NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, London WC1N 3BG, & Chalfont Centre for Epilepsy, Chalfont St Peter SL9 0RJ, United Kingdom; Neurology Unit, Department of Medicine, University of Maiduguri Teaching Hospital. PMB 1414 Maiduguri, Borno State, Nigeria.
Neurology Unit, Department of Medicine, Usman Danfodiyo University Teaching Hospital, Sokoto, Sokoto State Nigeria.
Epilepsy Behav. 2021 Jan;114(Pt A):107604. doi: 10.1016/j.yebeh.2020.107604. Epub 2020 Nov 30.
We describe the development, translation and validation of epilepsy-screening questionnaires in the three most popular Nigerian languages: Hausa, Igbo and Yoruba.
A 9-item epilepsy-screening questionnaire was developed by modifying previously validated English language questionnaires. Separate multilingual experts forward- and back-translated them to the three target languages. Translations were discussed with fieldworkers and community members for ethnolinguistic acceptability and comprehension. We used an unmatched affected-case versus unaffected-control design for the pilot study. Cases were people with epilepsy attending the tertiary hospitals where these languages are spoken. The controls were relatives of cases or people attending for other medical conditions. An affirmative response to any of the nine questions amounted to a positive screen for epilepsy.
We recruited 153 (75 cases and 78 controls) people for the Hausa version, 106 (45 cases and 61 controls) for Igbo and 153 (66 cases and 87 controls) for the Yoruba. The sensitivity and specificity of the questionnaire were: Hausa (97.3% and 88.5%), Igbo (91.1% and 88.5%) and Yoruba (93.9% and 86.7%). The three versions reliably indicated epilepsy with positive predictive values of 85.9% (Hausa), 85.4% (Igbo) and 87.3% (Yoruba) and reliably excluded epilepsy with negative predictive values of 97.1% (Hausa), 93.1% (Igbo) and 95.1% (Yoruba). Positive likelihood ratios were all greater than one.
Validated epilepsy screening questionnaires are now available for the three languages to be used for community-based epilepsy survey in Nigeria. The translation and validation process are discussed to facilitate usage and development for other languages in sub-Saharan Africa.
我们描述了在尼日利亚三种最流行的语言（豪萨语、伊博语和约鲁巴语）中开发、翻译和验证癫痫筛查问卷的过程。
通过修改先前验证过的英语问卷，我们开发了一个 9 项癫痫筛查问卷。由多语言专家将问卷分别正向和反向翻译为三种目标语言。翻译内容与现场工作者和社区成员进行了讨论，以确保其在语言和文化上的可接受性和理解度。我们使用未匹配的病例对照设计进行了初步研究。病例为在使用这些语言的三级医院就诊的癫痫患者。对照组为病例的亲属或因其他医疗条件就诊的人。如果对九个问题中的任何一个问题回答为肯定，则表示对癫痫有阳性筛查结果。
我们共招募了 153 名（75 例病例和 78 名对照组）使用豪萨语版本的参与者、106 名（45 例病例和 61 名对照组）使用伊博语版本的参与者和 153 名（66 例病例和 87 名对照组）使用约鲁巴语版本的参与者。问卷的灵敏度和特异性分别为：豪萨语（97.3%和 88.5%）、伊博语（91.1%和 88.5%）和约鲁巴语（93.9%和 86.7%）。三个版本都能可靠地提示癫痫，阳性预测值分别为 85.9%（豪萨语）、85.4%（伊博语）和 87.3%（约鲁巴语），且能可靠地排除癫痫，阴性预测值分别为 97.1%（豪萨语）、93.1%（伊博语）和 95.1%（约鲁巴语）。阳性似然比均大于 1。
现在已经有经过验证的癫痫筛查问卷可供尼日利亚使用，用于基于社区的癫痫调查。我们讨论了翻译和验证过程，以方便在撒哈拉以南非洲的其他语言中使用和开发。
