectly treated under these guidelines. Aims: This study aims to determine whether the sensitivity and the specificity of the latest WHO criteria, can be enhanced by the addition of nerve examination in the place of slit skin smears. Methods: 150 patients of untreated leprosy reporting at a TLM Hospital in Delhi from January to December 2006 were registered for the study. After physical examination, the number of skin lesions and nerves involved were counted and slit skin smears performed. Two groups were created, those with > 5 skin lesions, and those with 5 or less skin lesions. The diagnostic efficacy of the current WHO classification was calculated with and without the addition of nerve examination. Results: The sensitivity and the specificity of the current WHO operational classification are 76.6%, and 73.7% respectively, using slit skin smear as a standard. When the number of nerves was added to the diagnosis, the sensitivity increased to 94.4%, for more than 5 lesions and to 90.9%, for five or less than five lesions. Conclusions: Nerve examination can significantly improve the sensitivity of the WHO criterion in determination of MB versus PB leprosy. |
| Databáze: | OpenAIRE |
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