NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, London WC1N 3BG, United Kingdom; Chalfont Centre for Epilepsy, Chalfont St Peter, Bucks SL9 0RJ, United Kingdom; Faculty of Health Sciences, University of Bamenda, Cameroon; Neurology Department, Central Hospital Yaoundé/Faculty of Medicine and Biomedical Sciences (FMBS), The University of Yaoundé I, Cameroon.
NIHR University College London Hospitals Biomedical Research Centre, UCL Queen Square Institute of Neurology, London WC1N 3BG, United Kingdom; Chalfont Centre for Epilepsy, Chalfont St Peter, Bucks SL9 0RJ, United Kingdom.
Epilepsy Behav. 2021 Aug;121(Pt A):107997. doi: 10.1016/j.yebeh.2021.107997. Epub 2021 May 11.
Epilepsy is a common yet misunderstood condition in Cameroon, including in the Batibo Health district.
This cross-sectional study describes epilepsy clinical characteristics, the treatment gap, and associated factors in a rural district in Cameroon. After screening for epilepsy using a door-to-door survey, physicians confirmed suspected cases of epilepsy. Detailed information on the medical, seizure, and treatment history was collected from everyone with epilepsy, followed by a general and neurological examination.
We diagnosed 546 people with active epilepsy (at least one seizure in the previous 12 months). The mean age of people with active epilepsy was 25.2 years (SD: 11.1). The mean age at first seizure was 12.5 years (SD: 8.2). Convulsive seizures (uncertain whether generalized or focal) were the most common seizure types (60%), while 41% had focal-onset seizures. About 60% of people had seizures at least monthly. One-quarter of participants had had at least one episode of status epilepticus. Anti-seizure medication (ASM) was taken by 85%, but most were receiving inappropriate treatment or were non-adherent, hence the high treatment gap (80%). Almost a third had had seizure-related injuries. Epilepsy was responsible for low school attendance; 74% of school dropouts were because of epilepsy.
The high proportion of focal-onset seizures suggests acquired causes (such as neurocysticercosis and onchocerciasis, both endemic in this area). The high epilepsy treatment gap and the high rates of status epilepticus and epilepsy-related injuries underscore the high burden of epilepsy in this rural Cameroonian health district.
在喀麦隆，包括巴蒂博卫生区在内，癫痫是一种常见但仍被误解的疾病。
本横断面研究描述了喀麦隆农村地区癫痫的临床特征、治疗差距和相关因素。通过逐户调查筛查癫痫后，医生确认了疑似癫痫病例。从每位癫痫患者收集有关医疗、发作和治疗史的详细信息，随后进行全面和神经系统检查。
我们诊断出 546 名患有活动性癫痫（过去 12 个月至少有一次发作）的人。活动性癫痫患者的平均年龄为 25.2 岁（标准差：11.1）。首次发作的平均年龄为 12.5 岁（标准差：8.2）。最常见的发作类型是全身性或局灶性未确定的惊厥性发作（60%），而 41%的患者有局灶性发作。约 60%的人每月至少发作一次。四分之一的参与者至少有过一次癫痫持续状态发作。抗癫痫药物（ASM）的使用率为 85%，但大多数人接受的治疗不当或不遵医嘱，因此治疗差距很大（80%）。近三分之一的人因癫痫发作而受伤。癫痫导致低入学率；74%的辍学者是因为癫痫。
局灶性发作比例高提示存在获得性病因（如神经囊虫病和盘尾丝虫病，这两种疾病在该地区均流行）。癫痫治疗差距大，癫痫持续状态和癫痫相关损伤的发生率高，突显了该喀麦隆农村卫生区癫痫的高负担。
