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Study of lymphoedema of non-filarial origin in the northwest region of Cameroon: spatial distribution, profiling of cases and socio-economic aspects of podoconiosis

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E-pub ahead of print
  • Samuel Wanji
  • Jonas A. Kengne-Ouafo
  • Kebede Deribe
  • Ayok M. Tembei
  • Abdel Jelil Njouendo
  • Dizzel Bita Tayong
  • David D. Sofeu-Feugaing
  • Fabrice R. Datchoua-Poutcheu
  • Jorge Cano
  • Emanuele Giorgi
  • Yolande F. Longang-Tchounkeu
  • Peter A. Enyong
  • Melanie J. Newport
  • Gail Davey
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<mark>Journal publication date</mark>16/05/2018
<mark>Journal</mark>International Health
<mark>State</mark>E-pub ahead of print
Early online date16/05/18
<mark>Original language</mark>English

Abstract

Background Although podoconiosis is endemic in Cameroon, little is known about its epidemiology and spatial distribution. Methods This cross-sectional, population-based study enrolled all adults (≥15 y) residing in the districts of the northwest region of Cameroon for 10 or more years. Participants were interviewed and had a physical examination. The study outcomes were prevalence estimates of lymphoedema and podoconiosis. House-to-house screening was conducted by Community Health Implementers (CHIs). CHIs registered all individuals with lymphoedema and collected additional individual and household-related information. A panel of experts re-examined and validated all lymphoedema cases registered by CHIs. Results Of the 439 781 individuals registered, 214 195 were adults (≥15 y old) and had lived in the districts of the region for more than 10 y. A total of 2143 lymphoedema cases were identified by CHIs, giving a prevalence of lymphoedema of 1.0% (2143/214 195; 95% CI, 0.96–1.04). After review by experts, podoconiosis prevalence in the study area was 0.48% (1049/214 195; 95% CI, 0.46–0.52). The prevalence of podoconiosis varied by health district, from 0.16% in Oku to 1.92% in Bafut (p<0.05). A total of 374 patients were recruited by stratified random sampling from the validated CHIs’ register to assess the clinical features and socio-economic aspects of the disease. Patients reportedly were said to have first noticed swelling at an average age of 41.9±19.1 (range: 6–90 y). Most patients (86.1%; 315/366) complained of their legs suddenly becoming hot, red and painful. The majority (96.5%; 361/374) of the interviewees said they had worn shoes occasionally at some point in their life. The reported mean age at first shoe wearing was 14.2±10.1 (±SD,range 1–77 y). A high proportion (82.8%; 309/374) of the participants wore shoes at the time of interview. Of those wearing shoes, only 21.7% (67/309) were wearing protective shoes. Conclusion This study provides an insight into the geographical distribution and epidemiology of podoconiosis in the North West region of Cameroon, yet management is limited. Evidence-informed targeted interventions are needed to manage people with lymphoedema.