Utility of quantitative sensory testing and screening tools in identifying HIV-associated peripheral neuropathy in Western Kenya: Pilot testing

Deanna Cettomai, Judith Kwasa, Caroline Kendi, Gretchen L. Birbeck, Richard W. Price, Elizabeth A. Bukusi, Craig R. Cohen, Ana Claire Meyer

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background/Aim: Neuropathy is the most common neurologic complication of HIV but is widely under-diagnosed in resource-constrained settings. We aimed to identify tools that accurately distinguish individuals with moderate/severe peripheral neuropathy and can be administered by non-physician healthcare workers (HCW) in resource-constrained settings. Methods: We enrolled a convenience sample of 30 HIV-infected outpatients from a Kenyan HIV-care clinic. A HCW administered the Neuropathy Severity Score (NSS), Single Question Neuropathy Screen (Single-QNS), Subjective Peripheral Neuropathy Screen (Subjective-PNS), and Brief Peripheral Neuropathy Screen (Brief-PNS). Monofilament, graduated tuning fork, and two-point discrimination examinations were performed. Tools were validated against a neurologist's clinical assessment of moderate/severe neuropathy. Results: The sample was 57% male, mean age 38.6 years, and mean CD4 count 324 cells/μL. Neurologist's assessment identified 20% (6/30) with moderate/severe neuropathy. Diagnostic utilities for moderate/severe neuropathy were: Single- QNS - 83% sensitivity, 71% specificity; Subjective-PNS-total - 83% sensitivity, 83% specificity; Subjective-PNS-max and NSS - 67% sensitivity, 92% specificity; Brief-PNS - 0% sensitivity, 92% specificity; monofilament - 100% sensitivity, 88% specificity; graduated tuning fork - 83% sensitivity, 88% specificity; two-point discrimination - 75% sensitivity, 58% specificity. Conclusions: Pilot testing suggests Single-QNS, Subjective-PNS, and monofilament examination accurately identify HIVinfected patients with moderate/severe neuropathy and may be useful diagnostic tools in resource-constrained settings.

Original languageEnglish (US)
Article numbere14256
JournalPloS one
Volume5
Issue number12
DOIs
StatePublished - 2010
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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