Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Department of Neurology, Ignace Deen Teaching Hospital, Conakry, Republic of Guinea.
Trop Med Int Health. 2020 Jul;25(7):813-823. doi: 10.1111/tmi.13407. Epub 2020 May 11.
To explore the socioeconomic factors associated with epilepsy in the Republic of Guinea.
People living with epilepsy (PLWE) were prospectively recruited at Ignace Deen Hospital, Conakry, in 2018. An instrument exploring household assets as a measure of wealth was designed and administered. Multivariate logistic regression models with fixed effects were fitted to assess the associations of sociodemographic and microeconomic factors with self-reported frequency of seizures in the prior month and regular intake of antiseizure medications (ASMs). Participants were stratified by age group: children (<13 years), adolescents (13-21) and adults (>21).
A total of 285 participants (mean age 19.5 years; 129 females; 106 children, 72 adolescents, 107 adults, median household size 8) had an average of 4.2 seizures in the prior month. 64% were regularly taking ASMs. Direct costs of epilepsy were similar across income strata, averaging 60 USD/month in the lowest and 75 USD/month in the highest wealth quintiles (P = 0.42). The poorest PLWE were more likely to spend their money on traditional treatments (average 35USD/month) than on medical consultations (average 11 USD/month) (P = 0.01), whereas the wealthiest participants were not. Higher seizure frequency was associated with a lower household education level in adolescents and children (P = 0.028; P = 0.026) and with being male (P = 0.009) in children. Adolescents in higher-educated households were more likely to take ASMs (P = 0.004). Boys were more likely to regularly take ASMs than girls (P = 0.047).
Targeted programming for children and adolescents in the households with the lowest education and for girls would help improve epilepsy care in Guinea.
探讨几内亚共和国癫痫相关的社会经济因素。
2018 年，在科纳克里的伊格内斯·德恩医院前瞻性招募癫痫患者（PLWE）。设计并使用一种评估家庭资产作为财富衡量标准的工具。使用固定效应多变量逻辑回归模型评估社会人口学和微观经济因素与报告的前一个月癫痫发作频率和定期服用抗癫痫药物（ASM）之间的关联。参与者按年龄组分层：儿童（<13 岁）、青少年（13-21 岁）和成年人（>21 岁）。
共有 285 名参与者（平均年龄 19.5 岁；129 名女性；106 名儿童、72 名青少年、107 名成年人，中位数家庭规模为 8）前一个月平均有 4.2 次癫痫发作。64%的人定期服用 ASM。癫痫的直接费用在收入阶层之间相似，在最低收入五分位数平均为 60 美元/月，在最高收入五分位数平均为 75 美元/月（P=0.42）。最贫穷的 PLWE 更有可能将钱用于传统治疗（平均每月 35 美元），而不是医疗咨询（平均每月 11 美元）（P=0.01），而最富有的参与者则不然。青少年和儿童中较高的癫痫发作频率与家庭教育水平较低有关（P=0.028；P=0.026），儿童中与男性有关（P=0.009）。家庭受教育程度较高的青少年更有可能服用 ASM（P=0.004）。男孩比女孩更有可能定期服用 ASM（P=0.047）。
针对受教育程度最低的家庭中的儿童和青少年以及女孩制定有针对性的计划将有助于改善几内亚的癫痫护理。
