Development and testing of a de novo clinical staging system for podoconiosis (endemic non-filarial elephantiasis)
Identifieur interne : 003996 ( Pmc/Checkpoint ); précédent : 003995; suivant : 003997Development and testing of a de novo clinical staging system for podoconiosis (endemic non-filarial elephantiasis)
Auteurs : Fasil Tekola ; Zewdu Ayele ; Dereje Hailemariam ; Claire Fuller ; Gail DaveySource :
- Tropical medicine & international health : TM & IH [ 1360-2276 ] ; 2008.
Abstract
Podoconiosis (endemic non-filarial elephantiasis) is a geochemical disease in individuals exposed to red-clay soil. Despite the prevalence and public health importance of podoconiosis, there is as yet no accepted clinical staging system.
We aimed to develop and test a robust clinical staging system for podoconiosis.
We adapted the Dreyer system for staging filarial lymphoedema and tested it in four re-iterative field tests conducted in an area of high podoconiosis prevalence in Southern Ethiopia. The system finally arrived at has five stages according to proximal spread of disease and presence of dermal nodules, ridges and bands. We measured the one-week repeatability and the inter-observer agreement of the final staging system.
We have developed a five-stage system that is readily understood by community workers with little health training. Kappa for one-week repeatability was 0.88 (95% CI 0.80 to 0.96), Kappa for agreement between health professionals was 0.71 (95% CI 0.60 to 0.82), while that between health professionals and community podoconiosis agents without formal health training averaged 0.64 (95% CI 0.52 to 0.78).
A simple staging system with good inter-observer agreement and repeatability has been developed to assist in the management and further study of podoconiosis.
Url:
DOI: 10.1111/j.1365-3156.2008.02133.x
PubMed: 18721188
PubMed Central: 2992944
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Development and testing of a de novo clinical staging system for podoconiosis (endemic non-filarial elephantiasis)</title><author><name sortKey="Tekola, Fasil" sort="Tekola, Fasil" uniqKey="Tekola F" first="Fasil" last="Tekola">Fasil Tekola</name></author><author><name sortKey="Ayele, Zewdu" sort="Ayele, Zewdu" uniqKey="Ayele Z" first="Zewdu" last="Ayele">Zewdu Ayele</name></author><author><name sortKey="Hailemariam, Dereje" sort="Hailemariam, Dereje" uniqKey="Hailemariam D" first="Dereje" last="Hailemariam">Dereje Hailemariam</name></author><author><name sortKey="Fuller, Claire" sort="Fuller, Claire" uniqKey="Fuller C" first="Claire" last="Fuller">Claire Fuller</name></author><author><name sortKey="Davey, Gail" sort="Davey, Gail" uniqKey="Davey G" first="Gail" last="Davey">Gail Davey</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18721188</idno><idno type="pmc">2992944</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992944</idno><idno type="RBID">PMC:2992944</idno><idno type="doi">10.1111/j.1365-3156.2008.02133.x</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">003A47</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003A47</idno><idno type="wicri:Area/Pmc/Curation">003A46</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">003A46</idno><idno type="wicri:Area/Pmc/Checkpoint">003996</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">003996</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Development and testing of a de novo clinical staging system for podoconiosis (endemic non-filarial elephantiasis)</title><author><name sortKey="Tekola, Fasil" sort="Tekola, Fasil" uniqKey="Tekola F" first="Fasil" last="Tekola">Fasil Tekola</name></author><author><name sortKey="Ayele, Zewdu" sort="Ayele, Zewdu" uniqKey="Ayele Z" first="Zewdu" last="Ayele">Zewdu Ayele</name></author><author><name sortKey="Hailemariam, Dereje" sort="Hailemariam, Dereje" uniqKey="Hailemariam D" first="Dereje" last="Hailemariam">Dereje Hailemariam</name></author><author><name sortKey="Fuller, Claire" sort="Fuller, Claire" uniqKey="Fuller C" first="Claire" last="Fuller">Claire Fuller</name></author><author><name sortKey="Davey, Gail" sort="Davey, Gail" uniqKey="Davey G" first="Gail" last="Davey">Gail Davey</name></author></analytic><series><title level="j">Tropical medicine & international health : TM & IH</title><idno type="ISSN">1360-2276</idno><idno type="eISSN">1365-3156</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec id="S1"><title>Background</title><p id="P3">Podoconiosis (endemic non-filarial elephantiasis) is a geochemical disease in individuals exposed to red-clay soil. Despite the prevalence and public health importance of podoconiosis, there is as yet no accepted clinical staging system.</p></sec><sec id="S2"><title>Objective</title><p id="P4">We aimed to develop and test a robust clinical staging system for podoconiosis.</p></sec><sec id="S3"><title>Methods</title><p id="P5">We adapted the Dreyer system for staging filarial lymphoedema and tested it in four re-iterative field tests conducted in an area of high podoconiosis prevalence in Southern Ethiopia. The system finally arrived at has five stages according to proximal spread of disease and presence of dermal nodules, ridges and bands. We measured the one-week repeatability and the inter-observer agreement of the final staging system.</p></sec><sec id="S4"><title>Results</title><p id="P6">We have developed a five-stage system that is readily understood by community workers with little health training. Kappa for one-week repeatability was 0.88 (95% CI 0.80 to 0.96), Kappa for agreement between health professionals was 0.71 (95% CI 0.60 to 0.82), while that between health professionals and community podoconiosis agents without formal health training averaged 0.64 (95% CI 0.52 to 0.78).</p></sec><sec id="S5"><title>Conclusions</title><p id="P7">A simple staging system with good inter-observer agreement and repeatability has been developed to assist in the management and further study of podoconiosis.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9610576</journal-id><journal-id journal-id-type="pubmed-jr-id">20323</journal-id><journal-id journal-id-type="nlm-ta">Trop Med Int Health</journal-id><journal-id journal-id-type="iso-abbrev">Trop. Med. Int. Health</journal-id><journal-title-group><journal-title>Tropical medicine & international health : TM & IH</journal-title></journal-title-group><issn pub-type="ppub">1360-2276</issn><issn pub-type="epub">1365-3156</issn></journal-meta><article-meta><article-id pub-id-type="pmid">18721188</article-id><article-id pub-id-type="pmc">2992944</article-id><article-id pub-id-type="doi">10.1111/j.1365-3156.2008.02133.x</article-id><article-id pub-id-type="manuscript">UKMS33376</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Development and testing of a de novo clinical staging system for podoconiosis (endemic non-filarial elephantiasis)</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Tekola</surname><given-names>Fasil</given-names></name><degrees>MPH</degrees><role>Research Fellow</role><aff id="A1">Brighton and Sussex Medical School, University of Sussex, Tel: +00251-911-12 60 43 Fax: +00251-16-627876<email>fasiltekola@yahoo.com</email></aff></contrib><contrib contrib-type="author"><name><surname>Ayele</surname><given-names>Zewdu</given-names></name><degrees>MD</degrees><role>Assistant Professor</role><aff id="A2">Department of Dermatovenereology, ALERT & Tikur Anbessa Hospitals, Addis Ababa, Tel: +00251-917-800610<email>zewduayele@yahoo.co.uk</email></aff></contrib><contrib contrib-type="author"><name><surname>HaileMariam</surname><given-names>Dereje</given-names></name><degrees>MD</degrees><role>General Practitioner</role><aff id="A3">Otona Hospital, Wolaita Sodo, Tel: +00251-911-054486,<email>dereje113@yahoo.com</email></aff></contrib><contrib contrib-type="author"><name><surname>Fuller</surname><given-names>Claire</given-names></name><degrees>FRCP</degrees><role>Consultant Dermatologist</role><aff id="A4">East Kent Hospitals NHS Trust, Tel: +0044-7973-187025,<email>claire.fuller@nhs.net</email></aff></contrib><contrib contrib-type="author"><name><surname>Davey</surname><given-names>Gail</given-names></name><degrees>MD</degrees><role>Associate Professor</role><aff id="A5">Department of Community Health, Addis Ababa University, Addis Ababa, Ethiopia, Tel: +00251-911-388835 Fax: +00251-16-627876,<email>nerurkar@ethionet.et</email></aff></contrib></contrib-group><author-notes><corresp id="CR1">(Corresponding Author) <email>nerurkar@ethionet.et</email></corresp><fn id="FN1"><p id="P1">Contributors.</p><p id="P2">Fasil Tekola coordinated repeatability data collection in the field, analyzed these data, drafted the paper and critically revised it. Zewdu Ayele helped develop the staging system in the field and critically revised the paper. Dereje HaileMariam assisted with repeatability data collection and critically revised the paper for substantial intellectual content. Claire Fuller revised and validated the staging system in the field. Gail Davey designed the study; obtained funding; supervised the field work; interpreted data; drafted the paper and critically revised it.</p></fn></author-notes><pub-date pub-type="nihms-submitted"><day>17</day><month>11</month><year>2010</year></pub-date><pub-date pub-type="epub"><day>20</day><month>8</month><year>2008</year></pub-date><pub-date pub-type="ppub"><month>10</month><year>2008</year></pub-date><pub-date pub-type="pmc-release"><day>29</day><month>11</month><year>2010</year></pub-date><volume>13</volume><issue>10</issue><fpage>1277</fpage><lpage>1283</lpage><abstract><title>Summary</title><sec id="S1"><title>Background</title><p id="P3">Podoconiosis (endemic non-filarial elephantiasis) is a geochemical disease in individuals exposed to red-clay soil. Despite the prevalence and public health importance of podoconiosis, there is as yet no accepted clinical staging system.</p></sec><sec id="S2"><title>Objective</title><p id="P4">We aimed to develop and test a robust clinical staging system for podoconiosis.</p></sec><sec id="S3"><title>Methods</title><p id="P5">We adapted the Dreyer system for staging filarial lymphoedema and tested it in four re-iterative field tests conducted in an area of high podoconiosis prevalence in Southern Ethiopia. The system finally arrived at has five stages according to proximal spread of disease and presence of dermal nodules, ridges and bands. We measured the one-week repeatability and the inter-observer agreement of the final staging system.</p></sec><sec id="S4"><title>Results</title><p id="P6">We have developed a five-stage system that is readily understood by community workers with little health training. Kappa for one-week repeatability was 0.88 (95% CI 0.80 to 0.96), Kappa for agreement between health professionals was 0.71 (95% CI 0.60 to 0.82), while that between health professionals and community podoconiosis agents without formal health training averaged 0.64 (95% CI 0.52 to 0.78).</p></sec><sec id="S5"><title>Conclusions</title><p id="P7">A simple staging system with good inter-observer agreement and repeatability has been developed to assist in the management and further study of podoconiosis.</p></sec></abstract><kwd-group><kwd>podoconiosis</kwd><kwd>non-filarial elephantiasis</kwd><kwd>agreement</kwd><kwd>repeatability</kwd><kwd>community worker</kwd><kwd>staging system</kwd></kwd-group><funding-group><award-group><funding-source country="United Kingdom">Wellcome Trust : </funding-source><award-id>079791 || WT</award-id></award-group></funding-group></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Ayele, Zewdu" sort="Ayele, Zewdu" uniqKey="Ayele Z" first="Zewdu" last="Ayele">Zewdu Ayele</name><name sortKey="Davey, Gail" sort="Davey, Gail" uniqKey="Davey G" first="Gail" last="Davey">Gail Davey</name><name sortKey="Fuller, Claire" sort="Fuller, Claire" uniqKey="Fuller C" first="Claire" last="Fuller">Claire Fuller</name><name sortKey="Hailemariam, Dereje" sort="Hailemariam, Dereje" uniqKey="Hailemariam D" first="Dereje" last="Hailemariam">Dereje Hailemariam</name><name sortKey="Tekola, Fasil" sort="Tekola, Fasil" uniqKey="Tekola F" first="Fasil" last="Tekola">Fasil Tekola</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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