Wanji, Samuel, Kengne-Ouafo, Jonas A, Datchoua-Poutcheu, Fabrice R, Njouendou, Abdel Jelil, Tayong, Dizzel Bita, Sofeu-Feugaing, David D, Amvongo-Adjia, Nathalie, Fovennso, Bridget A, Longang-Tchounkeu, Yolande F, Tekola-Ayele, Fasil, Enyong, Peter A, Newport, Melanie J and Davey, Gail (2016) Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers. BMC Public Health, 16 (1). ISSN 1471-2458

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Abstract

BACKGROUND: 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.

METHODS: 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.

RESULTS: 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, p = 0.015 for all advanced stages). Accuracy of detecting cases showed statistically significant differences among health districts (χ2 = 25.30, p = 0.0001).

CONCLUSION: 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.

Item Type:	Article
Keywords:	Cameroon; Community Health Implementers; Podoconiosis; Predictive value; Screening
Schools and Departments:	Brighton and Sussex Medical School > Global Health and Infection
Research Centres and Groups:	Centre for Global Health Policy
Depositing User:	Rose McLafferty
Date Deposited:	08 Nov 2016 13:47
Last Modified:	05 Aug 2017 06:24
URI:	http://srodev.sussex.ac.uk/id/eprint/65354

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