The "Buruli Score": Development of a Multivariable Prediction Model for Diagnosis of Mycobacterium ulcerans Infection in Individuals with Ulcerative Skin Lesions, Akonolinga, Cameroon.

Détails

Ressource 1Télécharger: 2016_plosNTD_Buruliscore.pdf (1028.70 [Ko])
Etat: Serval
Version: Final published version
ID Serval
serval:BIB_BD527C394905
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
The "Buruli Score": Development of a Multivariable Prediction Model for Diagnosis of Mycobacterium ulcerans Infection in Individuals with Ulcerative Skin Lesions, Akonolinga, Cameroon.
Périodique
PLoS neglected tropical diseases
Auteur(s)
Mueller Y.K., Bastard M., Nkemenang P., Comte E., Ehounou G., Eyangoh S., Rusch B., Tabah E.N., Trellu L.T., Etard J.F.
ISSN
1935-2735 (Electronic)
ISSN-L
1935-2727
Statut éditorial
Publié
Date de publication
04/2016
Peer-reviewed
Oui
Volume
10
Numéro
4
Pages
e0004593
Langue
anglais
Notes
Publication types: Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Résumé
Access to laboratory diagnosis can be a challenge for individuals suspected of Buruli Ulcer (BU). Our objective was to develop a clinical score to assist clinicians working in resource-limited settings for BU diagnosis.
Between 2011 and 2013, individuals presenting at Akonolinga District Hospital, Cameroon, were enrolled consecutively. Clinical data were collected prospectively. Based on a latent class model using laboratory test results (ZN, PCR, culture), patients were categorized into high, or low BU likelihood. Variables associated with a high BU likelihood in a multivariate logistic model were included in the Buruli score. Score cut-offs were chosen based on calculated predictive values. Of 325 patients with an ulcerative lesion, 51 (15.7%) had a high BU likelihood. The variables identified for the Buruli score were: characteristic smell (+3 points), yellow color (+2), female gender (+2), undermining (+1), green color (+1), lesion hyposensitivity (+1), pain at rest (-1), size >5cm (-1), locoregional adenopathy (-2), age above 20 up to 40 years (-3), or above 40 (-5). This score had AUC of 0.86 (95%CI 0.82-0.89), indicating good discrimination between infected and non-infected individuals. The cut-off to reasonably exclude BU was set at scores <0 (NPV 96.5%; 95%CI 93.0-98.6). The treatment threshold was set at a cut-off ≥4 (PPV 69.0%; 95%CI 49.2-84.7). Patients with intermediate BU probability needed to be tested by PCR.
We developed a decisional algorithm based on a clinical score assessing BU probability. The Buruli score still requires further validation before it can be recommended for wide use.

Mots-clé
Adolescent, Adult, Aged, Aged, 80 and over, Buruli Ulcer/diagnosis, Cameroon, Child, Child, Preschool, Decision Support Techniques, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Prospective Studies, Sensitivity and Specificity, Skin/pathology, Young Adult
Pubmed
Open Access
Oui
Création de la notice
06/04/2016 13:24
Dernière modification de la notice
09/05/2019 0:32
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