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Abstract
Objective: To determine the diagnostic accuracy of Stool Color Card (SCC), as a screening tool in predicting Biliary Atresia (BA), in cholestatic infants up to 3 months (90 days) of age.
Study Design: Prospective cohort study
Place and Duration of Study: Department of Pediatric Gastroenterology and Hepatology, University of Child Health Sciences, Lahore; 10th March 2024 to 28th August 2024.
Materials & Methods:
Infants up to 3 months of age, presenting with cholestatic jaundice, were enrolled. Mothers of these infants, were asked to fill the stool color card, by matching the stool color of their baby. These infants were divided into group A (abnormal stool color) and group B (normal stool color). Both groups were followed up, for a final diagnosis of Biliary Atresia. Infants who screened as true positive and true negative by the stool color card were noted; sensitivity, specificity of the stool color card was calculated.
Results: Out of total 56 patients enrolled, 33 were male and 23 were female. 46/56 infants had abnormal (acholic) stool color - group A. Whereas, 10/56 babies had a normal (pigmented) stool color - group B. It was found that 22/56 babies in group A were diagnosed as Biliary Atresia. All 10 patients in group B, did not have biliary atresia. Sensitivity of SCC was 47.8%, Specificity was 100%, PPV was 100% and NPV was 29.4% according to our study.
Conclusion: Stool color remains the most practical means of screening for biliary atresia in terms of its ease to use and its economic value. It requires little expertise for the screening purpose, while having a high specificity.