Screening for HIV-Associated Peripheral Neuropathy in Resource-Limited Settings
Identifieur interne : 002307 ( Ncbi/Curation ); précédent : 002306; suivant : 002308Screening for HIV-Associated Peripheral Neuropathy in Resource-Limited Settings
Auteurs : Deanna Cettomai [États-Unis] ; Judith K. Kwasa [Kenya] ; Gretchen L. Birbeck [Zambie] ; Richard W. Price [États-Unis] ; Craig R. Cohen [États-Unis] ; Elizabeth A. Bukusi ; Mmed Ob Gyn [Kenya] ; Caroline Kendi [Kenya] ; Ana-Claire L. Meyer [États-Unis]Source :
- Muscle & nerve [ 0148-639X ] ; 2013.
Abstract
Peripheral neuropathy is the most common neurological complication of HIV but is widely under-diagnosed in resource-limited settings. We investigated the utility of screening tools administered by non-physician health care workers (HCW) and quantitative sensory testing (QST) administered by trained individuals for identification of moderate/severe neuropathy.
We enrolled 240 HIV-infected outpatients using two-stage cluster randomized sampling. HCWs administered the several screening tools. Trained study staff performed QST. Tools were validated against a clinical diagnosis of neuropathy.
Participants were 65% women, mean age 36.4 years, median CD4 324 cells/μL. 65% were taking antiretrovirals, and 18% had moderate/severe neuropathy. The screening tests were 76% sensitive in diagnosing moderate/severe neuropathy with negative predictive values of 84–92%. QST was less sensitive but more specific.
Screening tests administered by HCW have excellent negative predictive values and are promising tools for scale-up in resource-limited settings. QST shows promise for research use.
Url:
DOI: 10.1002/mus.23795
PubMed: 24037693
PubMed Central: 4019398
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>INTRODUCTION</title>
<p id="P1">Peripheral neuropathy is the most common neurological complication of HIV but is widely under-diagnosed in resource-limited settings. We investigated the utility of screening tools administered by non-physician health care workers (HCW) and quantitative sensory testing (QST) administered by trained individuals for identification of moderate/severe neuropathy.</p>
</sec>
<sec id="S2"><title>METHODS</title>
<p id="P2">We enrolled 240 HIV-infected outpatients using two-stage cluster randomized sampling. HCWs administered the several screening tools. Trained study staff performed QST. Tools were validated against a clinical diagnosis of neuropathy.</p>
</sec>
<sec id="S3"><title>RESULTS</title>
<p id="P3">Participants were 65% women, mean age 36.4 years, median CD4 324 cells/μL. 65% were taking antiretrovirals, and 18% had moderate/severe neuropathy. The screening tests were 76% sensitive in diagnosing moderate/severe neuropathy with negative predictive values of 84–92%. QST was less sensitive but more specific.</p>
</sec>
<sec id="S4"><title>DISCUSSION</title>
<p id="P4">Screening tests administered by HCW have excellent negative predictive values and are promising tools for scale-up in resource-limited settings. QST shows promise for research use.</p>
</sec>
</div>
</front>
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