{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T07:01:27Z","timestamp":1791615687550,"version":"4.3.4"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100006162","name":"FACEPE","doi-asserted-by":"publisher","award":["APQ 0057\u20134.00\/13"],"award-info":[{"award-number":["APQ 0057\u20134.00\/13"]}],"id":[{"id":"10.13039\/501100006162","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Periportal fibrosis (PPF) is the major pathological consequence of Schistosoma mansoni infection. The Coutinho index\u2014the alkaline phosphatase (ALP) to platelet ratio ([ALP\/upper limit of normality {ULN}]\/platelet count [106\/L] x 100)\u2014was validated. Validation consisted of modest laboratory tests to predict advanced PPF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 378 individuals from an endemic area of Brazil with a previous history of the disease and\/or a positive parasitological examination were evaluated. We used ultrasound examination as the gold standard for classification of the PPF pattern and measured the biological markers of the index.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty-one individuals (10.8%) without PPF, 291 (77%) with moderate PPF and 46 (12.2%) with advanced PPF, were identified. ALP and platelet count were used for the index. The cut-off point \u22650.228 predicted the presence of fibrosis with an area under the receiver operating characteristic curve (AUROC) of 0.56, sensitivity of 68.6% and specificity of 46.3%. There was an absence of PPF in 46.3% of individuals without fibrosis and the presence of PPF in 68.5% of cases with moderate and advanced ultrasound fibrosis. The identification of advanced fibrosis with a cut-off point \u22650.316 revealed an AUROC curve of 0.70, sensitivity of 67.4% and specificity of 68.3%, thus confirming the advanced phase in 65.2% of cases compared with ultrasound.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The Coutinho index was able to predict advanced PPF in most individuals. It is valid as a new tool, uses routine laboratory tests and therefore is more accessible for screening patients with a severe form of the disease in endemic areas.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/trab040","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T20:12:43Z","timestamp":1614197563000},"page":"19-25","source":"Crossref","is-referenced-by-count":4,"title":["The Coutinho index as a simple tool for screening patients with advanced forms of <i>Schistosomiasis mansoni<\/i>: a validation study"],"prefix":"10.1093","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3901-7144","authenticated-orcid":false,"given":"Ana V M S","family":"Barreto","sequence":"first","affiliation":[{"name":"Instituto Aggeu Magalh\u00e3es, Funda\u00e7\u00e3o Oswaldo Cruz, Recife-Pernambuco, 50670-420, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana L C","family":"Domingues","sequence":"additional","affiliation":[{"name":"Centro de Ci\u00eancias M\u00e9dicas, Universidade Federal de Pernambuco, Recife-Pernambuco, 50670-901, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George T N","family":"Diniz","sequence":"additional","affiliation":[{"name":"Instituto Aggeu Magalh\u00e3es, Funda\u00e7\u00e3o Oswaldo Cruz, Recife-Pernambuco, 50670-420, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M S","family":"Cavalcanti","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Central de Sa\u00fade P\u00fablica, Secretaria Estadual de Sa\u00fade, Recife-Pernambuco, 52171-011, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmundo P","family":"Lopes","sequence":"additional","affiliation":[{"name":"Centro de Ci\u00eancias M\u00e9dicas, Universidade Federal de Pernambuco, Recife-Pernambuco, 50670-901, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia M L","family":"Montenegro","sequence":"additional","affiliation":[{"name":"Instituto Aggeu Magalh\u00e3es, Funda\u00e7\u00e3o Oswaldo Cruz, Recife-Pernambuco, 50670-420, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarice N L","family":"Morais","sequence":"additional","affiliation":[{"name":"Instituto Aggeu Magalh\u00e3es, Funda\u00e7\u00e3o Oswaldo Cruz, Recife-Pernambuco, 50670-420, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"2022031008051529600_bib1","volume-title":"Plan of Action for the Elimination of Neglected Infectious Diseases and Post-elimination Actions 2016-2022","author":"World Health Organization","year":"2016"},{"key":"2022031008051529600_bib2","volume-title":"Vigil\u00e2ncia da esquistossomose mansoni","author":"Minist\u00e9rio da","year":"2014"},{"key":"2022031008051529600_bib3","author":"Secretaria Estadual de Sa\u00fade","year":"2018","journal-title":"Secretaria Executiva de Vigil\u00e2ncia em Sa\u00fade. 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