02703nas a2200349   4500000000100000008004100001653003900042653001700081653001300098653001400111653001900125653001400144100001200158700002000170700002500190700001700215700001400232700002200246700002000268700001600288700002500304700001900329700001300348700001400361700001200375245017400387856008900561300000800650490000700658520167400665022001402339       2016                            d10aNeglected tropical diseases (NTDs)10aPodoconiosis10aCameroon10aScreening10aHealth workers10adiagnosis1 aWanji S1 aKengne-Ouafo JA1 aDatchoua-Poutcheu FR1 aNjouendou AJ1 aTayong DB1 aSofeu-Feugaing DD1 aAmvongo-Adjia N1 aFovennso BA1 aLongang-Tchounkeu YF1 aTekola-Ayele F1 aEnyong P1 aNewport M1 aDavey G00aDetecting and staging podoconiosis cases in North West Cameroon: positive predictive value of clinical screening of patients by community health workers and researchers.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5029032/pdf/12889_2016_Article_3669.pdf  a9970 v163 a<p><strong>BACKGROUND: </strong>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.</p>

<p><strong>METHODS: </strong>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.</p>

<p><strong>RESULTS: </strong>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).</p>

<p><strong>CONCLUSION: </strong>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.</p>
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