SidaSubSaharaV1, Ncbi, Merge, bibRecord, 002307

Screening for HIV-Associated Peripheral Neuropathy in Resource-Limited Settings

Identifieur interne : 002307 ( Ncbi/Merge ); précédent : 002306; suivant : 002308

Screening 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.

RBID : PMC:4019398

Abstract

INTRODUCTION

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.

METHODS

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.

RESULTS

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.

DISCUSSION

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:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019398

DOI: 10.1002/mus.23795
PubMed: 24037693
PubMed Central: 4019398

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<series><title level="j">Muscle & nerve</title>
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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>
</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">7803146</journal-id>
<journal-id journal-id-type="pubmed-jr-id">5975</journal-id>
<journal-id journal-id-type="nlm-ta">Muscle Nerve</journal-id>
<journal-id journal-id-type="iso-abbrev">Muscle Nerve</journal-id>
<journal-title-group><journal-title>Muscle & nerve</journal-title>
</journal-title-group>
<issn pub-type="ppub">0148-639X</issn>
<issn pub-type="epub">1097-4598</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">24037693</article-id>
<article-id pub-id-type="pmc">4019398</article-id>
<article-id pub-id-type="doi">10.1002/mus.23795</article-id>
<article-id pub-id-type="manuscript">NIHMS559920</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Screening for HIV-Associated Peripheral Neuropathy in Resource-Limited Settings</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Cettomai</surname>
<given-names>Deanna</given-names>
</name>
<degrees>MD, MHS</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kwasa</surname>
<given-names>Judith K.</given-names>
</name>
<degrees>MBChB, MMed</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Birbeck</surname>
<given-names>Gretchen L.</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Price</surname>
<given-names>Richard W.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cohen</surname>
<given-names>Craig R.</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bukusi</surname>
<given-names>Elizabeth A.</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>(OB/Gyn)</surname>
<given-names>MMed</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kendi</surname>
<given-names>Caroline</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Meyer</surname>
<given-names>Ana-Claire L.</given-names>
</name>
<degrees>MD, MSHS</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Neurology, University of California San Francisco; San Francisco, CA, USA</aff>
<aff id="A2"><label>2</label>
Center for Microbiology Research, Kenya Medical Research Institute; Nairobi, Kenya</aff>
<aff id="A3"><label>3</label>
Chikankata Hospital, Mazabuka, Zambia</aff>
<aff id="A4"><label>4</label>
Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, CA, USA</aff>
<author-notes><corresp id="FN1">Corresponding Author: Ana-Claire Meyer, MD, MSHS, Assistant Professor, Neurology, University of California, San Francisco, Visiting Scientist, Center for Microbiology Research, Kenya Medical Research Institute, San Francisco General Hospital, 1001 Potrero Ave, 4M62, Box 0870, San Francisco, CA 94110, Phone: +1-415-206-6182, FAX: +1-415-476-3382, <email>meyerac@sfgh.ucsf.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>10</day>
<month>3</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>27</day>
<month>8</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub"><month>10</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>10</month>
<year>2014</year>
</pub-date>
<volume>48</volume>
<issue>4</issue>
<fpage>516</fpage>
<lpage>524</lpage>
<pmc-comment>elocation-id from pubmed: 10.1002/mus.23795</pmc-comment>
      <abstract><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>
</abstract>
<kwd-group><kwd>sensitivity and specificity</kwd>
<kwd>HIV</kwd>
<kwd>peripheral nervous system diseases</kwd>
<kwd>developing countries</kwd>
<kwd>screening tools</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>Kenya</li>
<li>Zambie</li>
<li>États-Unis</li>
</country>
<region><li>Californie</li>
</region>
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<tree><noCountry><name sortKey="Bukusi, Elizabeth A" sort="Bukusi, Elizabeth A" uniqKey="Bukusi E" first="Elizabeth A." last="Bukusi">Elizabeth A. Bukusi</name>
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<country name="États-Unis"><region name="Californie"><name sortKey="Cettomai, Deanna" sort="Cettomai, Deanna" uniqKey="Cettomai D" first="Deanna" last="Cettomai">Deanna Cettomai</name>
</region>
<name sortKey="Cohen, Craig R" sort="Cohen, Craig R" uniqKey="Cohen C" first="Craig R." last="Cohen">Craig R. Cohen</name>
<name sortKey="Meyer, Ana Claire L" sort="Meyer, Ana Claire L" uniqKey="Meyer A" first="Ana-Claire L." last="Meyer">Ana-Claire L. Meyer</name>
<name sortKey="Price, Richard W" sort="Price, Richard W" uniqKey="Price R" first="Richard W." last="Price">Richard W. Price</name>
</country>
<country name="Kenya"><noRegion><name sortKey="Kwasa, Judith K" sort="Kwasa, Judith K" uniqKey="Kwasa J" first="Judith K." last="Kwasa">Judith K. Kwasa</name>
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<name sortKey=" Ob Gyn, Mmed" sort=" Ob Gyn, Mmed" uniqKey=" Ob Gyn M" first="Mmed" last=" Ob Gyn">Mmed  Ob Gyn</name>
<name sortKey="Kendi, Caroline" sort="Kendi, Caroline" uniqKey="Kendi C" first="Caroline" last="Kendi">Caroline Kendi</name>
</country>
<country name="Zambie"><noRegion><name sortKey="Birbeck, Gretchen L" sort="Birbeck, Gretchen L" uniqKey="Birbeck G" first="Gretchen L." last="Birbeck">Gretchen L. Birbeck</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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Screening for HIV-Associated Peripheral Neuropathy in Resource-Limited Settings

Screening for HIV-Associated Peripheral Neuropathy in Resource-Limited Settings

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Abstract

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