Evaluation of Individual and Combined Markers of Urine Dipstick Parameters and Total Lymphocyte Count as a Substitute for CD4 Count in Low-Resource Communities in Ghana

We evaluated the individual and combined levels of urine dipstick and total lymphocyte count (TLC) as surrogate markers for CD4 count in a low-resource community in Ghana. This cross-sectional study recruited 200 HIV-infected patients from the Saint Francis Xavier Hospital, Assin Fosu, Ghana. Comple...

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Published in:Disease markers 2018-01, Vol.2018 (2018), p.1-7
Main Authors: Osaah, Esther, Jommo, Juliana, Donkor, Sampson, Oppong Afranie, Bright, Amankwaa, Bright, Acheampong, Emmanuel, Obirikorang, Christian, Odame Anto, Enoch, Hope, Isaac
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antiretroviral drugs
Blood
CD4 antigen
CD4 Lymphocyte Count
Cell number
Communities
Cross-Sectional Studies
Disease Progression
Ethylenediaminetetraacetic acid
Female
Ghana
Hematuria
HIV
HIV Infections - immunology
HIV Infections - urine
HIV patients
Human immunodeficiency virus
Humans
Lymphocyte Count
Lymphocytes
Male
Markers
Medical examination
Medical research
Medicine, Experimental
Middle Aged
Patients
Poverty
Proteinuria
Proteinuria - urine
Sensitivity
Sensitivity and Specificity
Substitutes
Urine
Young Adult
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cites cdi_FETCH-LOGICAL-c456t-361766d92f3a0a35c7549b893da2d8df02935fe0d8de8a89dbb5737310df079f3
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creator Osaah, Esther
Jommo, Juliana
Donkor, Sampson
Oppong Afranie, Bright
Amankwaa, Bright
Acheampong, Emmanuel
Obirikorang, Christian
Odame Anto, Enoch
Hope, Isaac
description We evaluated the individual and combined levels of urine dipstick and total lymphocyte count (TLC) as surrogate markers for CD4 count in a low-resource community in Ghana. This cross-sectional study recruited 200 HIV-infected patients from the Saint Francis Xavier Hospital, Assin Fosu, Ghana. Complete blood count, CD4 count, and urine dipstick analysis were measured for participants. The threshold values were determined as
doi_str_mv 10.1155/2018/7485942
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This cross-sectional study recruited 200 HIV-infected patients from the Saint Francis Xavier Hospital, Assin Fosu, Ghana. Complete blood count, CD4 count, and urine dipstick analysis were measured for participants. The threshold values were determined as &lt;350 cells/μl for CD4, &lt;1200 cells/μl for TLC, and ≥+ on urine dipstick analysis. The mean age of participants was 43.09 years. Proteinuria ≥ + [aOR = 4.30 (3.0–18.5)], leukocyturia ≥ + [aOR = 2.91 (1.33–12.5)], hematuria ≥ + [aOR = 2.30 (1.08–9.64)], and TLC &lt; 1200 cells/μl [aOR = 3.26 (3.94–15.29)] were significantly associated with increased risk of CD4 count &lt; 350 cells/μl. Using the individual markers, the best substitute marker for predicting CD4 count &lt; 350 cells/μl was proteinuria at a cutoff point ≥ 2++, AUC of 0.973, sensitivity of 97.6%, specificity of 100.0%, PPV of 100.0%, and NPV of 89.1%. A combination of ≤ 1200 TLC + ≥ 2++ (leukocyturia + proteinuria + hematuria) yielded an AUC of 0.980, sensitivity (72.8%), specificity (100.0%), PPV (100.0%), and NPV (97.9%). 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This cross-sectional study recruited 200 HIV-infected patients from the Saint Francis Xavier Hospital, Assin Fosu, Ghana. Complete blood count, CD4 count, and urine dipstick analysis were measured for participants. The threshold values were determined as &lt;350 cells/μl for CD4, &lt;1200 cells/μl for TLC, and ≥+ on urine dipstick analysis. The mean age of participants was 43.09 years. Proteinuria ≥ + [aOR = 4.30 (3.0–18.5)], leukocyturia ≥ + [aOR = 2.91 (1.33–12.5)], hematuria ≥ + [aOR = 2.30 (1.08–9.64)], and TLC &lt; 1200 cells/μl [aOR = 3.26 (3.94–15.29)] were significantly associated with increased risk of CD4 count &lt; 350 cells/μl. Using the individual markers, the best substitute marker for predicting CD4 count &lt; 350 cells/μl was proteinuria at a cutoff point ≥ 2++, AUC of 0.973, sensitivity of 97.6%, specificity of 100.0%, PPV of 100.0%, and NPV of 89.1%. 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This cross-sectional study recruited 200 HIV-infected patients from the Saint Francis Xavier Hospital, Assin Fosu, Ghana. Complete blood count, CD4 count, and urine dipstick analysis were measured for participants. The threshold values were determined as &lt;350 cells/μl for CD4, &lt;1200 cells/μl for TLC, and ≥+ on urine dipstick analysis. The mean age of participants was 43.09 years. Proteinuria ≥ + [aOR = 4.30 (3.0–18.5)], leukocyturia ≥ + [aOR = 2.91 (1.33–12.5)], hematuria ≥ + [aOR = 2.30 (1.08–9.64)], and TLC &lt; 1200 cells/μl [aOR = 3.26 (3.94–15.29)] were significantly associated with increased risk of CD4 count &lt; 350 cells/μl. Using the individual markers, the best substitute marker for predicting CD4 count &lt; 350 cells/μl was proteinuria at a cutoff point ≥ 2++, AUC of 0.973, sensitivity of 97.6%, specificity of 100.0%, PPV of 100.0%, and NPV of 89.1%. 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subjects Adolescent
Adult
Antiretroviral drugs
Blood
CD4 antigen
CD4 Lymphocyte Count
Cell number
Communities
Cross-Sectional Studies
Disease Progression
Ethylenediaminetetraacetic acid
Female
Ghana
Hematuria
HIV
HIV Infections - immunology
HIV Infections - urine
HIV patients
Human immunodeficiency virus
Humans
Lymphocyte Count
Lymphocytes
Male
Markers
Medical examination
Medical research
Medicine, Experimental
Middle Aged
Patients
Poverty
Proteinuria
Proteinuria - urine
Sensitivity
Sensitivity and Specificity
Substitutes
Urine
Young Adult
title Evaluation of Individual and Combined Markers of Urine Dipstick Parameters and Total Lymphocyte Count as a Substitute for CD4 Count in Low-Resource Communities in Ghana
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