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Meta-analysis of the diagnostic efficiency of the questionnaires screening for schistosomiasis

Abstract

Schistosomiasis is the second widespread tropical disease that affects the health of over 240 million people of 78 countries. Questionnaires have been commonly used to diagnose schistosomiasis, while no meta-analysis of their efficacy had been reported previously. This meta-analysis was conducted to assess their diagnostic accuracy of schistosomiasis. Studies published prior to December 1, 2014, that had used questionnaires as a diagnostic tool were searched in PubMed, Medline, EMBASE, and China National Knowledge Infrastructure (CNKI) database. A total of 32 studies with 72,812 cases were identified for the meta-analysis. The best diagnostic odds ratio (DOR) was obtained from Schistosoma haematobium (67.68, 95 % confidence interval (CI) = 31.48 to 145.54), followed by Schistosoma japonicum (11.74, 95 % CI = 4.59 to 30.05) then Schistosoma mansoni (2.98, 95 % CI = 1.95 to 4.54). Pooled sensitivity and specificity were respectively 0.82, 0.88, and 0.46, and 0.59, 0.86, and 0.81 for S. japonicum, S. haematobium, and S. mansoni. The multivariable subgroup analyses showed that the questionnaires which had been pretested and standardized had better diagnostic performance. The result suggested that questionnaires can be used to diagnose schistosomiasis with moderate sensitivity and specificity and the questionnaires for diagnosing S. haematobium performed best.

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Correspondence to Xiao-dong Tan.

Appendix

Appendix

A. Common questions about schistosomiasis (choices for answers)

  1. 1.

    What is your status of schistosomiasis infection?

  2. 2.

    Past schistosomiasis infection (yes, no)?

  3. 3.

    Have you been treated for schistosomiasis (yes, no)? If yes, answer: type of treatment, last time treated, and number of times treated?

B. Common questions about signs and symptoms of schistosomiasis infection

  1. 1.

    Itchy skin after water contact, weakness, fever, flatulence, abdominal pain, diarrhea, and blood in stool in the last 2 weeks?(S. japonicum)

  2. 2.

    Have you had any blood in stool, bloody diarrhea, abdominal pain, headache, and fever during the past month?(S. mansoni and S. haematobium)

C. Common questions about contact with potentially infected water

  1. 1.

    What water-contact patterns have you had in the infection season (anti-flood, recreational activities, occupational activities, swimming and paddling, wading, or other type)?

  2. 2.

    How often do you have water-contact activities?

D. Unique questions about S. japonicum

  1. 1.

    How many minutes were you exposed to contagious water each time and in each activity?

  2. 2.

    How large in area was your body exposed to contagious water each time and in each activity?

  3. 3.

    Which body part mainly contacted the water (hand, foot, four limbs, entire body, no contact)?

  4. 4.

    Season of highest recreational water contact (spring, summer, autumn, no contact)?

  5. 5.

    Distance from your home to infected water (<200 m, 200-500 m, >500 m)?

E. Unique questions about S. haematobium for school head-teachers

  1. 1.

    Rank most prevalent disease among schoolchildren (abdominal pain, diarrhoea, malaria, skin diseases, eye diseases, schistosomiasis, respiratory infections, measles, nutritional problems, worms, or other).

  2. 2.

    Rank the signs and symptoms most prevalent among schoolchildren (coughing, itching, headache, fever, abdominal pain, wounds, blood in urine, blood in stool, convulsions, joint pains, diarrhea, other).

  3. 3.

    Which diseases should be prioritized for control (no proposed list)?

F. Unique questions about S. haematobium for children

  1. 1.

    Have you had any blood in urine in the last month?

  2. 2.

    Have you had any pain while urinating in the last 2 weeks (yes, no, don’t know)?

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Yang, F., Tan, X., Liu, B. et al. Meta-analysis of the diagnostic efficiency of the questionnaires screening for schistosomiasis. Parasitol Res 114, 3509–3519 (2015). https://doi.org/10.1007/s00436-015-4579-8

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Keywords

  • Schistosomiasis
  • Questionnaires
  • Diagnosis
  • Sensitivity
  • Specificity