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Screening for HIV‐associated peripheral neuropathy in resource‐limited settings
Author(s) -
Cettomai Deanna,
Kwasa Judith K.,
Birbeck Gretchen L.,
Price Richard W.,
Cohen Craig R.,
Bukusi Elizabeth A.,
Kendi Caroline,
Meyer AnaClaire L.
Publication year - 2013
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.23795
Subject(s) - medicine , peripheral neuropathy , human immunodeficiency virus (hiv) , physical therapy , intensive care medicine , immunology , diabetes mellitus , endocrinology
ABSTRACT Introduction Peripheral neuropathy is the most common neurological complication of human immunodeficiency virus (HIV) infection but is widely under‐diagnosed in resource‐limited settings. We investigated the utility of screening tools administered by nonphysician healthcare workers (HCW) and quantitative sensory testing (QST) administered by trained individuals for identification of moderate/severe neuropathy. Methods We enrolled 240 HIV‐infected outpatients using 2‐stage cluster randomized sampling. HCWs administered the several screening tools. Trained study staff performed QST. Tools were validated against a clinical diagnosis of neuropathy. Results Participants were 65% women, mean age 36.4 years, median CD4 324 cells/μL. A total of 65% were taking antiretrovirals, and 18% had moderate/severe neuropathy. The screening tests were 76% sensitive in diagnosing moderate/severe neuropathy with negative predictive values of 84–92%. QST was less sensitive but more specific. Conclusions Screening tests administered by HCW have excellent negative predictive values and are promising tools for scale‐up in resource‐limited settings. QST shows promise for research use. Muscle Nerve 48 : 516–524, 2013