PT  - JOURNAL ARTICLE
AU  - Kebede Deribe
AU  - Jorge Cano
AU  - Abdel Jelil Njouendou
AU  - Mathias Esum Eyong
AU  - Amuam Andrew Beng
AU  - Emanuele Giorgi
AU  - David M Pigott
AU  - Rachel L Pullan
AU  - Abdisalan M Noor
AU  - Fikre Enquselassie
AU  - Christopher J L Murray
AU  - Simon I Hay
AU  - Melanie J Newport
AU  - Gail Davey
AU  - Samuel Wanji
TI  - Predicted distribution and burden of podoconiosis in Cameroon
AID  - 10.1136/bmjgh-2018-000730
DP  - 2018 Jun 01
TA  - BMJ Global Health
PG  - e000730
VI  - 3
IP  - 3
4099  - http://gh.bmj.com/content/3/3/e000730.short
4100  - http://gh.bmj.com/content/3/3/e000730.full
AB  - Introduction Understanding the number of cases of podoconiosis, its geographical distribution and the population at risk are crucial to estimating the burden of this disease in endemic countries. We assessed each of these using nationwide data on podoconiosis prevalence in Cameroon.Methods We analysed data arising from two cross-sectional surveys in Cameroon. The dataset was combined with a suite of environmental and climate data and analysed within a robust statistical framework, which included machine learning-based approaches and geostatistical modelling. The environmental limits, spatial variation of predicted prevalence, population at risk and number of cases of podoconiosis were each estimated.Results A total of 214 729 records of individuals screened for podoconiosis were gathered from 748 communities in all 10 regions of Cameroon. Of these screened individuals, 882 (0.41%; 95% CI 0.38 to 0.44) were living with podoconiosis. High environmental suitability for podoconiosis was predicted in three regions of Cameroon (Adamawa, North West and North). The national population living in areas environmentally suitable for podoconiosis was estimated at 5.2 (95% CI 4.7 to 5.8) million, which corresponds to 22.3% of Cameroon’s population in 2015. Countrywide, in 2015, the number of adults estimated to be suffering from podoconiosis was 41 556 (95% CI, 1170 to 240 993). Four regions (Central, Littoral, North and North West) contributed 61.2% of the cases.Conclusion In Cameroon, podoconiosis is more widely distributed geographically than was initially expected. The number of cases and the population at risk are considerable. Expanding morbidity management and follow-up of cases is of utmost necessity. Promotion of footwear use and regular foot hygiene should be at the forefront of any intervention plan.