Study of lymphoedema of non-filarial origin in the northwest 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;
+4 more...Longang-Tchounkeu, Yolande F;
Enyong, Peter A;
Newport, Melanie J;
Davey, Gail;
(2018)
Study of lymphoedema of non-filarial origin in the northwest region of Cameroon: spatial distribution, profiling of cases and socio-economic aspects of podoconiosis.
Int Health, 10 (4).
pp. 285-293.
ISSN 1876-3405
DOI: https://doi.org/10.1093/inthealth/ihy028
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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.