MMARAU Institutional Repository

Impact of Helminth Diagnostic Test Performance on Estimation of Risk Factors and Outcomes in HIV-Positive Adults

Show simple item record

dc.contributor.author Michael B. Arndt1, Grace John-Stewart, Barbra A. Richardson, Benson Singa, Lisette van Lieshout, Jaco J. Verweij, Laura R. Sangaré, Loice W. Mbogo, Jacqueline M. Naulikha, Judd L.Walson
dc.date.accessioned 2019-11-05T07:46:28Z
dc.date.available 2019-11-05T07:46:28Z
dc.date.issued 2013
dc.identifier.uri http://hdl.handle.net/123456789/9603
dc.description.abstract Traditional methods using microscopy for the detection of helminth infections have limited sensitivity.Polymerase chain reaction (PCR) assays enhance detection of helminths, particularly low burden infections.However, differences in test performance may modify the ability to detect associations between helminth infection,risk factors, and sequelae. We compared these associations using microscopy and PCR. Methods: This cross-sectional study was nested within a randomized clinical trial conducted at 3 sites in Kenya. Weperformed microscopy and real-time multiplex PCR for the stool detection and quantification of Ascaris lumbricoides,Necator americanus, Ancylostoma duodenale, Strongyloides stercoralis, and Schistosoma species. We utilizedregression to evaluate associations between potential risk factors or outcomes and infection as detected by eithermethod. Results: Of 153 HIV-positive adults surveyed, 55(36.0%) and 20(13.1%) were positive for one or more helminth species by PCR and microscopy, respectively (p<0.001). PCR-detected infections were associated with farming(Prevalence Ratio 1.57, 95% CI: 1.02, 2.40), communal water source (PR 3.80, 95% CI: 1.01, 14.27), and no primary education (PR 1.54, 95% CI: 1.14, 2.33), whereas microscopy-detected infections were not associated with any risk factors under investigation. Microscopy-detected infections were associated with significantly lower hematocrit and hemoglobin (means of -3.56% and -0.77 g/dl) and a 48% higher risk of anemia (PR 1.48, 95% CI: 1.17, 1.88)compared to uninfected. Such associations were absent for PCR-detected infections unless infection intensity was considered, Infections diagnosed with either method were associated with increased risk of eosinophilia (PCR PR2.42, 95% CI: 1.02, 5.76; microscopy PR 2.92, 95% CI: 1.29, 6.60). Conclusion: Newer diagnostic methods, including PCR, improve the detection of helminth infections. This heightened sensitivity may improve the identification of risk factors for infection while reducing ability to discriminate infections associated with adverse clinical outcomes. Quantitative assays can be used to differentiate infection loads and discriminate infections associated with sequelae. en_US
dc.language.iso en en_US
dc.title Impact of Helminth Diagnostic Test Performance on Estimation of Risk Factors and Outcomes in HIV-Positive Adults en_US
dc.type Learning Object en_US


Files in this item

This item appears in the following Collection(s)

Show simple item record

Search DSpace


Advanced Search

Browse

My Account