Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers
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 screenin...
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doaj-0a1f3e8f25c24637885f994496aecf132020-11-25T01:29:47ZengBMCBMC Public Health1471-24582016-09-011611810.1186/s12889-016-3669-6Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchersSamuel Wanji0Jonas A. Kengne-Ouafo1Fabrice R. Datchoua-Poutcheu2Abdel Jelil Njouendou3Dizzel Bita Tayong4David D. Sofeu-Feugaing5Nathalie Amvongo-Adjia6Bridget A. Fovennso7Yolande F. Longang-Tchounkeu8Fasil Tekola-Ayele9Peter A. Enyong10Melanie J. Newport11Gail Davey12Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of BueaParasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of BueaResearch Foundation for Tropical Diseases and the Environment (REFOTDE)Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of BueaParasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of BueaResearch Foundation for Tropical Diseases and the Environment (REFOTDE)Research Foundation for Tropical Diseases and the Environment (REFOTDE)Parasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of BueaResearch Foundation for Tropical Diseases and the Environment (REFOTDE)Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of HealthParasites and Vector Biology research unit (PAVBRU), Department of Microbiology and Parasitology, University of BueaWellcome Trust Centre for Global Health Research, Brighton and Sussex Medical School, Falmer CampusWellcome Trust Centre for Global Health Research, Brighton and Sussex Medical School, Falmer CampusAbstract 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.http://link.springer.com/article/10.1186/s12889-016-3669-6PodoconiosisScreeningPredictive valueCommunity Health ImplementersCameroon |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Samuel Wanji Jonas A. Kengne-Ouafo Fabrice R. Datchoua-Poutcheu Abdel Jelil Njouendou Dizzel Bita Tayong David D. Sofeu-Feugaing Nathalie Amvongo-Adjia Bridget A. Fovennso Yolande F. Longang-Tchounkeu Fasil Tekola-Ayele Peter A. Enyong Melanie J. Newport Gail Davey |
spellingShingle |
Samuel Wanji Jonas A. Kengne-Ouafo Fabrice R. Datchoua-Poutcheu Abdel Jelil Njouendou Dizzel Bita Tayong David D. Sofeu-Feugaing Nathalie Amvongo-Adjia Bridget A. Fovennso Yolande F. Longang-Tchounkeu Fasil Tekola-Ayele Peter A. Enyong Melanie J. Newport Gail Davey 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 Podoconiosis Screening Predictive value Community Health Implementers Cameroon |
author_facet |
Samuel Wanji Jonas A. Kengne-Ouafo Fabrice R. Datchoua-Poutcheu Abdel Jelil Njouendou Dizzel Bita Tayong David D. Sofeu-Feugaing Nathalie Amvongo-Adjia Bridget A. Fovennso Yolande F. Longang-Tchounkeu Fasil Tekola-Ayele Peter A. Enyong Melanie J. Newport Gail Davey |
author_sort |
Samuel Wanji |
title |
Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers |
title_short |
Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers |
title_full |
Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers |
title_fullStr |
Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers |
title_full_unstemmed |
Detecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers |
title_sort |
detecting and staging podoconiosis cases in north west cameroon: positive predictive value of clinical screening of patients by community health workers and researchers |
publisher |
BMC |
series |
BMC Public Health |
issn |
1471-2458 |
publishDate |
2016-09-01 |
description |
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. |
topic |
Podoconiosis Screening Predictive value Community Health Implementers Cameroon |
url |
http://link.springer.com/article/10.1186/s12889-016-3669-6 |
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