Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaoundé, Cameroon.
Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
BMC Public Health. 2020 Jun 5;20(1):871. doi: 10.1186/s12889-020-08997-8.
Epilepsy is a severe neurological disorder with huge psychological, social, and economic consequences, including premature deaths and loss of productivity. Sub-Saharan Africa carries the highest burden of epilepsy. The management of epilepsy in Cameroon remains unsatisfactory due to poor identification of cases and a limited knowledge of the distribution of the disease. The objective of this study was to determine whether community drug distributors (CDDs) - volunteers selected by their communities to distribute ivermectin against onchocerciasis and who have been proven efficient to deliver other health interventions such as insecticide-treated bed nets to prevent malaria, vitamin A tablets, and albendazole to treat soil transmitted helminthiasis - can be used to reliably identify people living with epilepsy to promote better management of cases.
This study was carried out in three health Districts in Cameroon. An exhaustive house to house census was carried out by trained CDDs under the supervision of local nurses. In each household, all suspected cases of epilepsy were identified. In each health district, five communities were randomly selected for a second census by trained health personnel (research team). The results of the two censuses were compared for verification purposes.
A total of 53,005 people was registered in the 190 communities surveyed with 794 (1.4%) individuals identified as suspected cases of epilepsy (SCE) by the CDDs. In the 15 communities where the SCE census was verified, the average ratio between the number of suspected cases of epilepsy reported in a community by the research team and that reported by the CDDs was 1.1; this ratio was < 0.8 and > 1.2 in 6 communities.
The results of this study suggest that CDDs, who are present in about 200,000 communities in 31 Sub Saharan African countries where onchocerciasis is endemic, can be successfully used to assess epilepsy prevalence, and therefore map epilepsy in many African countries.
癫痫是一种严重的神经系统疾病，具有巨大的心理、社会和经济后果，包括过早死亡和生产力丧失。撒哈拉以南非洲地区的癫痫负担最重。由于病例识别不佳和对疾病分布的了解有限，喀麦隆的癫痫管理仍不尽人意。本研究的目的是确定社区药物分发者（CDD）——由社区选择分发伊维菌素以治疗盘尾丝虫病的志愿者，他们已经被证明能够有效地提供其他健康干预措施，如驱虫蚊帐以预防疟疾、维生素 A 片和阿苯达唑治疗土壤传播的蠕虫病——是否可以用于可靠地识别癫痫患者，以促进更好地管理病例。
本研究在喀麦隆的三个卫生区进行。经过培训的 CDD 在当地护士的监督下进行了详尽的逐户普查。在每个家庭中，都确定了所有疑似癫痫患者。在每个卫生区，随机选择五个社区由经过培训的卫生人员（研究团队）进行第二次普查。为了验证目的，比较了两次普查的结果。
在所调查的 190 个社区中，共登记了 53005 人，其中有 794 人（1.4%）被 CDD 确定为疑似癫痫患者（SCE）。在 15 个进行了 SCE 普查验证的社区中，研究团队报告的社区疑似癫痫病例数与 CDD 报告的疑似癫痫病例数之比平均为 1.1；在 6 个社区中，这一比例小于 0.8 且大于 1.2。
这项研究的结果表明，在 31 个流行盘尾丝虫病的撒哈拉以南非洲国家的大约 20 万个社区中都有 CDD，他们可以成功地用于评估癫痫的患病率，从而绘制许多非洲国家的癫痫地图。
