Predictive models for the diagnostic of human visceral leishmaniasis in Brazil.

<h4>Background and objectives</h4>In Brazil, as in many other affected countries, a large proportion of visceral leishmaniasis (VL) occurs in remote locations and treatment is often performed on basis of clinical suspicion. This study aimed at developing predictive models to help with th...

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Autores principales:	Tália S Machado de Assis, Ana Rabello, Guilherme L Werneck
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/ff6f4a54d2c7435da1caff1611c62e5e
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spelling	oai:doaj.org-article:ff6f4a54d2c7435da1caff1611c62e5e2021-11-18T09:14:24ZPredictive models for the diagnostic of human visceral leishmaniasis in Brazil.1935-27271935-273510.1371/journal.pntd.0001542https://doaj.org/article/ff6f4a54d2c7435da1caff1611c62e5e2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22389742/pdf/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background and objectives</h4>In Brazil, as in many other affected countries, a large proportion of visceral leishmaniasis (VL) occurs in remote locations and treatment is often performed on basis of clinical suspicion. This study aimed at developing predictive models to help with the clinical management of VL in patients with suggestive clinical of disease.<h4>Methods</h4>Cases of VL (n = 213) had the diagnosis confirmed by parasitological method, non-cases (n = 119) presented suggestive clinical presentation of VL but a negative parasitological diagnosis and a firm diagnosis of another disease. The original data set was divided into two samples for generation and validation of the prediction models. Prediction models based on clinical signs and symptoms, results of laboratory exams and results of five different serological tests, were developed by means of logistic regression and classification and regression trees (CART). From these models, clinical-laboratory and diagnostic prediction scores were generated. The area under the receiver operator characteristic curve, sensitivity, specificity, and positive predictive value were used to evaluate the models' performance.<h4>Results</h4>Based on the variables splenomegaly, presence of cough and leukopenia and on the results of five serological tests it was possible to generate six predictive models using logistic regression, showing sensitivity ranging from 90.1 to 99.0% and specificity ranging from 53.0 to 97.2%. Based on the variables splenomegaly, leukopenia, cough, age and weight loss and on the results of five serological tests six predictive models were generated using CART with sensitivity ranging from 90.1 to 97.2% and specificity ranging from 68.4 to 97.4%. The models composed of clinical-laboratory variables and the rk39 rapid test showed the best performance.<h4>Conclusion</h4>The predictive models showed to be a potential useful tool to assist healthcare systems and control programs in their strategical choices, contributing to more efficient and more rational allocation of healthcare resources.Tália S Machado de AssisAna RabelloGuilherme L WerneckPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 6, Iss 2, p e1542 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Tália S Machado de Assis Ana Rabello Guilherme L Werneck Predictive models for the diagnostic of human visceral leishmaniasis in Brazil.
description	<h4>Background and objectives</h4>In Brazil, as in many other affected countries, a large proportion of visceral leishmaniasis (VL) occurs in remote locations and treatment is often performed on basis of clinical suspicion. This study aimed at developing predictive models to help with the clinical management of VL in patients with suggestive clinical of disease.<h4>Methods</h4>Cases of VL (n = 213) had the diagnosis confirmed by parasitological method, non-cases (n = 119) presented suggestive clinical presentation of VL but a negative parasitological diagnosis and a firm diagnosis of another disease. The original data set was divided into two samples for generation and validation of the prediction models. Prediction models based on clinical signs and symptoms, results of laboratory exams and results of five different serological tests, were developed by means of logistic regression and classification and regression trees (CART). From these models, clinical-laboratory and diagnostic prediction scores were generated. The area under the receiver operator characteristic curve, sensitivity, specificity, and positive predictive value were used to evaluate the models' performance.<h4>Results</h4>Based on the variables splenomegaly, presence of cough and leukopenia and on the results of five serological tests it was possible to generate six predictive models using logistic regression, showing sensitivity ranging from 90.1 to 99.0% and specificity ranging from 53.0 to 97.2%. Based on the variables splenomegaly, leukopenia, cough, age and weight loss and on the results of five serological tests six predictive models were generated using CART with sensitivity ranging from 90.1 to 97.2% and specificity ranging from 68.4 to 97.4%. The models composed of clinical-laboratory variables and the rk39 rapid test showed the best performance.<h4>Conclusion</h4>The predictive models showed to be a potential useful tool to assist healthcare systems and control programs in their strategical choices, contributing to more efficient and more rational allocation of healthcare resources.
format	article
author	Tália S Machado de Assis Ana Rabello Guilherme L Werneck
author_facet	Tália S Machado de Assis Ana Rabello Guilherme L Werneck
author_sort	Tália S Machado de Assis
title	Predictive models for the diagnostic of human visceral leishmaniasis in Brazil.
title_short	Predictive models for the diagnostic of human visceral leishmaniasis in Brazil.
title_full	Predictive models for the diagnostic of human visceral leishmaniasis in Brazil.
title_fullStr	Predictive models for the diagnostic of human visceral leishmaniasis in Brazil.
title_full_unstemmed	Predictive models for the diagnostic of human visceral leishmaniasis in Brazil.
title_sort	predictive models for the diagnostic of human visceral leishmaniasis in brazil.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/ff6f4a54d2c7435da1caff1611c62e5e
work_keys_str_mv	AT taliasmachadodeassis predictivemodelsforthediagnosticofhumanvisceralleishmaniasisinbrazil AT anarabello predictivemodelsforthediagnosticofhumanvisceralleishmaniasisinbrazil AT guilhermelwerneck predictivemodelsforthediagnosticofhumanvisceralleishmaniasisinbrazil
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Predictive models for the diagnostic of human visceral leishmaniasis in Brazil.

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