A screening questionnaire for convulsive seizures: A three-stage field-validation in rural Bolivia

Loretta Giuliano 1 Calogero Edoardo Cicero 1 Elizabeth Blanca Crespo Gómez 2 Sandra Padilla 3 Elisa Bruno 4 Mario Camargo 5 Benoît Marin 6, 7, 8 Vito Sofia 1 Pierre-Marie Preux 6, 8, 7 Marianne Strohmeyer 9 Alessandro Bartoloni 9 Alessandra Nicoletti 1, *
* Auteur correspondant
1 Department of Neurosciences
2 Hospital Universitario Hernández Vera
3 Center of Anthropological Researches of the Teko Guaraní
4 Department of Neurology
5 The Bolivian League Against Epilepsy
6 NET - Neuroépidémiologie Tropicale
7 Laboratoire de Biostatistique et d'Informatique Médicale
8 SIME - Service de l'Information Médicale et de l'Évaluation [CHU Limoges]
9 Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit
Abstract : Introduction: Epilepsy is one of the most common neurological diseases in Latin American Countries (LAC) and epilepsy associated with convulsive seizures is the most frequent type. Therefore, the detection of convulsive seizures is a priority, but a validated Spanish-language screening tool to detect convulsive seizures is not available. We performed a field validation to evaluate the accuracy of a Spanish-language questionnaire to detect convulsive seizures in rural Bolivia using a three-stage design. The questionnaire was also administered face-to-face, using a two-stage design, to evaluate the difference in accuracy. Methods: The study was carried out in the rural communities of the Gran Chaco region. The questionnaire consists of a single screening question directed toward the householders and a confirmatory section administered face-to-face to the index case. Positive subjects underwent a neurological examination to detect false positive and true positive subjects. To estimate the proportion of false negative, a random sample of about 20% of the screened negative underwent a neurological evaluation. Results: 792 householders have been interviewed representing a population of 3,562 subjects (52.2% men; mean age 24.5 ± 19.7 years). We found a sensitivity of 76.3% (95% CI 59.8–88.6) with a specificity of 99.6% (95% CI 99.4–99.8). The two-stage design showed only a slightly higher sensitivity respect to the three-stage design. Conclusion: Our screening tool shows a good accuracy and can be easily used by trained health workers to quickly screen the population of the rural communities of LAC through the householders using a three-stage design.
Keywords : Epilepsy Bolivia health screaning Tonic-clonic seizures Epilepsy and seizures Rural Areas Confidence intervals
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Loretta Giuliano, Calogero Edoardo Cicero, Elizabeth Blanca Crespo Gómez, Sandra Padilla, Elisa Bruno, et al.. A screening questionnaire for convulsive seizures: A three-stage field-validation in rural Bolivia. PLoS ONE, Public Library of Science, 2017, 12 (3), pp.e0173945. ⟨10.1371/journal.pone.0173945⟩. ⟨hal-01503708⟩

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