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Proportion of palpable nodules by age

Palpation of a patient
Palpation of a patient

(Source: WHO/TDR/image 9203234)
On average, about one third of the nodules can be found by palpation. Diagnosis by palpation, however, must be judged age-dependently. The proportion of palpable nodules is very low in children and increases to about 30% in 10 year old children and to about 40% in aged people. The estimates differ considerably between villages, showing strong observer variability (upper graph).

Inter-individual heterogeneity in the probability to palpate a nodule clearly challenges the usefulness of palpation on the level of the individual patient. E.g., in 20 year old patients, the median value is 20% and the region of tolerance (range between quantiles 2.5% and 97.5%) runs from 0% to 92% (lower graph).
Proportion of palpable nodules by age
Figure: The proportion of palpable nodules by age. Curves in the grey part of both graphs result from extrapolation of the simulation results.

A: Expected proportion of palpable nodules among the 14 West African villages. The grey curve represents the common estimate for all 2560 inhabitants in the 14 villages.

B: Common distribution, represented by quantiles. The region of tolerance, in which the central 95% of observations are expected, is delimited by dashed lines. (Source: Duerr et al., 2007)
Related pages: Nodules, Diagnosis by palpation of nodules, Diagnostic value of nodule palpation.

Further reading: Duerr HP, Raddatz G, Eichner M, 2007. Diagnostic value of nodule palpation in onchocerciasis. Transactions of the Royal Society of Tropical Medicine and Hygiene. In press.

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Responsable de cette page: Dr. H.-P. Duerr
Webmaster: Prof. Dr. M. Eichner (dernière modification de cette page: 13 juli 2009)
Collaborateur: Dr. M. Eichner
Soutenu financièrement par: Deutsche Forschungsgemeinschaft (DFG, DI 308/12-1)
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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