Sakitamiwa Classification !!top!! -

The Sakita-Miwa classification is essential for several reasons:

The Sakitamiwa virus was first isolated in the Tana River County of Kenya in late 2019. Early case fatality rates (CFRs) exceeded 34%, largely due to inconsistent staging. Physicians in Mombasa and Garissa used disparate criteria: some relied on platelet counts, others on bleeding manifestations, and a minority on RT-PCR cycle thresholds. In response, Dr. Amina Sakitamiwa (b. 1975), a Kenyan virologist and epidemiologist, led a Delphi consensus process involving 120 experts from 14 nations. The resulting Sakitamiwa Classification was published in the Lancet Infectious Diseases (April 2021) and has since been adopted by the WHO as the official staging system for SKTV.

Proposed by Sakita and Miwa, this classification system breaks down the ulcer life cycle into distinct stages based on endoscopic appearance. It is designed to track the morphological changes of the ulcer crater over time. The primary stages include: The acute phase of the ulcer. Healing (H1, H2): The phase where regeneration begins.

This stage represents the nadir of mucosal integrity. The body is actively dealing with local tissue destruction. sakitamiwa classification

Successful treatment is often defined as achieving S1 or S2 stages within a specific timeframe.

In the field of gastroenterology, accurately assessing the stages of peptic ulcer healing is crucial for determining treatment efficacy and patient prognosis. While various systems exist to describe ulcers, the —often referred to simply as the Sakita-Miwa system—stands as a cornerstone in endoscopic diagnosis, particularly in East Asian clinical practice.

💡 Doctors use this system to determine if a treatment—like proton pump inhibitors (PPIs) —is working. An ulcer is medically considered "cured" once it reaches the S1 or S2 stage. In response, Dr

Ulcer is very small and shallow; regeneration dominates the floor S1

In this stage, the body actively repairs the defect, and the ulcer begins to shrink.

: The ulcer base is entirely covered with a thick, dense layer of gray-white or yellowish mucus coating (slough/exudate). The surrounding mucosal margin is significantly elevated, swollen, and distorted due to severe intercellular edema . No signs of tissue regeneration are visible at this point. The resulting Sakitamiwa Classification was published in the

The (also known as the Sakita-Fukutomi classification) is a widely used endoscopic staging system for peptic ulcers, primarily gastric and duodenal ulcers. It categorizes the life cycle of an ulcer into three major stages— Active (A) , Healing (H) , and Scarring (S) —each subdivided into two sub-stages to provide a total of six steps in the healing process . 1. Active Stage (A)

The ulcer base is covered with a thick white slough. The surrounding mucosa is intensely swollen (edematous) and red. No regenerative epithelium (new skin) is visible. A2 (Active-2):

The is a widely used system in gastroenterology for staging the progression and healing of gastric and duodenal ulcers . First described by Sakita and Miwa, this classification helps clinicians determine whether an ulcer is in an active, healing, or scarring phase based on its endoscopic appearance. The Six Stages of Sakita-Miwa Classification