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

Wanji, Samuel, Kengne-Ouafo, Jonas A, Deribe, Kebede, Tembei, Ayok M, Njouendou, Abdel Jelil, Tayong, Dizzel Bita, Sofeu-Feugaing, David D, Datchoua-Poutcheu, Fabrice R, Cano, Jorge, Giorgi, Emanuele, Longang-Tchounkeu, Yolande F, Enyong, Peter A, Newport, Melanie J and Davey, Gail (2018) Study of lymphoedema of non-filarial origin in the north west region of Cameroon: spatial distribution, profiling of cases and socio-economic aspects of podoconiosis. International Health, 10 (4). pp. 285-293. ISSN 876-3413

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Abstract

Background:
Although podoconiosis is endemic in Cameroon, little is known about its epidemiology and spatial distribution.

Methods:
In this cross-sectional, population-based study, we enrolled all adults (≥15 years) residing in the districts of North-West Region of Cameroon for more than 10 or more years. Participants were interviewed, had physical examination. The study outcomes were prevalence estimates 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 years old) and had lived in the districts of the Region for more than 10 years. A total of 2,143 lymphoedema cases, were identified by CHIs, giving a prevalence of lymphoedema 1.0% (95% confidence interval [CI]; 0.96-1.04) (2,143/214,195). After review by experts, podoconiosis prevalence in the study area was 0.48% (1,049/214,195) (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 said to have first noticed swelling at an average age of 41.9 ± 19.1 (range: 6-90 years). Most patients (86.1%) complained of their legs suddenly becoming hot, red and painful. The majority (309, 96.5%) of the interviewees said they had worn shoes occasionally at some point in their life. The reportedly mean age at first shoe wearing was 14.2 ± 10.1 (± Standard Deviation), range (1-77 years). A high proportion (82.8%) of the participants wore shoes at the time of interview. Of those wearing shoes, only 67 (21.7%) were wearing protective shoes.

Conclusion:
This study provides 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

Item Type: Article
Keywords: non-filarial lymphoedema; podoconiosis; spatial distribution; epidemiology; Cameroon
Schools and Departments: Brighton and Sussex Medical School > Global Health and Infection
Research Centres and Groups: Centre for Global Health Policy
Wellcome Trust Brighton and Sussex Centre for Global Health Research
Depositing User: Esther Garibay
Date Deposited: 14 May 2018 15:48
Last Modified: 01 Jul 2019 15:02
URI: http://sro.sussex.ac.uk/id/eprint/75752

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