Agreement of abdominal palpation with point-of-care ultrasound for hepatosplenic organomegaly: a cross-sectional, population-based study in schistosomiasis-endemic settings of rural Uganda

Standardized spleen palpation in rural Uganda’s SchistoTrack cohort shows high specificity (98.4%) and strong agreement with ultrasound for severe splenomegaly (kappa=0.57).

• Why it matters: Ultrasound is used to assess hepatosplenic schistosomiasis morbidity, but limited access in resource-constrained settings leaves uncertainty about whether abdominal palpation can reliably detect enlargement.
• What they did: In January–February 2024, 3177 participants (ages 5–92) from Pakwach, Buliisa, and Mayuge underwent standardized liver and spleen palpation by trained nurses, compared with point-of-care B-mode ultrasound using height-standardized reference values.
• The result: Palpation sensitivity for spleen enlargement ranged from 10.9% (moderate) to 48.6% (severe), with weak agreement for moderate splenomegaly (kappa=0.14), implying palpation can miss many ultrasound-defined cases.

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