Proteinuria screening using sulfosalicylic acid: advantages of the method for the monitoring of prenatal consultations in West Africa.

Screening for proteinuria is widely recommended in the monitoring of pregnancy in order to detect preeclampsia. The method often used in primary health care centers (urine heated with acetic acid) has often attained results of over 50% positive cases. This result indicates a considerable lack of specificity outside highly endemic, for urinary schistosomiasis areas. The sulfosalicylic acid test (SSA) represents a simple, reliable and inexpensive alternative. In order to validade this procedure in the conditions of a primary mother and child health (MCH) center, results of the SSA method were compared with standard commercial strip tests a. in a well equipped Swiss laboratory, b. in a school setting in Northern Cameroon. The proportion of agreement between the two methods was 82% (CI 66-98) and 90% (CI 83-96) respectively. The relatively easy implementation of the SSA test in a MCH center in an urban area in Southern Mali lead to results more compatible with what was expected epidemiologically (less than 5% from positive to highly positive results). This experiment confirms that the SSA technique is a simple method, easy to demonstrate and implement, as well as inexpensive. Consequences for monitoring of pregnancies in such conditions are finally discussed.