Evaluation of inter-observer agreement for periportal fibrosis related to Schistosoma mansoni: A population-based study of 3302 individuals using point-of-care ultrasound images and video in the SchistoTrack cohort

Background: Schistosomiasis-related periportal fibrosis (PPF) diagnoses rely on point-of-care ultrasound imaging. Yet, the extent of agreement between sonographers, limitations of existing World Health Organization (WHO) protocols, and the applicability of ultrasound video remain poorly understood. Methods: In 2024, six sonographers performed ultrasound scans for 3302 participants aged 5-92 years within SchistoTrack, a community-based cohort in rural Uganda. We adapted and standardised the WHO Niamey protocol for the collection of curated ultrasound images of liver fibrosis patterns related to

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