Hepatitis C Virus universal screening versus risk based selective screening during pregnancy.

OBJECTIVES: We sought to compare the value of HCV universal screening versus risk-based selective screening in pregnant women. STUDY DESIGN: In a prospective observational study (Jan 2012 - March 2012), pregnant women, in a high risk inner city clinic, who were at "low risk" for HCV infection were tested for HCV antibodies (universal screening) and their medical records were compared to the medical records of pregnant women who were at "high risk" (risk based selective screening as assessed by their obstetricians' screening questionnaire). RESULTS: During the study period, 419 women delivered at our institution with 8.8% (37/419) at high risk for HCV. In 95% (183/193) of available and consenting low risk women, HCV antibody testing was done. The prevalence of HCV was 3.18% (7/220; 95% CI: 1.36-6.50) in all tested women versus 0.95% (4/419; 95% CI: 0.31-2.59) in risk-based selectively tested women. Overall the screening questionnaire had a sensitivity of 0.85 (0.42-0.99) and a specificity of 0.52 (0.45-0.58) in all women who had HCV antibody testing and questionnaire screening. CONCLUSIONS: Using a screening questionnaire to identify women at risk for HCV infection during pregnancy under-estimates the real prevalence of HCV. A universal screening should be considered in high risk cities.

[French translation and validation of the Edinburgh Questionnaire for the diagnosis of intermittent claudication]. / Traduction française et validation du questionnaire d'Edimbourg pour le dépistage de la claudication intermittente.

Obliterative arterial disease of the lower limbs is diagnosed by simple, reproducible, sensitive and non-invasive methods. One of these, a questionnaire for the diagnosis on intermittent limping, is a method of choice. Until recent years, the only validated questionnaire was the one proposed by the World Health Organisation. This was criticised a lot, especially for its lack of sensitivity. Recently, a Scottish group proposed an improvement in the diagnostic performance of this questionnaire by carrying out several changes. This new version, called the Edinburgh Questionnaire, has promising diagnostic qualities. The authors present a French version of this questionnaire. This French translation was validated in 105 patients referred for diagnosis of obliterative lower limb arterial disease. A sensitivity of 86.5%, a specificity of 95.6%, a positive predictive value of 91.4% and a negative predictive value of 92.9% of this French version are comparable to the results obtained with the English version. Therefore, the authors suggest using this questionnaire in epidemiological and public health studies in France.