Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS)-pilot evaluation of a simple point-of-care ultrasound protocol and short training program for detecting urinary tract morbidity in highly endemic settings
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Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS)-pilot evaluation of a simple point-of-care ultrasound protocol and short training program for detecting urinary tract morbidity in highly endemic settings. / Remppis, J.; Verheyden, A.; Bustinduy, A. L.; Heller, T.; García-Tardón, N.; Manouana, G. P.; Obiang, R.; Adegnika, A. A.; Grobusch, M. P.; Ramharter, M.; Joekes, E.; Bélard, S.
In: Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol. 114, No. 1, 06.01.2020, p. 38-48.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS)-pilot evaluation of a simple point-of-care ultrasound protocol and short training program for detecting urinary tract morbidity in highly endemic settings
AU - Remppis, J.
AU - Verheyden, A.
AU - Bustinduy, A. L.
AU - Heller, T.
AU - García-Tardón, N.
AU - Manouana, G. P.
AU - Obiang, R.
AU - Adegnika, A. A.
AU - Grobusch, M. P.
AU - Ramharter, M.
AU - Joekes, E.
AU - Bélard, S.
N1 - © The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2020/1/6
Y1 - 2020/1/6
N2 - Background: Urogenital schistosomiasis (UGS) causes inflammation and fibrosis of the urinary tract. In resource-limited settings, affordable tools for morbidity assessment in clinical care are needed. Point-of-care ultrasound has not yet been validated for UGS-related pathology. Methods: We developed a protocol for Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS), assessing pathology of the bladder wall, ureters and kidneys. Following standardized training, two clinicians performed FASUS on children and adults with hematuria in Lambaréné, Gabon. Recorded ultrasound clips were remotely reviewed by two ultrasound experts as a diagnostic reference. Results: In 2015 and 2016, scans were performed in 118 patients. The image quality was sufficient in 90% of bladder views and more than 97% of kidney views. UGS-compatible pathology was detected in 51/118 (43%) by the operator and in 46/107 (43%) by the experts among baseline scans of sufficient quality. Inter-rater agreement between operators and experts was very good (κ > 0.8) for hydronephrosis and good (κ > 0.6) for bladder wall thickening. Conclusions: FASUS is a promising clinical, point-of-care tool for detecting UGS-related urinary tract morbidity in symptomatic patients. Based on larger validation studies, appropriate diagnostic and therapeutic algorithms for the use of FASUS should be established.
AB - Background: Urogenital schistosomiasis (UGS) causes inflammation and fibrosis of the urinary tract. In resource-limited settings, affordable tools for morbidity assessment in clinical care are needed. Point-of-care ultrasound has not yet been validated for UGS-related pathology. Methods: We developed a protocol for Focused Assessment with Sonography for Urinary Schistosomiasis (FASUS), assessing pathology of the bladder wall, ureters and kidneys. Following standardized training, two clinicians performed FASUS on children and adults with hematuria in Lambaréné, Gabon. Recorded ultrasound clips were remotely reviewed by two ultrasound experts as a diagnostic reference. Results: In 2015 and 2016, scans were performed in 118 patients. The image quality was sufficient in 90% of bladder views and more than 97% of kidney views. UGS-compatible pathology was detected in 51/118 (43%) by the operator and in 46/107 (43%) by the experts among baseline scans of sufficient quality. Inter-rater agreement between operators and experts was very good (κ > 0.8) for hydronephrosis and good (κ > 0.6) for bladder wall thickening. Conclusions: FASUS is a promising clinical, point-of-care tool for detecting UGS-related urinary tract morbidity in symptomatic patients. Based on larger validation studies, appropriate diagnostic and therapeutic algorithms for the use of FASUS should be established.
KW - diagnostic imaging
KW - Gabon
KW - hydronephrosis
KW - point-of-care testing
KW - Schistosoma haematobium
KW - tropical medicine
KW - Humans
KW - Morbidity
KW - Pilot Projects
KW - Animals
KW - Point-of-Care Systems
KW - Schistosomiasis haematobia/diagnostic imaging
KW - Ultrasonography
KW - Adult
KW - Child
UR - http://www.scopus.com/inward/record.url?scp=85077948740&partnerID=8YFLogxK
U2 - 10.1093/trstmh/trz101
DO - 10.1093/trstmh/trz101
M3 - SCORING: Journal article
C2 - 31735956
AN - SCOPUS:85077948740
VL - 114
SP - 38
EP - 48
JO - T ROY SOC TROP MED H
JF - T ROY SOC TROP MED H
SN - 0035-9203
IS - 1
ER -