SENSITIVITY AND SPECIFICITY OF ULTRASOUND DETECTION AND RISK FACTORS FOR FILARIAL-ASSOCIATED HYDROCELES

AARON A. R. TOBIAN Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; University Hospitals of Cleveland, Veteran’s Affairs Medical Center, Cleveland, Ohio; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea

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NANDAO TARONGKA Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; University Hospitals of Cleveland, Veteran’s Affairs Medical Center, Cleveland, Ohio; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea

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MOSES BAISOR Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; University Hospitals of Cleveland, Veteran’s Affairs Medical Center, Cleveland, Ohio; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea

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MOSES BOCKARIE Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; University Hospitals of Cleveland, Veteran’s Affairs Medical Center, Cleveland, Ohio; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea

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JAMES W. KAZURA Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; University Hospitals of Cleveland, Veteran’s Affairs Medical Center, Cleveland, Ohio; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea

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CHRISTOPHER L. KING Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; University Hospitals of Cleveland, Veteran’s Affairs Medical Center, Cleveland, Ohio; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea

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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.

Author Notes

Reprint requests: Christopher L. King, Center for Global Health and Diseases, Room W137, Case Western Reserve University School of Medicine, 2109 Adelbert Road, Cleveland, OH 44106-4983, Telephone: 216-368-4817, Fax: 216-368-4825, E-mail: cxk21@po.cwru.edu
  • 1

    Partono F, 1987. The spectrum of disease in lymphatic filariasis. Ciba Found Symp 127 :15–31.

  • 2

    Dreyer G, Noroes J, Figueredo-Silva J, Piessens WF, 2000. Pathogenesis of lymphatic disease in Bancroftian filariasis: a clinical perspective. Parasitol Today 16 :544–548.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Wijers DJ, 1977. Bancroftian filariasis in Kenya. IV. Disease distribution and transmission dynamics. Ann Trop Med Parasitol 1 :452–463.

  • 4

    Gyapong JO, 1998. The relationship between infection and disease in Wuchereria bancrofti infection in Ghana. Trans R Soc Trop Med Hyg 92 :390–392.

  • 5

    Meyrowitsch DW, Simonsen PE, Makunde WH, 1995. Bancroftian filariasis: analysis of infection and disease in five endemic communities of north-eastern Tanzania. Ann Trop Med Parasitol 89 :653–663.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Tisch DJ, Hazlett FE, Kastens W, Alpers MP, Bockarie MJ, Kazura JW, 2001. Ecologic and biologic determinants of filarial antigenemia in bancroftian filariasis in Papua New Guinea. J Infect Dis 184 :898–904.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Kazura JW, Bockarie M, Alexander N, Perry R, Bockarie F, Dagoro H, Dimber Z, Hyun P, Alpers MP, 1997. Transmission intensity and its relationship to infection and disease due to Wuchereria bancrofti in Papua New Guinea. J Infect Dis 176 :242–246.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    World Health Organization, 1984. Lymphatic filariasis. Fourth Report of the WHO Expert Committee on Filariasis. World Health Organ Tech Rep Ser 702 :3–112.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Leung ML, Gooding GA, Williams RD, 1984. High-resolution sonography of scrotal contents in asymptomatic subjects. AJR Am J Roentgenol 143 :161–164.

  • 10

    Gyapong JO, Webber RH, Morris J, Bennett S, 1998. Prevalence of hydrocele as a rapid diagnostic index for lymphatic filariasis. Trans R Soc Trop Med Hyg 92 :40–43.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Dreyer G, Addiss D, Santos A, Figueredo-Silva J, Noroes J, 1998. Direct assessment in vivo of the efficacy of combined single-dose ivermectin and diethylcarbamazine against adult Wuchereria bancrofti.Trans R Soc Trop Med Hyg 92 :219–222.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Subramanian AK, Mungai P, Ouma JH, Magak P, King CH, Mahmoud AA, King CL, 1999. Long-term suppression of adult bladder morbidity and severe hydronephrosis following selective population chemotherapy for Schistosoma haematobium.Am J Trop Med Hyg 61 :476–481.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Noroes J, Addiss D, Santos A, Medeiros Z, Coutinho A, Dreyer G, 1996. Ultrasonographic evidence of abnormal lymphatic vessels in young men with adult Wuchereria bancrofti infection in the scrotal area. J Urol 156 :409–412.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Dreyer G, Addiss D, Roberts J, Noroes J, 2002. Progression of lymphatic vessel dilatation in the presence of living adult Wuchereria bancrofti.Trans R Soc Trop Med Hyg 96 :157–161.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Marchetti F, Piessens WF, Medeiros Z, Dreyer G, 1998. Abnormalities of the leg lymphatic are not specific for bancroftian filariasis. Trans R Soc Trop Med Hyg 92 :650–652.

    • PubMed
    • Search Google Scholar
    • Export Citation
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