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Is ultrasonography useful for population studies on schistosomiasis mansoni? An evaluation based on a survey on a population from Kome Island, Tanzania

Journal article
Authors Mats Asztely
Bo Eriksson
Reverianus M Gabone
Lars-Åke Nilsson
Published in Acta Radiologica Open
Volume 5
Issue 12
Pages 8
ISSN 2058-4601
Publication year 2016
Published at Institute of Biomedicine, Department of Microbiology and Immunology
Institute of Clinical Sciences, Department of Radiology
Institute of Medicine, Department of Public Health and Community Medicine, Health Metrics
Pages 8
Language en
Links dx.doi.org/10.1177/2058460116686392
Keywords Schistosoma mansoni,ultrasonography,in-service training,mass screening,estimation reliability,population survey
Subject categories Diagnostic radiology, Immunology in the medical area, Microbiology in the medical area, Biostatistics

Abstract

BackgroundObservation of characteristic alterations at liver ultrasonography in clinical schistosomiasis mansoni cases has initiated utilization of this examination method in population surveys in areas where this disease is endemic.PurposeTo present results of liver ultrasonography and their relation to epidemiological data of a population in an area endemic for S. mansoni, to estimate the precision of classification of periportal anatomy changes known as periportal fibrosis (PPF), and to evaluate the relevance of ultrasonography in epidemiological studies on S. mansoni.Material and MethodsA total of 459 inhabitants on Kome Island, Lake Victoria, Tanzania were examined by ultrasound with image documentation by locally trained personnel. A subsample of this population, 116 individuals, was subject to ultrasonography by two examiners independently. Separately, the images were classified for PPF according to the Managil protocol, twice for the subsample.ResultsPPF could be classified for 458 individuals; 64% and 36% were classified as I or II, respectively; none was classified as 0; only one as III. Results were similar for the subsample examined twice. Comparing the two separate classifications of all 232 sets of images of the subsample gave a Kappa (K) value of 0.50. When comparing the classifications of each of the two different examinations of the same individuals of the subsample, K values of 0.29 and 0.34 for the first and second classification, respectively, were obtained.ConclusionUltrasonography does not appear to correlate well with disease stage. Presently, it should not be utilized for staging of schistosoma mansoni-related liver damage in population surveys.

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