Evaluating diagnostic indicators of urogenital Schistosoma haematobium infection in young women: A cross sectional study in rural South Africa.
Evaluating diagnostic indicators of urogenital Schistosoma haematobium infection in young women: A cross sectional study in rural South Africa.
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DOI：
10.1371/journal.pone.0191459
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Kjetland EF
中科院分区：
文献类型：
--
作者：
Galappaththi-Arachchige HN;Holmen S;Koukounari A;Kleppa E;Pillay P;Sebitloane M;Ndhlovu P;van Lieshout L;Vennervald BJ;Gundersen SG;Taylor M;Kjetland EF
尿液显微镜检查是泌尿生殖道埃及沙门氏菌感染的标准诊断方法。然而，这可能导致泌尿生殖系统血吸虫病的诊断不足，因为在尿液中没有卵子的情况下，该疾病可能会出现生殖器症状。目前还没有单一可靠且负担得起的诊断方法来诊断泌尿生殖道埃及沙门氏菌感染的全谱。在本研究中，我们探讨了诊断泌尿生殖道沙门氏菌感染的经典指标，重点关注年轻女性。在一项针对南非农村地区 1237 名性活跃的年轻女性的横断面研究中，我们评估了泌尿生殖道埃及沙门氏菌感染的四种诊断指标：尿液显微镜检查、宫颈阴道灌洗液 (CVL) 的聚合酶链反应 (PCR)、泌尿生殖道症状和临床检测到的沙斑，并结合阴道镜图像的计算机图像分析。我们通过以下分析估计了这些诊断指标的准确性：1）根据沙斑和/或计算机图像分析的综合结果进行测试的交叉制表（假设经验黄金标准），2）四个指标的潜在类别模型，不假设任何黄金标准。经验方法显示尿液显微镜检的敏感性为 34.7%，特异性为 75.2%，而潜在类别分析方法 (LCA) 的敏感性为 81.0%，特异性为 85.6%。经验方法和LCA表明，CVL中血吸虫PCR的敏感性较低（分别为14.1％和52.4％），而特异性较高（分别为93.0％和98.0）。使用 LCA，沙斑的存在显示出 81.6 的敏感性和 42.4% 的特异性。经验方法和 LCA 显示泌尿生殖系统症状的敏感性较高（分别为 89.4% 和 100.0%），而特异性较低（分别为 10.6% 和 12.3%）。研究中使用的所有诊断指标的准确性都有限。在 CVL 中使用尿液显微镜检查或血吸虫 PCR 只能确认阴道镜检查发现的一小部分沙斑。
Urine 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. In 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. The 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). All 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.
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DOI：
10.4269/ajtmh.2011.11-0135
发表时间：
2011-12-01
影响因子：
3.3
作者：
Jourdan, Peter Mark;Holmen, Sigve Dhondup;Kjetland, Eyrun Floerecke
通讯作者：
Kjetland, Eyrun Floerecke
影响因子：
3.8
作者：
Hegertun, Ingrid Elise Amlie;Gundersen, Kristin Marie Sulheim;Kjetland, Eyrun Floerecke
通讯作者：
Kjetland, Eyrun Floerecke
影响因子：
--
作者：
Obeng, B. B.;Aryeetey, Y. A.;van Lieshout, L.
通讯作者：
van Lieshout, L.
DOI：
10.1046/j.1365-3156.1997.d01-209.x
发表时间：
1997-12-01
影响因子：
3.3
作者：
Ansell, J;Guyatt, H;Bundy, D
通讯作者：
Bundy, D
影响因子：
1.9
作者：
Pillay P;van Lieshout L;Taylor M;Sebitloane M;Zulu SG;Kleppa E;Roald B;Kjetland EF
通讯作者：
Kjetland EF