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Developing and validating a clinical algorithm for the diagnosis of podoconiosis

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Developing and validating a clinical algorithm for the diagnosis of podoconiosis. / Deribe, Kebede; Florence, Lyndsey; Kelemework, Abebe et al.

In: Transactions of The Royal Society of Tropical Medicine and Hygiene, Vol. 114, No. 12, 01.12.2020, p. 916-925.

Research output: Contribution to Journal/MagazineJournal articlepeer-review

Harvard

Deribe, K, Florence, L, Kelemework, A, Getaneh, T, Tsegay, G, Cano, J, Giorgi, E, Newport, MJ & Davey, G 2020, 'Developing and validating a clinical algorithm for the diagnosis of podoconiosis', Transactions of The Royal Society of Tropical Medicine and Hygiene, vol. 114, no. 12, pp. 916-925. https://doi.org/10.1093/trstmh/traa074

APA

Deribe, K., Florence, L., Kelemework, A., Getaneh, T., Tsegay, G., Cano, J., Giorgi, E., Newport, M. J., & Davey, G. (2020). Developing and validating a clinical algorithm for the diagnosis of podoconiosis. Transactions of The Royal Society of Tropical Medicine and Hygiene, 114(12), 916-925. https://doi.org/10.1093/trstmh/traa074

Vancouver

Deribe K, Florence L, Kelemework A, Getaneh T, Tsegay G, Cano J et al. Developing and validating a clinical algorithm for the diagnosis of podoconiosis. Transactions of The Royal Society of Tropical Medicine and Hygiene. 2020 Dec 1;114(12):916-925. Epub 2020 Nov 11. doi: 10.1093/trstmh/traa074

Author

Deribe, Kebede ; Florence, Lyndsey ; Kelemework, Abebe et al. / Developing and validating a clinical algorithm for the diagnosis of podoconiosis. In: Transactions of The Royal Society of Tropical Medicine and Hygiene. 2020 ; Vol. 114, No. 12. pp. 916-925.

Bibtex

@article{2a3560056b4a48568b423ce4f3edc38e,
title = "Developing and validating a clinical algorithm for the diagnosis of podoconiosis",
abstract = "BackgroundDifficulties 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.MethodsWe 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.ResultsBased 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).ConclusionsWe 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.",
keywords = "diagnosis, clinical algorithm, clinical decision algorithms, Ethiopia, lymphoedema, podoconiosis",
author = "Kebede Deribe and Lyndsey Florence and Abebe Kelemework and Tigist Getaneh and Girmay Tsegay and Jorge Cano and Emanuele Giorgi and Newport, {Melanie J.} and Gail Davey",
year = "2020",
month = dec,
day = "1",
doi = "10.1093/trstmh/traa074",
language = "English",
volume = "114",
pages = "916--925",
journal = "Transactions of The Royal Society of Tropical Medicine and Hygiene",
issn = "0035-9203",
publisher = "Oxford University Press Inc",
number = "12",

}

RIS

TY - JOUR

T1 - Developing and validating a clinical algorithm for the diagnosis of podoconiosis

AU - Deribe, Kebede

AU - Florence, Lyndsey

AU - Kelemework, Abebe

AU - Getaneh, Tigist

AU - Tsegay, Girmay

AU - Cano, Jorge

AU - Giorgi, Emanuele

AU - Newport, Melanie J.

AU - Davey, Gail

PY - 2020/12/1

Y1 - 2020/12/1

N2 - BackgroundDifficulties 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.MethodsWe 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.ResultsBased 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).ConclusionsWe 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.

AB - BackgroundDifficulties 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.MethodsWe 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.ResultsBased 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).ConclusionsWe 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.

KW - diagnosis

KW - clinical algorithm

KW - clinical decision algorithms

KW - Ethiopia

KW - lymphoedema

KW - podoconiosis

U2 - 10.1093/trstmh/traa074

DO - 10.1093/trstmh/traa074

M3 - Journal article

VL - 114

SP - 916

EP - 925

JO - Transactions of The Royal Society of Tropical Medicine and Hygiene

JF - Transactions of The Royal Society of Tropical Medicine and Hygiene

SN - 0035-9203

IS - 12

ER -