The Micral-Test as a screening tool to detect micro- albuminuria in children 5 - 15 years old with sickle cell anaemia, Lagos State University Teaching Hospital

Abstract

Objective. To determine the sensitivity, specificity, and positive and negative predictive values of the Micral-Test in determination of microalbuminuria (MA).

Methods. Eighty children aged 5 - 15 years with sickle cell anaemia (SCA) (HbSS) in a steady state attending the Lagos State University Teaching Hospital were recruited. The subjects were age-, sex- and social-class-matched with controls of genotype AA (HbAA). This prospective, descriptive and cross-sectional study lasted for 3 months, between October and December 2009. Morning random spot urine was used to assess the Micral-Test and the albumin/creatinine ratio (ACR). The performance of the Micral-Test was determined using the ACR as the gold standard.

Result. The sensitivity and specificity of the Micral-Test were 84.6% and 81.0%, respectively. The sensitivity and specificity were 100% and 86.6%, respectively, in children <10 years of age compared with 80% and 73.8%, respectively, in those >10 years old. The positive predictive value was 28.2% and the negative predictive value was 98% among the study subjects.

Conclusion. The sensitivity and specificity of the Micral-Test make it a good screening tool to detect MA in children with SCA. The Micral- Test is cheaper than quantitative measurement of ACR. Patients with a single positive Micral-Test should be followed up with two more Micral-Tests over a 3-month period to confirm persistent MA.