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Developing and validating a clinical algorithm for the diagnosis of podoconiosis
Version 2 2023-06-07, 08:55
Version 1 2023-06-07, 07:41
journal contribution
posted on 2023-06-07, 08:55 authored by Kebede Kassaye, Lyndsey Florence, Abebe Kelemework, Tigist Getaneh, Girmay Tsegay, Jorge Cano, Emanuele Giorgi, Melanie NewportMelanie Newport, Gail DaveyGail DaveyBackground Difficulties in reliably diagnosing podoconiosis have severely limited the scale-up and uptake of the World Health Organization–recommended morbidity management and disability prevention interventions for affected people. We aimed to identify a set of clinical features that, combined into an algorithm, allow for diagnosis of podoconiosis. Methods We identified 372 people with lymphoedema and administered a structured questionnaire on signs and symptoms associated with podoconiosis and other potential causes of lymphoedema in northern Ethiopia. All individuals were tested for Wuchereria bancrofti–specific immunoglobulin G4 in the field using Wb123. Results Based on expert diagnosis, 344 (92.5%) of the 372 participants had podoconiosis. The rest had lymphoedema due to other aetiologies. The best-performing set of symptoms and signs was the presence of moss on the lower legs and a family history of leg swelling, plus the absence of current or previous leprosy, plus the absence of swelling in the groin, plus the absence of chronic illness (such as diabetes mellitus or heart or kidney diseases). The overall sensitivity of the algorithm was 91% (95% confidence interval [CI] 87.6 to 94.4) and specificity was 95% (95% CI 85.45 to 100). Conclusions We developed a clinical algorithm of clinical history and physical examination that could be used in areas suspected or endemic for podoconiosis. Use of this algorithm should enable earlier identification of podoconiosis cases and scale-up of interventions.
Funding
The Global Atlas of Podoconiosis; G1974; WELLCOME TRUST; 201900/Z/16/Z
History
Publication status
- Published
File Version
- Published version
Journal
Transactions of the Royal Society of Tropical Medicine and HygieneISSN
0035-9203Publisher
Oxford University PressExternal DOI
Issue
12Volume
114Page range
916-925Department affiliated with
- Global Health and Infection Publications
Full text available
- No
Peer reviewed?
- Yes
Legacy Posted Date
2020-08-04First Open Access (FOA) Date
2020-11-16First Compliant Deposit (FCD) Date
2020-08-03Usage metrics
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