Siewe Fodjo Joseph Nelson, Mandro Michel, Wonya'rossi Deogratias, Inaç Yasemine, Ngave Francoise, Lokonda Richard, Anyolito Aimé, Verelst Frederik, Colebunders Robert
Global Health Institute, University of Antwerp, Belgium.
Division Provinciale de la Santé, Ituri, Democratic Republic of the Congo.
EClinicalMedicine. 2019 Mar 27;9:60-66. doi: 10.1016/j.eclinm.2019.03.010. eCollection 2019 Mar.
Epilepsy is still very prevalent in Sub-Saharan Africa, particularly in remote, poverty-confronted onchocerciasis-endemic villages. It constitutes a significant burden for the families and communities. However, the financial costs of managing persons with epilepsy (PWE) have not been assessed in these settings. Proper cost analyses will facilitate future health interventions.
In November 2017, persons with epilepsy (PWE) and their caretakers were recruited at health centres of the Logo health zone in the Democratic Republic of Congo. A pre-tested questionnaire was administered to collect information on both direct and indirect costs of epilepsy, as well as household income of participants.
The weighted mean cost of epilepsy was 241.2 USD per PWE per year (50.2% direct cost, 49.8% indirect cost). Epilepsy-related expenses represented 46.5% of the mean household income. Traditional medicine accounted for 68.2% of the direct cost. An estimated cumulative cost of 1929.6 USD attributable to epilepsy had been incurred by the populations of the Logo health zone for each PWE in the community.
Almost half of the household revenue was spent on epilepsy care. Expenses on traditional medicine must be discouraged via education and regular provision of affordable anti-epileptic drugs. Prevention of onchocerciasis-associated epilepsy using optimal control measures will avert additional epilepsy-related costs on the community. Early diagnosis and proper management of epilepsy would be economically beneficial in the study villages.
癫痫在撒哈拉以南非洲地区仍然非常普遍，尤其是在偏远、贫困且有盘尾丝虫病流行的村庄。它给家庭和社区带来了巨大负担。然而，在这些地区，癫痫患者（PWE）的管理费用尚未得到评估。进行适当的成本分析将有助于未来的健康干预措施。
2017年11月，在刚果民主共和国洛戈健康区的卫生中心招募了癫痫患者及其照料者。使用预先测试的问卷收集有关癫痫直接和间接成本以及参与者家庭收入的信息。
癫痫的加权平均成本为每位癫痫患者每年241.2美元（直接成本占50.2%，间接成本占49.8%）。与癫痫相关的费用占家庭平均收入的46.5%。传统医学占直接成本的68.2%。洛戈健康区的人群为社区中每位癫痫患者承担的癫痫累计成本估计为1929.6美元。
几乎一半的家庭收入用于癫痫护理。必须通过教育和定期提供负担得起的抗癫痫药物来减少在传统医学上的支出。采用最佳控制措施预防与盘尾丝虫病相关的癫痫将避免社区产生额外的癫痫相关成本。在研究村庄中，早期诊断和妥善管理癫痫在经济上是有益的。
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