title: Validity of selected clinical signs and symptoms in diagnosis of Schistosoma mansoni infection.
abstract: Sensitivity, specificity and positive predictive values of selected clinical signs and symptoms in the diagnosis of Schistosoma mansoni infection were evaluated in 403 individuals (69% of inhabitants over 1 year of age) in an endemic area in Brazil (Divino). Highest sensitivity (13%) was found for blood in stools. Specificity over 90% was found for blood in stools, palpable liver with normal consistency and palpable hardened liver at middle clavicular (MCL) or middle sternal lines (MSL). Hardened liver at MSL (83%) or MCL (75%), and blood in stools (78%) presented higher positive predictive values for S. mansoni infection, while palpable liver with normal consistency at MCL (45%) or MSL (48%) presented smaller values. Enlarged liver without specification of its consistency has been traditionally used as an indicator of the infection in areas where malaria or Kala-azar are not endemic. Our results demonstrate that the probability that a person with blood in stools or hardened palpable liver is infected is higher than among those with palpable liver with normal consistency.
authors.affiliation: Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais, Brasil.
authors.forename: M F
authors.initials: MF
authors.lastname: de Lima e Costa
authors.forename: R S
authors.initials: RS
authors.lastname: Rocha
authors.forename: D
authors.initials: D
authors.lastname: Colley
authors.forename: G
authors.initials: G
authors.lastname: Gazzinelli
authors.forename: N
authors.initials: N
authors.lastname: Katz
mesh_terms: D001938:Brazil; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D006801:Humans; D009780:Occult Blood; D011237:Predictive Value of Tests; D012555:Schistosomiasis mansoni / Q000175:diagnosis* / Q000453:epidemiology