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Diagnosing onchocerciasis by palpation of nodules

Boy with palapable nodule
Boy with palpable nodule

(Source: WHO/TDR/image 98031026)
The parasite Onchocerca volvulus aggregates within subdermal nodules which can be palpated. Diagnosis by palpating nodules, however, is uncertain because nodules may be very small, located in deeper layers of the skin, etc. Diagnostic measures are difficult to derive and depend on the age of the patients. Is diagnosis by palpation sufficiently reliable to support epidemiological decision making?
Diagnostic measures
The sensitivity of nodule palpation depends on the parasite burden, because a patient with many nodules is more likely to be found "positive" than a patient with few nodules. How can we determine the sensitivity of nodule palpation when at the same time exactly this depends on knowing how many nodules a patient harbours? More…
Palpation diagnosis by age
Data on nodule palpation show that the diagnosis strongly depends on the age of a patient. It is important to look at the proportions of true-positive, false-positive, false-negative and true-negative diagnoses. More…
Diagnostic value of palpation
Compiling the information on sensitivity, specifity, and the true and the negative predictive value allows for predicting the true prevalence of onchocerciasis from a prevalence which has been determined by palpation. However, it turns out that only slight insights can be gained through nodule palpation. More…

Responsable de cette page: Dr. H.-P. Duerr
Webmaster: Prof. Dr. M. Eichner (dernière modification de cette page: 13 juli 2009)
Traduit en français par: Claire Le Roux, Université de Valenciennes et du Hainaut Cambraisis (UVHC), Institut des Sciences et Techniques (ISTV), France
Avertissement: L'Université Eberhard Karl de Tübingen, le Centre Hospitalier Universitaire de Tübingen, le Département de Biométrie Médicale (IMB), ainsi que les auteurs de cette page déclinent toute responsabilité pour le contenu des pages auxquelles cette page renvoie

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