Development and Validation of a simple score for diagnosis of Leptospirosis at outpatient departments.
BACKGROUND:Leptospirosis is an important zoonotic disease within the tropics. Diagnosing leptospirosis is a clinical obstacle, as clinical presentations are similar to other tropical infectious diseases. Available serological tests are often insensitive and not cost-effective. Many clinical diagnost...
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ftdoajarticles:oai:doaj.org/article:91db56a0bb6941f2a4db0cf4a38fd2ab 2023-05-15T15:16:41+02:00 Development and Validation of a simple score for diagnosis of Leptospirosis at outpatient departments. Nidhikul Temeiam Sutthi Jareinpituk Phichayut Phinyo Jayanton Patumanond Nattachai Srisawat 2020-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0007977 https://doaj.org/article/91db56a0bb6941f2a4db0cf4a38fd2ab EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0007977 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007977 https://doaj.org/article/91db56a0bb6941f2a4db0cf4a38fd2ab PLoS Neglected Tropical Diseases, Vol 14, Iss 1, p e0007977 (2020) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2020 ftdoajarticles https://doi.org/10.1371/journal.pntd.0007977 2022-12-31T13:53:10Z BACKGROUND:Leptospirosis is an important zoonotic disease within the tropics. Diagnosing leptospirosis is a clinical obstacle, as clinical presentations are similar to other tropical infectious diseases. Available serological tests are often insensitive and not cost-effective. Many clinical diagnostic scorings had been developed but most were based on hospitalized patients, and wound not be suitable for use in suspected patients in setting of ambulatory care. OBJECTIVES:To develop and internal validate multivariable diagnostic prediction score of leptospirosis in patients suspicious of leptospirosis at out-patient clinics of community hospitals. MATERIALS AND METHODS:We performed a prospective, multisite diagnostic prediction research with development of a diagnostic score. The development cohort was based on patients suspicious of leptospirosis who visited five community hospitals in Si Sa Ket province, Thailand during December 2017 to November 2018. Leptospirosis confirmed cases were defined when one of the three standard confirmatory tests was positive. Multivariable logistic regression was used for score derivation. Test of AuROC equality was done to compare diagnostic performance of the newly derived score and conventional WHO score. RESULTS:A total of 262 leptospirosis suspicious patients were enrolled. Eighty-two patients (31.5%) were leptospirosis confirmed cases. Five final predictors remained within the reduced logistic model which were history of exposure to wet ground at workplace, history of contact water reservoir used by animal, urine protein and urine blood positive from dipstick test, and neutrophil count from CBC ≥80%. The OPD score diagnostic performance was AuROC 0.72 (95%CI 0.65-0.79). Test of equality revealed significant differences of AuROC between the OPD and WHO score (0.72 vs 0.62, p-value 0.014). Patients were categorized into low and high probability of having leptospirosis at score point of 3.5 with sensitivity 72.4% and specificity 61.7%. CONCLUSIONS:This study developed and ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 14 1 e0007977 |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Nidhikul Temeiam Sutthi Jareinpituk Phichayut Phinyo Jayanton Patumanond Nattachai Srisawat Development and Validation of a simple score for diagnosis of Leptospirosis at outpatient departments. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Leptospirosis is an important zoonotic disease within the tropics. Diagnosing leptospirosis is a clinical obstacle, as clinical presentations are similar to other tropical infectious diseases. Available serological tests are often insensitive and not cost-effective. Many clinical diagnostic scorings had been developed but most were based on hospitalized patients, and wound not be suitable for use in suspected patients in setting of ambulatory care. OBJECTIVES:To develop and internal validate multivariable diagnostic prediction score of leptospirosis in patients suspicious of leptospirosis at out-patient clinics of community hospitals. MATERIALS AND METHODS:We performed a prospective, multisite diagnostic prediction research with development of a diagnostic score. The development cohort was based on patients suspicious of leptospirosis who visited five community hospitals in Si Sa Ket province, Thailand during December 2017 to November 2018. Leptospirosis confirmed cases were defined when one of the three standard confirmatory tests was positive. Multivariable logistic regression was used for score derivation. Test of AuROC equality was done to compare diagnostic performance of the newly derived score and conventional WHO score. RESULTS:A total of 262 leptospirosis suspicious patients were enrolled. Eighty-two patients (31.5%) were leptospirosis confirmed cases. Five final predictors remained within the reduced logistic model which were history of exposure to wet ground at workplace, history of contact water reservoir used by animal, urine protein and urine blood positive from dipstick test, and neutrophil count from CBC ≥80%. The OPD score diagnostic performance was AuROC 0.72 (95%CI 0.65-0.79). Test of equality revealed significant differences of AuROC between the OPD and WHO score (0.72 vs 0.62, p-value 0.014). Patients were categorized into low and high probability of having leptospirosis at score point of 3.5 with sensitivity 72.4% and specificity 61.7%. CONCLUSIONS:This study developed and ... |
format |
Article in Journal/Newspaper |
author |
Nidhikul Temeiam Sutthi Jareinpituk Phichayut Phinyo Jayanton Patumanond Nattachai Srisawat |
author_facet |
Nidhikul Temeiam Sutthi Jareinpituk Phichayut Phinyo Jayanton Patumanond Nattachai Srisawat |
author_sort |
Nidhikul Temeiam |
title |
Development and Validation of a simple score for diagnosis of Leptospirosis at outpatient departments. |
title_short |
Development and Validation of a simple score for diagnosis of Leptospirosis at outpatient departments. |
title_full |
Development and Validation of a simple score for diagnosis of Leptospirosis at outpatient departments. |
title_fullStr |
Development and Validation of a simple score for diagnosis of Leptospirosis at outpatient departments. |
title_full_unstemmed |
Development and Validation of a simple score for diagnosis of Leptospirosis at outpatient departments. |
title_sort |
development and validation of a simple score for diagnosis of leptospirosis at outpatient departments. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2020 |
url |
https://doi.org/10.1371/journal.pntd.0007977 https://doaj.org/article/91db56a0bb6941f2a4db0cf4a38fd2ab |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 14, Iss 1, p e0007977 (2020) |
op_relation |
https://doi.org/10.1371/journal.pntd.0007977 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0007977 https://doaj.org/article/91db56a0bb6941f2a4db0cf4a38fd2ab |
op_doi |
https://doi.org/10.1371/journal.pntd.0007977 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
14 |
container_issue |
1 |
container_start_page |
e0007977 |
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1766346973592420352 |