Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers
Identifieur interne : 001205 ( Main/Exploration ); précédent : 001204; suivant : 001206Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers
Auteurs : Samuel Wanji [Cameroun] ; Jonas A. Kengne-Ouafo [Cameroun] ; Fabrice R. Datchoua-Poutcheu [Cameroun] ; Abdel Jelil Njouendou [Cameroun] ; Dizzel Bita Tayong [Cameroun] ; David D. Sofeu-Feugaing [Cameroun] ; Nathalie Amvongo-Adjia [Cameroun] ; Bridget A. Fovennso [Cameroun] ; Yolande F. Longang-Tchounkeu [Cameroun] ; Fasil Tekola-Ayele [États-Unis] ; Peter A. Enyong [Cameroun] ; Melanie J. Newport ; Gail DaveySource :
- BMC Public Health [ 1471-2458 ] ; 2016.
Descripteurs français
- KwdFr :
- Accessibilité des services de santé, Adulte, Agents de santé communautaire, Cameroun (épidémiologie), Dépistage systématique (), Femelle, Humains, Indice de gravité médicale, Mâle, Personnel de recherche, Population rurale, Zone médicalement sous-équipée, Éléphantiasis (), Éléphantiasis (anatomopathologie), Éléphantiasis (diagnostic), Éléphantiasis (épidémiologie), Études de faisabilité.
- MESH :
- anatomopathologie : Éléphantiasis.
- diagnostic : Éléphantiasis.
- épidémiologie : Cameroun, Éléphantiasis.
- Accessibilité des services de santé, Adulte, Agents de santé communautaire, Dépistage systématique, Femelle, Humains, Indice de gravité médicale, Mâle, Personnel de recherche, Population rurale, Zone médicalement sous-équipée, Éléphantiasis, Études de faisabilité.
English descriptors
- KwdEn :
- Adult, Cameroon (epidemiology), Community Health Workers, Elephantiasis (diagnosis), Elephantiasis (epidemiology), Elephantiasis (pathology), Elephantiasis (prevention & control), Feasibility Studies, Female, Health Services Accessibility, Humans, Male, Mass Screening (methods), Medically Underserved Area, Research Personnel, Rural Population, Severity of Illness Index.
- MESH :
- diagnosis : Elephantiasis.
- epidemiology : Cameroon, Elephantiasis.
- methods : Mass Screening.
- pathology : Elephantiasis.
- prevention & control : Elephantiasis.
- Adult, Community Health Workers, Feasibility Studies, Female, Health Services Accessibility, Humans, Male, Medically Underserved Area, Research Personnel, Rural Population, Severity of Illness Index.
Abstract
The suitability of using clinical assessment to identify patients with podoconiosis in endemic communities has previously been demonstrated. In this study, we explored the feasibility and accuracy of using Community Health Implementers (CHIs) for the large scale clinical screening of the population for podoconiosis in North-west Cameroon.
Before a regional podoconiosis mapping, 193 CHIs and 50 health personnel selected from 6 health districts were trained in the clinical diagnosis of the disease. After training, CHIs undertook community screening for podoconiosis patients under health personnel supervision. Identified cases were later re-examined by a research team with experience in the clinical identification of podoconiosis.
Cases were identified by CHIs with an overall positive predictive value (PPV) of 48.5% [34.1–70%]. They were more accurate in detecting advanced stages of the disease compared to early stages; OR 2.07, 95% CI = 1.15–3.73,
Podoconiosis being a stigmatized disease, the use of CHIs who are familiar to the community appears appropriate for identifying cases through clinical diagnosis. However, to improve their effectiveness and accuracy, more training, supervision and support are required. More emphasis must be given in identifying early clinical stages and in health districts with relatively lower PPVs.
Url:
DOI: 10.1186/s12889-016-3669-6
PubMed: 27650390
PubMed Central: 5029032
Affiliations:
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Kengne-Ouafo</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Datchoua Poutcheu, Fabrice R" sort="Datchoua Poutcheu, Fabrice R" uniqKey="Datchoua Poutcheu F" first="Fabrice R." last="Datchoua-Poutcheu">Fabrice R. Datchoua-Poutcheu</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Njouendou, Abdel Jelil" sort="Njouendou, Abdel Jelil" uniqKey="Njouendou A" first="Abdel Jelil" last="Njouendou">Abdel Jelil Njouendou</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Tayong, Dizzel Bita" sort="Tayong, Dizzel Bita" uniqKey="Tayong D" first="Dizzel Bita" last="Tayong">Dizzel Bita Tayong</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Sofeu Feugaing, David D" sort="Sofeu Feugaing, David D" uniqKey="Sofeu Feugaing D" first="David D." last="Sofeu-Feugaing">David D. Sofeu-Feugaing</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff3">Department of Biochemistry and Molecular Biology, University of Buea, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Department of Biochemistry and Molecular Biology, University of Buea, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Amvongo Adjia, Nathalie" sort="Amvongo Adjia, Nathalie" uniqKey="Amvongo Adjia N" first="Nathalie" last="Amvongo-Adjia">Nathalie Amvongo-Adjia</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff4">Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, University of Yaoundé I, Yaounde, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Laboratory of Parasitology and Ecology, Department of Animal Biology and Physiology, University of Yaoundé I, Yaounde</wicri:regionArea><wicri:noRegion>Yaounde</wicri:noRegion></affiliation></author><author><name sortKey="Fovennso, Bridget A" sort="Fovennso, Bridget A" uniqKey="Fovennso B" first="Bridget A." last="Fovennso">Bridget A. Fovennso</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Longang Tchounkeu, Yolande F" sort="Longang Tchounkeu, Yolande F" uniqKey="Longang Tchounkeu Y" first="Yolande F." last="Longang-Tchounkeu">Yolande F. Longang-Tchounkeu</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Tekola Ayele, Fasil" sort="Tekola Ayele, Fasil" uniqKey="Tekola Ayele F" first="Fasil" last="Tekola-Ayele">Fasil Tekola-Ayele</name><affiliation wicri:level="2"><nlm:aff id="Aff5">Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda</wicri:cityArea></affiliation></author><author><name sortKey="Enyong, Peter A" sort="Enyong, Peter A" uniqKey="Enyong P" first="Peter A." last="Enyong">Peter A. Enyong</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon</nlm:aff><country xml:lang="fr">Cameroun</country><wicri:regionArea>Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea</wicri:regionArea><wicri:noRegion>Buea</wicri:noRegion></affiliation></author><author><name sortKey="Newport, Melanie J" sort="Newport, Melanie J" uniqKey="Newport M" first="Melanie J." last="Newport">Melanie J. Newport</name><affiliation><nlm:aff id="Aff6">Wellcome Trust Centre for Global Health Research, Brighton and Sussex Medical School, Falmer Campus, Brighton, BN1 9PX UK</nlm:aff><wicri:noCountry code="subfield">BN1 9PX UK</wicri:noCountry></affiliation></author><author><name sortKey="Davey, Gail" sort="Davey, Gail" uniqKey="Davey G" first="Gail" last="Davey">Gail Davey</name><affiliation><nlm:aff id="Aff6">Wellcome Trust Centre for Global Health Research, Brighton and Sussex Medical School, Falmer Campus, Brighton, BN1 9PX UK</nlm:aff><wicri:noCountry code="subfield">BN1 9PX UK</wicri:noCountry></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Cameroon (epidemiology)</term><term>Community Health Workers</term><term>Elephantiasis (diagnosis)</term><term>Elephantiasis (epidemiology)</term><term>Elephantiasis (pathology)</term><term>Elephantiasis (prevention & control)</term><term>Feasibility Studies</term><term>Female</term><term>Health Services Accessibility</term><term>Humans</term><term>Male</term><term>Mass Screening (methods)</term><term>Medically Underserved Area</term><term>Research Personnel</term><term>Rural Population</term><term>Severity of Illness Index</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Accessibilité des services de santé</term><term>Adulte</term><term>Agents de santé communautaire</term><term>Cameroun (épidémiologie)</term><term>Dépistage systématique ()</term><term>Femelle</term><term>Humains</term><term>Indice de gravité médicale</term><term>Mâle</term><term>Personnel de recherche</term><term>Population rurale</term><term>Zone médicalement sous-équipée</term><term>Éléphantiasis ()</term><term>Éléphantiasis (anatomopathologie)</term><term>Éléphantiasis (diagnostic)</term><term>Éléphantiasis (épidémiologie)</term><term>Études de faisabilité</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Éléphantiasis</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Elephantiasis</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Éléphantiasis</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Cameroon</term><term>Elephantiasis</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Mass Screening</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Elephantiasis</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Elephantiasis</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Cameroun</term><term>Éléphantiasis</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Community Health Workers</term><term>Feasibility Studies</term><term>Female</term><term>Health Services Accessibility</term><term>Humans</term><term>Male</term><term>Medically Underserved Area</term><term>Research Personnel</term><term>Rural Population</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Accessibilité des services de santé</term><term>Adulte</term><term>Agents de santé communautaire</term><term>Dépistage systématique</term><term>Femelle</term><term>Humains</term><term>Indice de gravité médicale</term><term>Mâle</term><term>Personnel de recherche</term><term>Population rurale</term><term>Zone médicalement sous-équipée</term><term>Éléphantiasis</term><term>Études de faisabilité</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The suitability of using clinical assessment to identify patients with podoconiosis in endemic communities has previously been demonstrated. In this study, we explored the feasibility and accuracy of using Community Health Implementers (CHIs) for the large scale clinical screening of the population for podoconiosis in North-west Cameroon.</p></sec><sec><title>Methods</title><p>Before a regional podoconiosis mapping, 193 CHIs and 50 health personnel selected from 6 health districts were trained in the clinical diagnosis of the disease. After training, CHIs undertook community screening for podoconiosis patients under health personnel supervision. Identified cases were later re-examined by a research team with experience in the clinical identification of podoconiosis.</p></sec><sec><title>Results</title><p>Cases were identified by CHIs with an overall positive predictive value (PPV) of 48.5% [34.1–70%]. They were more accurate in detecting advanced stages of the disease compared to early stages; OR 2.07, 95% CI = 1.15–3.73, <italic>p</italic> = 0.015 for all advanced stages). Accuracy of detecting cases showed statistically significant differences among health districts (χ2 = 25.30, <italic>p</italic> = 0.0001).</p></sec><sec><title>Conclusion</title><p>Podoconiosis being a stigmatized disease, the use of CHIs who are familiar to the community appears appropriate for identifying cases through clinical diagnosis. However, to improve their effectiveness and accuracy, more training, supervision and support are required. More emphasis must be given in identifying early clinical stages and in health districts with relatively lower PPVs.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Sherrill, W" uniqKey="Sherrill W">W Sherrill</name></author><author><name sortKey="Crew, L" uniqKey="Crew L">L Crew</name></author><author><name sortKey="Mayo, Rb" uniqKey="Mayo R">RB Mayo</name></author><author><name sortKey="Mayo, Wf" uniqKey="Mayo W">WF Mayo</name></author><author><name sortKey="Rogers, Bl" uniqKey="Rogers B">BL Rogers</name></author><author><name sortKey="Haynes, Df" uniqKey="Haynes D">DF Haynes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Berman, Pa" uniqKey="Berman P">PA Berman</name></author><author><name sortKey="Gwatkin, Dr" uniqKey="Gwatkin D">DR Gwatkin</name></author><author><name sortKey="Burger, Se" uniqKey="Burger S">SE 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sort="Davey, Gail" uniqKey="Davey G" first="Gail" last="Davey">Gail Davey</name><name sortKey="Newport, Melanie J" sort="Newport, Melanie J" uniqKey="Newport M" first="Melanie J." last="Newport">Melanie J. Newport</name></noCountry><country name="Cameroun"><noRegion><name sortKey="Wanji, Samuel" sort="Wanji, Samuel" uniqKey="Wanji S" first="Samuel" last="Wanji">Samuel Wanji</name></noRegion><name sortKey="Amvongo Adjia, Nathalie" sort="Amvongo Adjia, Nathalie" uniqKey="Amvongo Adjia N" first="Nathalie" last="Amvongo-Adjia">Nathalie Amvongo-Adjia</name><name sortKey="Amvongo Adjia, Nathalie" sort="Amvongo Adjia, Nathalie" uniqKey="Amvongo Adjia N" first="Nathalie" last="Amvongo-Adjia">Nathalie Amvongo-Adjia</name><name sortKey="Datchoua Poutcheu, Fabrice R" sort="Datchoua Poutcheu, Fabrice R" uniqKey="Datchoua Poutcheu F" first="Fabrice R." last="Datchoua-Poutcheu">Fabrice R. Datchoua-Poutcheu</name><name sortKey="Enyong, Peter A" sort="Enyong, Peter A" uniqKey="Enyong P" first="Peter A." last="Enyong">Peter A. Enyong</name><name sortKey="Enyong, Peter A" sort="Enyong, Peter A" uniqKey="Enyong P" first="Peter A." last="Enyong">Peter A. Enyong</name><name sortKey="Fovennso, Bridget A" sort="Fovennso, Bridget A" uniqKey="Fovennso B" first="Bridget A." last="Fovennso">Bridget A. Fovennso</name><name sortKey="Fovennso, Bridget A" sort="Fovennso, Bridget A" uniqKey="Fovennso B" first="Bridget A." last="Fovennso">Bridget A. Fovennso</name><name sortKey="Kengne Ouafo, Jonas A" sort="Kengne Ouafo, Jonas A" uniqKey="Kengne Ouafo J" first="Jonas A." last="Kengne-Ouafo">Jonas A. Kengne-Ouafo</name><name sortKey="Kengne Ouafo, Jonas A" sort="Kengne Ouafo, Jonas A" uniqKey="Kengne Ouafo J" first="Jonas A." last="Kengne-Ouafo">Jonas A. Kengne-Ouafo</name><name sortKey="Longang Tchounkeu, Yolande F" sort="Longang Tchounkeu, Yolande F" uniqKey="Longang Tchounkeu Y" first="Yolande F." last="Longang-Tchounkeu">Yolande F. Longang-Tchounkeu</name><name sortKey="Njouendou, Abdel Jelil" sort="Njouendou, Abdel Jelil" uniqKey="Njouendou A" first="Abdel Jelil" last="Njouendou">Abdel Jelil Njouendou</name><name sortKey="Njouendou, Abdel Jelil" sort="Njouendou, Abdel Jelil" uniqKey="Njouendou A" first="Abdel Jelil" last="Njouendou">Abdel Jelil Njouendou</name><name sortKey="Sofeu Feugaing, David D" sort="Sofeu Feugaing, David D" uniqKey="Sofeu Feugaing D" first="David D." last="Sofeu-Feugaing">David D. Sofeu-Feugaing</name><name sortKey="Sofeu Feugaing, David D" sort="Sofeu Feugaing, David D" uniqKey="Sofeu Feugaing D" first="David D." last="Sofeu-Feugaing">David D. Sofeu-Feugaing</name><name sortKey="Tayong, Dizzel Bita" sort="Tayong, Dizzel Bita" uniqKey="Tayong D" first="Dizzel Bita" last="Tayong">Dizzel Bita Tayong</name><name sortKey="Tayong, Dizzel Bita" sort="Tayong, Dizzel Bita" uniqKey="Tayong D" first="Dizzel Bita" last="Tayong">Dizzel Bita Tayong</name><name sortKey="Wanji, Samuel" sort="Wanji, Samuel" uniqKey="Wanji S" first="Samuel" last="Wanji">Samuel Wanji</name></country><country name="États-Unis"><region name="Maryland"><name sortKey="Tekola Ayele, Fasil" sort="Tekola Ayele, Fasil" uniqKey="Tekola Ayele F" first="Fasil" last="Tekola-Ayele">Fasil Tekola-Ayele</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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