ArticleAfrican health sciences2019
The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemic.
Article in African health sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 15 citations in OpenAlex.
- The diagnostic accuracy of triphasic abdominal CT in detecting esophageal varices.BMC medical imaging · 2024Article
- Diagnosis and Management of Esophagogastric Varices.Diagnostics (Basel, Switzerland) · 2023Review
- Hepatic schistosomiasis, upper gastrointestinal bleeding, and health related quality of life measurements from the Albert Nile Basin.Journal of patient-reported outcomes · 2021Article
- Praziquantel and Upper Gastrointestinal Bleeding in Hepatic Schistosomiasis: A Quasi-Experimental Study.Drugs - real world outcomes · 2021Article
- Patients with severe schistosomiasis mansoni in Ituri Province, Democratic Republic of the Congo.Infectious diseases of poverty · 2021Article
- NCD epidemic and sexual reproductive health issues in the infectious disease world.African health sciences · 2019Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundVariceal upper gastrointestinal bleeding (UGIB) is common in sub-Saharan Africa (SSA). However, poor access to endoscopy services precludes the diagnosis of varices.
objectivesWe determined the diagnostic accuracy of routine clinical findings for detection of esophageal varices among patients with UGIB in rural SSA where schistosomiasis is endemic.
methodsWe studied patients with a history of UGIB. The index tests included routine clinical findings and the reference test was diagnostic endoscopy. Multivariable regression with post-estimation provided measures of association and diagnostic accuracy.
resultsWe studied 107 participants with UGIB and 21% had active bleeding. One hundred and three (96%) had liver disease and 86(80%) varices. Factors associated with varices (p-value <0.05) were ≥ 4 lifetime episodes of UGIB, prior blood transfusion, splenomegaly, liver fibrosis, thrombocytopenia, platelet count spleen diameter ratio <909, and a dilated portal vein. Two models showed an overall diagnostic accuracy of > 90% in detection of varices with a number needed to misdiagnose of 13(number of patients who needed to be tested in order for one to be misdiagnosed by the test).
conclusionWhere access to endoscopy is limited, routine clinical findings could improve the diagnosis of patients with UGIB in Africa. The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemic.
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