Ekanem Emmanuel E, Fajola Akinwunmi O, Usman Rakiya, Ogbimi Rebecca N, Ikeagwu Gloria O, Anidima Tamunoibim E, Etieh Michael N, Umejiego Chidozie N
Department of Paediatrics, University of Calabar, Calabar, Nigeria.
Department of Community Health, Shell Petroleum and Development Company, Rivers State, Nigeria.
Niger Med J. 2019 Jul-Aug;60(4):186-189. doi: 10.4103/nmj.NMJ_6_18. Epub 2019 Nov 25.
The epilepsy problem in much of Africa is characterized by stigmatization and neglect. This article describes the efforts at a cottage hospital level to ameliorate the epilepsy problem in a resource-limited environment.
A seizure clinic was started in a cottage hospital after targeted health talks. The International League against Epilepsy (ILEA)/World Health Organization (WHO)/International Bureau for Epilepsy (IBE) manual was adopted for the training of staff and to guide management. Patients were followed up in the clinic and with the use of simple information communication technology.
Forty-five patients with ages ranging from 3 months to 42 years (who had lived with epilepsy for periods ranging from 3 weeks to 32 years) were registered over 12 months period. The most common seizure type was generalized tonic clonic (21 or 46.67%) followed by generalized clonic (8 or 17.78%). Ten (22.22%) had comorbidities mainly cerebral palsy (4 or 8.89%) and attention-deficit hyperactivity disorder (3 or 6.67%). Most (98.15%) were placed on carbamazepine. Twenty-three (51.11%) had complete control of seizures, 21 (46.67%) had reduced frequencies of attacks, and all 8 children who had dropped out of school resumed schooling.
The epilepsy challenge in the developing world can be demystified and effectively managed at the cottage hospital level. Targeted health education, affordable management regimes, and committed follow-up are keys. A training manual based on the ILEA/WHO/IBE document should be developed for Africa.
非洲大部分地区的癫痫问题存在污名化和被忽视的特点。本文描述了一家乡村医院在资源有限的环境下为改善癫痫问题所做的努力。
在开展针对性的健康讲座后，一家乡村医院开设了癫痫诊所。采用国际抗癫痫联盟（ILEA）/世界卫生组织（WHO）/国际癫痫局（IBE）手册对工作人员进行培训并指导管理工作。在诊所对患者进行随访，并使用简单的信息通信技术。
在12个月的时间里登记了45名患者，年龄从3个月到42岁不等（患癫痫的时间从3周到32年不等）。最常见的癫痫发作类型是全身强直阵挛发作（21例，占46.67%），其次是全身阵挛发作（8例，占17.78%）。10例（22.22%）有合并症，主要是脑瘫（4例，占8.89%）和注意力缺陷多动障碍（3例，占6.67%）。大多数患者（98.15%）服用卡马西平。23例（51.11%）癫痫发作得到完全控制，21例（46.67%）发作频率降低，所有8名辍学儿童都重新上学。
发展中国家的癫痫挑战在乡村医院层面可以得到清晰认识并有效管理。有针对性的健康教育、负担得起的治疗方案和持续的随访是关键。应为非洲制定基于ILEA/WHO/IBE文件的培训手册。
