03259nas a2200325   4500000000100000008004100001653003900042653002900081653001700110653001300127653001700140653002500157100001200182700002000194700001300214700001300227700001700240700001400257700002200271700002500293700001100318700001300329700002500342700001300367700001400380700001200394245017000406520234300576022001402919       2018                            d10aNeglected tropical diseases (NTDs)10aNon-filarial lymphoedema10aPodoconiosis10aCameroon10aEpidemiology10aSpatial distribution1 aWanji S1 aKengne-Ouafo JA1 aDeribe K1 aTembei A1 aNjouendou AJ1 aTayong DB1 aSofeu-Feugaing DD1 aDatchoua-Poutcheu FR1 aCano J1 aGiorgi E1 aLongang-Tchounkeu YF1 aEnyong P1 aNewport M1 aDavey G00aStudy of lymphoedema of non-filarial origin in the northwest region of Cameroon: spatial distribution, profiling of cases and socio-economic aspects of podoconiosis.3 a<p><strong>Background: </strong>Although podoconiosis is endemic in Cameroon, little is known about its epidemiology and spatial distribution.</p>

<p><strong>Methods: </strong>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.</p>

<p><strong>Results: </strong>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&lt;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.</p>

<p><strong>Conclusion: </strong>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.</p>
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