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1. Comparison of Two Different Semiquantitative Urinary Dipstick Tests with Albumin-to-Creatinine Ratio for Screening and Classification of Albuminuria According to KDIGO. A Diagnostic Test Study

Author

Nikolai C. Hodel, Ali Hamad, Klaus Reither, Irene Mndala Kasella, Salim Abdulla, Andreas Schoetzau, Christoph F. R. Hatz, and Michael Mayr

Subjects
albuminuria, urinary dipstick test, albumin-to-creatinine ratio, ACR, diagnostic test study, Micral-Test®, Medicine (General), R5-920
Abstract

Background: Semiquantitative dipstick tests are utilized for albuminuria screening. Methods: In a prospective cross-sectional survey, we analyzed the diagnostic test validity of the semiquantitative colorimetric indicator-dye-based Combur9-Test® and the albumin-specific immunochromatographic assay Micral-Test® for the detection of albuminuria, the distribution of the semiquantitative measurements within the albuminuria stages according to KDIGO, and the utility for albuminuria screening compared with an albumin-to-creatinine ratio (ACR) in a walk-in population. Results: In 970 subjects, albuminuria (≥30 mg/g) was detected in 12.7% (95% CI 85.6–96.3%) with the ACR. Sensitivity was 82.9% (95% CI 75.1–89.1%) and 91.9% (95% CI 88.7–96.9%) and specificity 71.5% (95% CI 68.4–74.6%) and 17.5% (95% CI 15.0–20.2%) for the Combur9-Test® and Micral-Test®, respectively. Correct classification to KDIGO albuminuria stages A2/A3 with the Combur9-Test® was 15.4%, 51.4%, and 87.9% at cut-offs of 30, 100, and ≥300 mg/dL, and with the Micral-Test® it was 1.8%, 10.5%, and 53.6% at cut-offs of 2, 5, and 10 mg/dL, respectively. Overall, disagreement to KDIGO albuminuria was seen in 27% and 73% with the Combur9-Test® and Micral-Test®, respectively. From the total population, 62.5% and 15.3% were correctly ruled out and 2.2% and 1% were missed as false-negatives by the Combur9-Test® and Micral-Test®, respectively. Conclusion: Compared to the Combur9-Test®, the utility of the Micral-Test® is limited, because the fraction of correctly ruled out patients is small and a large proportion with a positive Micral-Test® require a subsequent ACR conformation test.

Published
2021
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2. The epidemiology of chronic kidney disease and the association with non-communicable and communicable disorders in a population of sub-Saharan Africa.

Author

Nikolai C Hodel, Ali Hamad, Claudia Praehauser, Grace Mwangoka, Irene Mndala Kasella, Klaus Reither, Salim Abdulla, Christoph F R Hatz, and Michael Mayr

Subjects
Medicine, Science
Abstract

In sub-Saharan Africa (SSA), epidemiological data for chronic kidney disease (CKD) are scarce. We conducted a prospective cross-sectional study including 952 patients in an outpatient clinic in Tanzania to explore CKD prevalence estimates and the association with cardiovascular and infectious disorders. According to KDIGO, we measured albumin-to-creatinine ratio and calculated eGFR using CKD-EPI formula. Factors associated with CKD were calculated by logistic regression. Venn diagrams were modelled to visualize interaction between associated factors and CKD. Overall, the estimated CKD prevalence was 13.6% (95% CI 11-16%). Ninety-eight patients (11.2%) (95% CI 9-14%) were categorized as moderate, 12 (1.4%) (95% CI 0-4%) as high, and 9 (1%) (95% CI 0-3%) as very high risk according to KDIGO. History of tuberculosis (OR 3.75, 95% CI 1.66-8.18; p = 0.001) and schistosomiasis (OR 2.49, 95% CI 1.13-5.18; p = 0.02) were associated with CKD. A trend was seen for increasing systolic blood pressure (OR 1.02 per 1 mmHg, 95% CI 1.00-1.03; p = 0.01). Increasing BMI (OR 0.92 per 1kg/m2, 95% CI 0.88-0.96; p =

Published
2018
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3. Assessment of diabetes and prediabetes prevalence and predictors by HbA1c in a population from sub-Saharan Africa with a high proportion of anemia: a prospective cross-sectional study

Author

Claudia Praehauser, Nikolai C. Hodel, Christoph Hatz, Ali Hamad, Grace Mwangoka, Salim Abdulla, Klaus Reither, Michael Mayr, and Irene Mndala Kasella

Subjects
Cross-sectional study, Endocrinology, Diabetes and Metabolism, Prevalence, Overweight, Tanzania, chemistry.chemical_compound, 0302 clinical medicine, risk factors, 030212 general & internal medicine, Prediabetes, Prospective Studies, education.field_of_study, diabetes, Anemia, Middle Aged, epidemiology, medicine.symptom, Adult, medicine.medical_specialty, HbA1c, Adolescent, Population, 030209 endocrinology & metabolism, body mass index, Diseases of the endocrine glands. Clinical endocrinology, Prediabetic State, 03 medical and health sciences, Young Adult, pre-diabetes, Internal medicine, sub-Sahara Africa, medicine, Diabetes Mellitus, Humans, Epidemiology/Health Services Research, education, Aged, Glycated Hemoglobin, business.industry, medicine.disease, RC648-665, Cross-Sectional Studies, chemistry, age, Glycated hemoglobin, business, Body mass index
Abstract

IntroductionEpidemiological data about diabetes mellitus (DM) for sub-Saharan Africa (SSA) are scarce and the utility of glycated hemoglobin (HbA1c) to diagnose DM is uncertain in African populations with a high proportion of anemia.Research design and methodsIn a cross-sectional study, age-adjusted prevalence rates and predictors for DM and pre-DM were prospectively assessed by HbA1c in a semirural walk-in population of Tanzania (n=992). Predictors for DM were calculated by logistic regression. Correlations between HbA1c, hemoglobin, and blood glucose levels were done by Pearson’s correlation.ResultsOverall, DM and pre-DM prevalence rates were 6.8% (95% CI 5.3 to 8.5) and 25% (95% CI 22.8 to 28.3), respectively. There was an increase in DM prevalence in patients 50–59 (14.9%; 95% CI 9.1 to 22.5), ≥60 years old (18.5%; 95% CI 12.2 to 26.2) and in patients with overweight (9.3%; 95% CI 5.9 to 13.7), obesity (10.9%; 95% CI 6.9 to 16) compared with patients 18–29 years old (2.2%; 95% CI 0.9 to 4.4) (p2 and a BMI of 35 kg/m2, the relative risk for DM increases in average by 2.12-fold (range 1.91–2.24) across the age groups. Comparing patients 20 years old with patients 70 years old, the relative risk for DM increases in average 9.7-fold (range 8.9–10.4) across the BMI groups. Overall, 333 patients (36%) suffered from anemia. Pearson’s correlation coefficients (r) between HbA1c and hemoglobin was −0.009 (p=0.779), and between HbA1c and fasting blood glucose and random blood glucose, it was 0.775 and 0.622, respectively (pConclusionWe observed a high prevalence of DM and pre-DM, mainly triggered by increasing age and BMI, and provide evidence that HbA1c is suitable to assess DM also in populations of SSA with high proportions of anemia.Trial registration numberNCT03458338.

Published
2020
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4. The epidemiology of chronic kidney disease and the association with non-communicable and communicable disorders in a population of sub-Saharan Africa

Author

Claudia Praehauser, Nikolai C. Hodel, Christoph Hatz, Irene Mndala Kasella, Ali Hamad, Grace Mwangoka, Klaus Reither, Michael Mayr, and Salim Abdulla

Subjects
Male, Bacterial Diseases, 030232 urology & nephrology, lcsh:Medicine, Blood Pressure, Kidney, Tanzania, Vascular Medicine, 0302 clinical medicine, Endocrinology, Risk Factors, Epidemiology, Chronic Kidney Disease, Medicine and Health Sciences, Outpatient clinic, Schistosomiasis, 030212 general & internal medicine, lcsh:Science, Aged, 80 and over, education.field_of_study, Multidisciplinary, Anemia, Hematology, Middle Aged, Infectious Diseases, Cardiovascular Diseases, Nephrology, Helminth Infections, Creatinine, Hypertension, Urinary Tract Infections, Female, medicine.symptom, Anatomy, Glomerular Filtration Rate, Research Article, Neglected Tropical Diseases, Adult, medicine.medical_specialty, Adolescent, Endocrine Disorders, Urology, Population, Communicable Diseases, 03 medical and health sciences, Young Adult, Internal medicine, Diabetes mellitus, medicine, Diabetes Mellitus, Parasitic Diseases, Humans, Tuberculosis, Renal Insufficiency, Chronic, education, Noncommunicable Diseases, Africa South of the Sahara, Aged, History of tuberculosis, business.industry, lcsh:R, Biology and Life Sciences, Kidneys, Renal System, medicine.disease, Tropical Diseases, Metabolic Disorders, Albuminuria, lcsh:Q, business, Kidney disease
Abstract

In sub-Saharan Africa (SSA), epidemiological data for chronic kidney disease (CKD) are scarce. We conducted a prospective cross-sectional study including 952 patients in an outpatient clinic in Tanzania to explore CKD prevalence estimates and the association with cardiovascular and infectious disorders. According to KDIGO, we measured albumin-to-creatinine ratio and calculated eGFR using CKD-EPI formula. Factors associated with CKD were calculated by logistic regression. Venn diagrams were modelled to visualize interaction between associated factors and CKD. Overall, the estimated CKD prevalence was 13.6% (95% CI 11-16%). Ninety-eight patients (11.2%) (95% CI 9-14%) were categorized as moderate, 12 (1.4%) (95% CI 0-4%) as high, and 9 (1%) (95% CI 0-3%) as very high risk according to KDIGO. History of tuberculosis (OR 3.75, 95% CI 1.66-8.18; p = 0.001) and schistosomiasis (OR 2.49, 95% CI 1.13-5.18; p = 0.02) were associated with CKD. A trend was seen for increasing systolic blood pressure (OR 1.02 per 1 mmHg, 95% CI 1.00-1.03; p = 0.01). Increasing BMI (OR 0.92 per 1kg/m2, 95% CI 0.88-0.96; p =

Published
2018

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