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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

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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, Elizabeth and Bélard, S (2020) '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'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol 114, Issue 1, pp. 38-48.

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Abstract

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.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 810 Schistosomiasis
WJ Urogenital System > WJ 151 Urinary tract infections
WN Radiology. Diagnostic imaging > WN 20 Research (General)
Faculty: Department: Education
Digital Object Identifer (DOI): https://doi.org/10.1093/trstmh/trz101
Depositing User: Stacy Murtagh
Date Deposited: 17 Dec 2019 11:17
Last Modified: 21 Feb 2020 15:40
URI: https://archive.lstmed.ac.uk/id/eprint/13350

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