title: Sensitivity and specificity of ultrasound detection and risk factors for filarial-associated hydroceles.
abstract: To better understand risk factors for hydrocele as a consequence of Wuchereria bancrofti infection, 342 men more than 15 years of age in an endemic area in Papua New Guinea were evaluated. Thirty-four subjects (9.9%) had hydrocele by physical examination. Ultrasound examination detected hydroceles in 57 men (16.7%). Compared with ultrasonography, the sensitivity of physical examination was 44.3%, the specificity was 98.2%, and the positive predictive value was 73.5%. Hydrocele was independently associated with age (odds ratio [OR] = 3.3, P < 0.01) and intensity of infection as determined by filarial antigenemia (OR = 2.3, P = 0.07). Dilation of spermatic cord lymphatics detectable by ultrasound did not correlate with hydrocele, but was associated with the presence of infection. These observations suggest that filarial pathology of the male genitalia is under-reported when evaluated by physical examination alone and that duration and intensity of infection are risk factors for hydrocele.
authors.affiliation: Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106-4983, USA.
authors.forename: Aaron A R
authors.initials: AA
authors.lastname: Tobian
authors.forename: Nandao
authors.initials: N
authors.lastname: Tarongka
authors.forename: Moses
authors.initials: M
authors.lastname: Baisor
authors.forename: Moses
authors.initials: M
authors.lastname: Bockarie
authors.forename: James W
authors.initials: JW
authors.lastname: Kazura
authors.forename: Christopher L
authors.initials: CL
authors.lastname: King
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000947:Antigens, Helminth / Q000097:blood; D005368:Filariasis / Q000150:complications* / Q000469:parasitology; D006801:Humans; D008297:Male; D008842:Microfilariae / Q000302:isolation & purification*; D010219:Papua New Guinea / Q000453:epidemiology; D010808:Physical Examination; D012307:Risk Factors; D012680:Sensitivity and Specificity; D006848:Testicular Hydrocele / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000469:parasitology; D014463:Ultrasonography; D014958:Wuchereria bancrofti / Q000254:growth & development / Q000302:isolation & purification*
chemical_list: D000947:Antigens, Helminth