The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemic

dc.contributor.authorFrancis, Kazibwe et.al
dc.date.accessioned2022-05-24T15:26:43Z
dc.date.available2022-05-24T15:26:43Z
dc.date.issued2019
dc.descriptionJournal of The diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemicen_US
dc.description.abstractBackground: 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 pa tients 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 accu racy. 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 trans fusion, 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.description.sponsorshipfunded through an educational research grant from the Programmatic Award: Medical Education for Services to All Ugandans. http://www.fic.nih.gov/Grants/Search/Pages/ME PI-R24TW008886.aspxen_US
dc.identifier.otherdoi.org/10.4314/ahs.v19i4.46
dc.identifier.urihttps://ir.bsu.ac.ug//handle/20.500.12284/232
dc.language.isoenen_US
dc.publisherAfrican Health Sciencesen_US
dc.subjectThe diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saha ran Africa where schistosomiasis is endemicen_US
dc.titleThe diagnostic accuracy of routine clinical findings for detection of esophageal varices in rural sub-Saharan Africa where schistosomiasis is endemicen_US
dc.typeArticleen_US

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