Browsing by Author "Tukahebwa, Edridah M."
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Item Field Evaluation of the Meade Readiview Handheld MicroscopeFor Diagnosis of Intestinal Schistosomiasis in Ugandan School Children(The American Society of Tropical Medicine and Hygiene, 2005) Russell Stothard, J.; Kabatereine, Narcis B.; Tukahebwa, Edridah M.; Kazibwe, Francis; Mathieson, William; P. Webster, Joanne; Fenwick, AlanA novel, inexpensive handheld microscope, the Meade Readiview, was evaluated for field diagnosis of intestinal schistosomiasis by comparison of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) against conventional compound microscopy as part of a parasitologic survey in nine sentinel schools and a rapid mapping survey across 22 schools in Uganda. Fecal smears from 685 primary school children were examined and the overall prevalence of Schistosoma mansoni was 45%. However, prevalence by school ranged widely from 0% to 100%. For individual diagnosis the Readiview had a sensitivity of 85%, a specificity of 96%, a PPV of 95%, and an NPV of 88%. Due to the poorer movement control of the glass slide on the Readiview stage, fecal smears with less than four eggs could be overlooked. At the highest magnification (160×), egg-like objects could be confounding. Estimating prevalence by school was usually within ± 7% of that of conventional microscopy. Since the Readiview is more robust and portable, both in size and weight, and one-tenth as expensive as the traditional compound microscope, a change in the logistics and costs associated with field infection surveillance is possible. This inexpensive microscope is a pragmatic alternative to the compound microscope. It could play an important role in the collection of prevalence data to better guide anthelmintic drug delivery and also empower the diagnostic capacity of peripheral health centers where compound microscopes are few or absent.Item Morbidity due to Schistosoma mansoni: an epidemiological assessment of distended abdomen syndrome in Ugandan school children with observations before and 1-year after anthelminthic chemotherapy(Transactions of the Royal Society of Tropical Medicine and Hygiene, 2006-06) Balena, Julie; Stotharda, J. Russell; Kabatereine, Narcis B.; Tukahebwa, Edridah M.; Kazibwee, Francis; Whawell, Sarah; Webster, Joanne P.; Utzinger, J¨urg; Fenwick, AlanSummary: The objectives of this study were to determine the prevalence and distribution of distended abdomens among Ugandan school children across a range of eco-epidemiological settings and to investigate the relationship between distended abdomens and helminth infections, in particular Schistosoma mansoni, before and 1-year after anthelminthic treatment. A cross-sectional survey was conducted on 4354 school children across eight districts, with a longitudinal 1-year follow-up of 2644 children (60.7%). On both occasions, parasitological,biometrical and clinical data were collected for each child. Baseline prevalence of S. mansoni and hookworms was 44.3% and 51.8%, respectively. Distended abdomens, defined as an abdominal circumference ratio (ACR) >1.05, were observed in 2.5% of the sampled children,several of whom presented with particularly severe distensions necessitating hospital referral.ACR scores were highly overdispersed between districts and schools. Multivariate regression analysis revealed that S. mansoni infection accounted for only a small fraction of ACR variation,suggesting that either single point prevalence and intensity measures failed to reflectthis more chronically evolved morbidity and/or that other interacting factors were involved,