Translation and validation of an epilepsy-screening questionnaire in three Nigerian languages

Watila, Musa Mamman; Balarabe, Salisu A.; Komolafe, Morenikeji; Igwe, Stanley C.; Fawale, Bimbo; Diessen, Eric van; Nyandaiti, Yakub; Singh, Gagandeep; Winkler, Andrea Sylvia; Sander, Josemir W.

doi:10.1016/j.yebeh.2020.107604

Cited by 5 publications

(8 citation statements)

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“…Consequently, also under-estimation of seizure prevalence may occur [ 39 , 40 ]. Although screening tools usually take special beliefs and translation issues into account, these effects cannot be completely ruled out [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Community-level prevalence of epilepsy and of neurocysticercosis among people with epilepsy in the Balaka district of Malawi: A cross-sectional study

et al. 2022

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Background Epilepsy and neurocysticercosis (NCC) prevalence estimates in sub-Saharan Africa are still scarce but show important variation due to the population studied and different screening and diagnosis strategies used. The aims of this study were to estimate the prevalence of epileptic seizures and epilepsy in the sampled population, and the proportion of NCC among people with epilepsy (PWE) in a large cross-sectional study in a rural district of southern Malawi. Methods We conducted a community-based door-to-door screening study for epileptic seizures in Balaka, Malawi between October and December 2012. Past epileptic seizures were reported through a 15-item questionnaire answered by at least one person per household generating five major criteria. People who screened positive were further examined by a neurologist to establish diagnosis. Patients diagnosed with epilepsy were examined and offered Taenia solium cyst antigen and antibody serological tests, and a CT scan for the diagnosis of NCC. Results In total, screening information on 69,595 individuals was obtained for lifetime occurrence of epileptic seizures. 3,100 (4.5%) participants screened positive, of whom 1,913 (62%) could be followed-up and underwent further assessment. Lifetime prevalence was 3.0% (95% Bayesian credible interval [CI] 2.8 to 3.1%) and 1.2% (95%BCI 0.9 to 1.6%) for epileptic seizures and epilepsy, respectively. NCC prevalence among PWE was estimated to be 4.4% (95%BCI 0.8 to 8.5%). A diagnosis of epilepsy was ultimately reached for 455 participants. Conclusion The results of this large community-based study contribute to the evaluation and understanding of the burden of epilepsy in the population and of NCC among PWE in sub-Saharan Africa.

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Section: Discussionmentioning

confidence: 99%

Community-level prevalence of epilepsy and of neurocysticercosis among people with epilepsy in the Balaka district of Malawi: A cross-sectional study

et al. 2022

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“…We adjusted the prevalence estimates for nonresponse and sensitivity of the screening questionnaires. 23 Using the Oxford Poverty and Human Development Index data, we correlated the multidimensional poverty index (MPI) with the prevalence estimates from these sites. The MPI is a function of the intensity of deprivation at the individual level regarding education, health, living standard, income, and employment.…”

Section: Discussionmentioning

confidence: 99%

“…We described the development and validation of the questionnaire elsewhere. 23 Trained health workers interviewed and administered the questionnaires to heads of individual households or a senior member who answered on behalf of the whole household. Physicians conducted a second-stage confirmatory evaluation for any household member with a positive response to at least 1 screening question.…”

Section: Procedures For the Census And Screening And Recruitment Of C...mentioning

confidence: 99%

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Epidemiology of Epilepsy in Nigeria

et al. 2021

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BackgroundWe determined the prevalence, incidence, and risk factors for epilepsy in Nigeria.MethodsWe conducted a door-to-door survey to identify cases of epilepsy in 3 regions. We estimated age-standardized prevalence adjusted for nonresponse and sensitivity and the 1-year retrospective incidence for active epilepsy. To assess potential risk factors, we conducted a case-control study by collecting sociodemographic and risk factor data. We estimated odds ratios using logistic regression analysis and corresponding population attributable fractions (PAFs).ResultsWe screened 42,427 persons (age ≥6 years), of whom 254 had confirmed active epilepsy. The pooled prevalence of active epilepsy per 1,000 was 9.8 (95% confidence interval [CI] 8.6–11.1), 17.7 (14.2–20.6) in Gwandu, 4.8 (3.4–6.6) in Afikpo, and 3.3 (2.0–5.1) in Ijebu-Jesa. The pooled incidence per 100,000 was 101.3 (95% CI 57.9–167.6), 201.2 (105.0–358.9) in Gwandu, 27.6 (3.3–128.0) in Afikpo, and 23.9 (3.2–157.0) in Ijebu-Jesa. Children's significant risk factors included febrile seizures, meningitis, poor perinatal care, open defecation, measles, and family history in first-degree relatives. In adults, head injury, poor perinatal care, febrile seizures, family history in second-degree relatives, and consanguinity were significant. Gwandu had more significant risk factors. The PAF for the important factors in children was 74.0% (71.0%–76.0%) and in adults was 79.0% (75.0%–81.0%).ConclusionThis work suggests varied epidemiologic numbers, which may be explained by differences in risk factors and population structure in the different regions. These variations should differentially determine and drive prevention and health care responses.

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“…We conducted a review of evidence on screening tools (questionnaires) previously used in LMICs [16, 20–22] to develop our instrument A local neurologist reviewed the initial version to arrive at the final draft. We then translated and back-translated the tool into the two targeted languages Twi and Dangme.…”

Section: Methodsmentioning

confidence: 99%

Translation and Validation of an Epilepsy Screening Instrument in Two Ghanaian Languages

Darkwa,

Asiamah,

Awini

et al. 2024

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IntroductionThe prevalence of epilepsy in sub-Saharan Africa varies considerably, and the exact estimate in Ghana is unknown, with few data available from peri-urban areas. More community-based studies are required to understand the tangible burden of epilepsy in these areas and the difficulties in healthcare access.ObjectiveTo validate a household survey epilepsy-screening instrument in Shai-Osudoku and Ningo-Prampram District of Greater Accra Region, Ghana.MethodsWe developed a 17-item epilepsy screening instrument by modifying validated English language questionnaires. We included questions that could identify convulsive and non-convulsive seizures. Language experts translated and back-translated the survey instrument into the two languages in this region: Asante Twi and Dangme. Cases were people with epilepsy attending healthcare facilities where these languages are used. Controls were unaffected relatives of cases or people attending the healthcare centres for other medical conditions. We matched cases and controls for geographical location and ethnicity. An affirmative response to one of the seventeen questions was deemed as a positive screen.ResultsOne hundred and Forty Dangme Twi speakers (70 cases and 70 controls) and 100 Twi speakers (50 cases and 50 controls) were recruited. The sensitivity and specificity for Dangme were: Stage 1;100% (95% CI: 88.6, 94.9) and 80% (95% CI: 68.7, 88.6) and Stage 2, 98.6% (95% CI: 92.3, 100.0) and 85.7% (95% CI: 75.3, 92.9). The Dangme version reliably identified epilepsy with positive predictive values of 83.3% (95% CI: 73.6, 90.6) and 87.3% (95% CI: 78.6, 90.6) at stages 1 and 2. The questionnaire excluded epilepsy with negative predictive values of 100% (95% CI: 93.6, 100.0) and 98.4% (95% CI: 91.2, 100.0). For the Twi version, the sensitivity and specificity were: 98% (95% CI: 89.4, 99.9) and 92% (95% CI: 80.8, 97.8) at Stage 1, and for Stage 2, 96% (95% CI: 86.3, 99.5) and 94% (95% CI 83.5, 98.7). The Twi questionnaire reliably specified epilepsy with positive predictive values of 92.5% (95% CI: 81.8%, 97.9) and 94.1% (95% CI: 83.8, 98.8) at stages 1 and 2. It excluded epilepsy with negative predictive values of 97.9% (95% CI: 88.7, 99.9) and 95.9% (95% CI: 86.0, 99.5) for the two-stagesConclusionsOur questionnaire is valid for the two tested languages and is usable for community-based epilepsy surveys in Ghana. The questionnaire can be adapted for other resource-poor settings, although there will need to be translation and iterative in-country testing to ensure its validity is maintained.

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Translation and validation of an epilepsy-screening questionnaire in three Nigerian languages

Cited by 5 publications

References 31 publications

Community-level prevalence of epilepsy and of neurocysticercosis among people with epilepsy in the Balaka district of Malawi: A cross-sectional study

Community-level prevalence of epilepsy and of neurocysticercosis among people with epilepsy in the Balaka district of Malawi: A cross-sectional study

Epidemiology of Epilepsy in Nigeria

Translation and Validation of an Epilepsy Screening Instrument in Two Ghanaian Languages

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