Namakoola, I., Wakeham, K., Parkes-Ratanshi, R., Levin, J., Mugagga, T., Seymour, C., Kissa, J.., Kamali, A. and Lalloo, D. G. (2010) Use of nail and oral pigmentation to determine ART eligibility among HIV-infected Ugandan adults. Tropical Medicine and International Health, 15(2), pp. 259-262. (doi: 10.1111/j.1365-3156.2009.02448.x)
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Publisher's URL: http://dx.doi.org/10.1111/j.1365-3156.2009.02448.x
Abstract
Objectives: To evaluate the use of grey/distal banded nails as an indicator of advanced immunosuppression, and thus eligibility for ART, in resource poor settings.<p></p> Methods: We tested whether grey/distal banded nails and/or oral pigmentation could be used to identify patients with low CD4 cell counts at two cut-offs: <200 and <350 cells/μl in ART naive adults.<p></p> Results: Four hundred and three nail and oral cavities were photographed and assessed. Grey/distal banded nails and/or oral pigmentation were significantly associated with a CD4 cell count <200 cells/μl (P < 0.001), with a sensitivity of 66%, a specificity of 50% and a negative predictive value of 77%. However, there was no association when a CD4 cell count cut-off of <350 cells/μl was used. Inter-observer agreement (k 0.46) was fair/moderate.<p></p> Conclusions: While grey/distal banded nails and/or oral pigmentation are associated with low CD4 counts, the sensitivity and kappa score are too low for this method to be recommended as a tool to guide ART initiation; large number of individuals eligible for ART would be missed.<p></p>
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Wakeham, Dr Katie |
| Authors: | Namakoola, I., Wakeham, K., Parkes-Ratanshi, R., Levin, J., Mugagga, T., Seymour, C., Kissa, J.., Kamali, A., and Lalloo, D. G. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cancer Sciences |
| Journal Name: | Tropical Medicine and International Health |
| Journal Abbr.: | Trop Med Int Health |
| Publisher: | Wiley |
| ISSN: | 1360-2276 |
| ISSN (Online): | 1365-3156 |
| Related URLs: |
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