1,721,204 research outputs found
Malaria in travellers to Gambia
No full textMalaria incidence is reportedly declining steadily in many parts of the world, including in at least several African countries. The incidence of imported malaria is also declining in a number of European countries. However, incidence rates in travellers, both European tourists and the so called VFR (visiting friends and relatives) are difficult to estimate, due to problems with the numerator (many cases are not reported) and more importantly with the denominator, for which the information is generally lacking. An exception in the European Union is the United Kingdom (UK), where the International Passenger Survey provides a reliable denominator on the number of travellers to the different countries, duration of stay and reason for travel
Dissemination: the fatal risk for a missed diagnosis of Strongyloides stercoralis infection
No full textSerologic tools are the most sensitive available assays for the screening of chronic strongyloidiasis and should be always used in case of suspicion, in order to avois the risk of the fatal, disseminated infection
Comment on: Subcutaneous ivermectin use in the treatment of severe Strongyloides stercoralis infection: two case reports and a discussion of the literature
No full textn.a
Costs of treating malaria according to test results; improving diagnostic tests can reduce costs if adherence to results is improved [editorial]
No full textThe management of malaria in endemic areas, based on Rapid diagnostic tests, could be a valid option only if a satisfactory adherence is obtained to the (negative) test results. However, more research is needed on the safety of the shift from presumptive treatment to RDT-based management
Mefloquine restrictions, anti-malarial drug safety and the new Italian recommendations for malaria prophylaxis
No full textn.a
Bayesian clinical reasoning: does intuitive estimation of likelihood ratios on an ordinal scale outperform estimation of sensitivities and specificities?
No full textRationale: Bedside use of Bayes' theorem for estimating probabilities of diseases is cumbersome. An alternative approach based on five categories of powers of tests from 'useless' to 'very strong' has been proposed. The performance of clinicians using it was assessed.
Methods Fifty clinicians attending a course of tropical medicine estimated powers of tests and post-test probabilities using the classical vs. the categorical Bayesian approach. The estimation of post-test probability was assessed for real and dummy diseases in order to avoid the bias of previous knowledge. Accuracy of answers was measured by the difference with reference values obtained from an expert system (Kabisa).
Results Clinicians estimated positive likelihood ratios (LRs) a median of −1.07 log10 lower than Kabisa [interquartile range (IQR): −1.47; −0.80] when derived classically and −0.17 (IQR: −0.42; +0.04) when estimated categorically (P < 0.001). For negative LRs the median was +0.39 log10 higher (IQR: +0.71; +0.08) when derived classically and −0.18 log10 lower (IQR: +0.03; −0.36) when estimated categorically (P < 0.001).
Twenty (40%) disclosed not being able to calculate post-test probabilities using sensitivities and specificities. Regardless the approach post-test probabilities were overestimated both for real and dummy diseases [respectively +1.23 log10 (IQR: +0,67; +2.08) and +2.03 log10 (IQR: +0.49; +2.42)] (P = 0277), but the range was wider for the latter (P = 0.001).
Conclusions Participants were more accurate in estimating powers with a categorical approach than with sensitivities and specificities. Post-test probabilities were overestimated with both approaches. Knowledge of the disease did not influence the estimation of post-test probabilities. A categorical approach might be an interesting instructional tool, but the effect of training with this approach needs assessment
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