TY - JOUR
T1 - Cervical lesion proportion measure using a digital gridded imaging technique to assess cervical pathology in women with genital schistosomiasis
AU - Arenholt, Louise Thomsen Schmidt
AU - Aaroe, Katrina Kaestel
AU - Norderud, Kanutte
AU - Lumholdt, Mads
AU - Randrianasolo, Bodo Sahondra
AU - Ramarokoto, Charles Emile
AU - Rabozakandraina, Oliva
AU - Broennum, Dorthe
AU - Feldmeier, Hermann
AU - Leutscher, Peter Derek Christian
N1 - Publisher Copyright:
© 2022 Arenholt et al.
PY - 2022/7
Y1 - 2022/7
N2 - Female genital schistosomiasis (FGS) is characterized by a pattern of lesions which manifest at the cervix and the vagina, such as homogeneous and grainy sandy patches, rubbery papules in addition to neovascularization. A tool for quantification of the lesions is needed to improve FGS research and control programs. Hitherto, no tools are available to quantify clinical pathology at the cervix in a standardized and reproducible manner. This study aimed to develop and validate a cervical lesion proportion (CLP) measure for quantification of cervical pathology in FGS. A digital imaging technique was applied in which a grid containing 424 identical squares was positioned on high resolution digital images from the cervix of 70 women with FGS. CLP was measured for each image by observers counting the total number of squares containing at least one type of FGS associated lesion. For assessment of inter-and intra-observer reliability, three different observers measured CLP independently. In addition, a rubbery papule count (RPC) was determined in a similar manner. The intra-class correlation coefficient was 0.94 (excellent) for the CLP interrater reliability and 0.90 (good) for intra-rater reliability and the coefficients for the RPC were 0.88 and 0.80 (good), respectively. The CLP facilitated a reliable and reproducible quantification of FGS associated lesions of the cervix. In the future, grading of cervical pathology by CLP may provide insight into the natural course of schistosome egg-induced pathology of the cervix and may have a role in assessing praziquantel treatment efficacy against FGS. Trial Registration: ClinicalTrials.gov, trial number NCT04115072; trial URL https:// clinicaltrials.gov/ct2/show/NCT04115072?term=Female+genital+schistosomiasis+AND +Madagascar&draw=2&rank=1.
AB - Female genital schistosomiasis (FGS) is characterized by a pattern of lesions which manifest at the cervix and the vagina, such as homogeneous and grainy sandy patches, rubbery papules in addition to neovascularization. A tool for quantification of the lesions is needed to improve FGS research and control programs. Hitherto, no tools are available to quantify clinical pathology at the cervix in a standardized and reproducible manner. This study aimed to develop and validate a cervical lesion proportion (CLP) measure for quantification of cervical pathology in FGS. A digital imaging technique was applied in which a grid containing 424 identical squares was positioned on high resolution digital images from the cervix of 70 women with FGS. CLP was measured for each image by observers counting the total number of squares containing at least one type of FGS associated lesion. For assessment of inter-and intra-observer reliability, three different observers measured CLP independently. In addition, a rubbery papule count (RPC) was determined in a similar manner. The intra-class correlation coefficient was 0.94 (excellent) for the CLP interrater reliability and 0.90 (good) for intra-rater reliability and the coefficients for the RPC were 0.88 and 0.80 (good), respectively. The CLP facilitated a reliable and reproducible quantification of FGS associated lesions of the cervix. In the future, grading of cervical pathology by CLP may provide insight into the natural course of schistosome egg-induced pathology of the cervix and may have a role in assessing praziquantel treatment efficacy against FGS. Trial Registration: ClinicalTrials.gov, trial number NCT04115072; trial URL https:// clinicaltrials.gov/ct2/show/NCT04115072?term=Female+genital+schistosomiasis+AND +Madagascar&draw=2&rank=1.
KW - Animals
KW - Cervix Uteri/diagnostic imaging
KW - Female
KW - Humans
KW - Reproducibility of Results
KW - Schistosoma haematobium
KW - Schistosomiasis haematobia/diagnostic imaging
KW - Vagina/pathology
UR - http://www.scopus.com/inward/record.url?scp=85134489940&partnerID=8YFLogxK
U2 - 10.1371/JOURNAL.PNTD.0009995
DO - 10.1371/JOURNAL.PNTD.0009995
M3 - Journal article
C2 - 35788749
AN - SCOPUS:85134489940
SN - 1935-2727
VL - 16
JO - PLoS Neglected Tropical Diseases
JF - PLoS Neglected Tropical Diseases
IS - 7
M1 - e0009995
ER -