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• W4213091090 abstract "Abstract Background Schistosoma mansoni related hepatic fibrosis is usually associated with hemodynamic alteration with increased mortality due to bleeding varices. The diagnosis of varices before bleeding imposes a big challenge in resource-limited countries using endoscopy. Published evidence on the utility of non-invasive clinical tools in predicting the presence of varices among patients with S. mansoni related periportal fibrosis is still inadequate including APRI and PSDR levels. This study describes the determinants of portal varices and assesses the potential utility of the APRI and PSDR level in the discrimination of portal varices among patients with S. mansoni related periportal fibrosis. Methods All patients with periportal fibrosis were cross-sectionally assessed for the presence of esophageal varices at Bugando medical centre, in Mwanza Tanzania. Socio-demographic, laboratory and ultrasound data were collected for analysis using STATA 13. The prevalence of varices and associated factors were determined, and the sensitivity and specificity of independent factors were assessed to determine their utility in discriminating presence of varices in patients with PPF. Results In total, 250 patients were included in this study, 109 (43.6%; 95%CI: 37.3-.49.9) of them had varices. On multivariate analysis the odds of having varices were independently increased among patients with higher median APRI levels, (1.51; vs. 0.9; AOR: 5.6; 95%CI: 3.1-10.1; p=<0.001) and PSDR levels that were lower than 5700 (AOR: 3.9; 95%CI: 2.0-7.6; p<0.001. Both APRI and PSDR levels had significantly high sensitivity and specificity in predicting the presence of esophageal varices. Conclusions This study indicates that varices are a common encounter among patients with S. mansoni related periportal fibrosis and it is independently associated with higher median APRI and lower PSDR levels suggesting that these tools are potential discriminators of varices in this subgroup of patients. The reproducibility of these results should further be assessed longitudinally as potential non-invasive tools in selecting patients at high risk of having esophageal varices who could benefit from the targeted endoscopic intervention in a resource-limited setting like ours." @default.
• W4213091090 created "2022-02-24" @default.
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• W4213091090 date "2020-04-07" @default.
• W4213091090 modified "2023-09-26" @default.
• W4213091090 title "Schistosoma mansoni -related periportal fibrosis; are APRI and PSDR levels of any potential utility in a well-timed selection of patients for targeted endoscopy in a resource-limited setting?: a case-control clinic-based study" @default.
• W4213091090 doi "https://doi.org/10.21203/rs.3.rs-20359/v1" @default.
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