TY - JOUR

T1 - Study of lymphoedema of non-filarial origin in the northwest region of Cameroon

T2 - spatial distribution, profiling of cases and socio-economic aspects of podoconiosis

AU - Wanji, Samuel

AU - Kengne-Ouafo, Jonas A.

AU - Deribe, Kebede

AU - Tembei, Ayok M.

AU - Njouendo, Abdel Jelil

AU - Tayong, Dizzel Bita

AU - Sofeu-Feugaing, David D.

AU - Datchoua-Poutcheu, Fabrice R.

AU - Cano, Jorge

AU - Giorgi, Emanuele

AU - Longang-Tchounkeu, Yolande F.

AU - Enyong, Peter A.

AU - Newport, Melanie J.

AU - Davey, Gail

N1 - This is a pre-copy-editing, author-produced PDF of an article accepted for publication in International Health following peer review. The definitive publisher-authenticated version Samuel Wanji, Jonas A Kengne-Ouafo, Kebede Deribe, Ayok M Tembei, Abdel Jelil Njouendou, 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; Study of lymphoedema of non-filarial origin in the northwest region of Cameroon: spatial distribution, profiling of cases and socio-economic aspects of podoconiosis, International Health, Volume 10, Issue 4, 1 July 2018, Pages 285–293, https://doi.org/10.1093/inthealth/ihy028 is available online at: https://academic.oup.com/inthealth/article/10/4/285/4996566

PY - 2018/7

Y1 - 2018/7

N2 - 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.

AB - 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.

KW - Cameroon, epidemiology

KW - non-filarial lymphoedema

KW - podoconiosis

KW - spatial distribution

U2 - 10.1093/inthealth/ihy028

DO - 10.1093/inthealth/ihy028

M3 - Journal article

VL - 10

SP - 285

EP - 293

JO - International Health

JF - International Health

SN - 1876-3413

IS - 4

ER -