The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemic
dc.contributor.author | Opio, Christopher K. | |
dc.contributor.author | Rejani, Lalitha | |
dc.contributor.author | Kazibwe, Francis | |
dc.contributor.author | Ocama, Ponsiano | |
dc.date.accessioned | 2022-05-01T21:12:31Z | |
dc.date.available | 2022-05-01T21:12:31Z | |
dc.date.issued | 2019 | |
dc.description.abstract | Variceal upper gastrointestinal bleeding (UGIB) is common in sub-Saharan Africa (SSA). However, poor access to endoscopy services precludes the diagnosis of varices. Objectives: We determined the diagnostic accuracy of routine clinical findings for detection of esophageal varices among patients with UGIB in rural SSA where schistosomiasis is endemic. Methods: We 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. Results: We 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). Conclusion: Where access to endoscopy is limited, routine clinical findings could improve the diagnosis of patients with UGIB in Africa. | en_US |
dc.identifier.citation | Opio CK, Rejani L, Kazibwe F, Ocama P. The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemic. Afri Health Sci.2019;19(4):3225-3234.https://dx.doi.org/10.4314/ahs. v19i4.46 | en_US |
dc.identifier.uri | https://dx.doi.org/10.4314/ahs. v19i4.46 | |
dc.identifier.uri | https://nru.uncst.go.ug/handle/123456789/3101 | |
dc.language.iso | en | en_US |
dc.publisher | African health sciences | en_US |
dc.subject | Diagnostic accuracy | en_US |
dc.subject | Clinical findings | en_US |
dc.subject | Esophageal varices | en_US |
dc.subject | Rural sub-Saharan Africa | en_US |
dc.title | The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemic | en_US |
dc.type | Article | en_US |
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