title: A screening questionnaire for convulsive seizures: A three-stage field-validation in rural Bolivia.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Loretta
authors.initials: L
authors.lastname: Giuliano
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Calogero Edoardo
authors.initials: CE
authors.lastname: Cicero
authors.affiliation: Hospital Universitario Hernández Vera, Santa Cruz, Bolivia.
authors.forename: Elizabeth Blanca
authors.initials: EB
authors.lastname: Crespo Gómez
authors.affiliation: Center of Anthropological Researches of the Teko Guaraní, Gutierrez, Bolivia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Padilla
authors.affiliation: Department of Neurology, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Elisa
authors.initials: E
authors.lastname: Bruno
authors.affiliation: The Bolivian League Against Epilepsy, Santa Cruz, Bolivia.
authors.forename: Mario
authors.initials: M
authors.lastname: Camargo
authors.affiliation: INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Marin
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Sofia
authors.affiliation: INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Preux
authors.affiliation: Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, University of Florence, Florence, Italy.
authors.forename: Marianne
authors.initials: M
authors.lastname: Strohmeyer
authors.affiliation: Department of Experimental and Clinical Medicine, Infectious and Tropical Diseases Unit, University of Florence, Florence, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bartoloni
authors.affiliation: Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Nicoletti
mesh_terms: D000293:Adolescent; D000328:Adult; D001838:Bolivia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012424:Rural Population; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult