Sakadi Foksouna, Christian Madjirabe Ngardidjim, Lamine Toure Mohamed, Dakisia Kamis, Christelle Nderbe Melom, Doufene Diponbe, Foksia Lintel Anicet, Nguelngar Carlos Othon, Balanmo Anatole, Babing-Ne Kobada, Nalire Desire, Amara Cisse
Neurology Unit, National Reference Teaching Hospital, N'djamena, Chad.
Neurology Unit, Renaissance Teaching Hospital, N'djamena, Chad.
Epilepsia Open. 2024 Dec;9(6):2049-2054. doi: 10.1002/epi4.13087. Epub 2024 Nov 4.
Epilepsy is a significant public health problem. More than 50 million people worldwide live with epilepsy, and over three-quarters of them are in low- and middle-income countries. The situation in Chad regarding people with epilepsy is challenging to assess, starting from the shortage of scientific data, the inadequacy of technical facilities, the lack of human resources, and the inadequacy of government action. The Ministry of Health and Chadian Society of Neurology are looking forward to prioritizing epilepsy as well as improving the living conditions of persons with this disease. The epilepsy treatment issue is also problematic. Most of the patients are either off treatment or under-medicated. Few antiseizure medications (ASMs) are available, notably carbamazepine, phenobarbital, and valproic acid. Epilepsy remains little-known and does not seem to be a priority for decision-makers. We describe the current situation in Chad, to improve the conditions under which epilepsy is treated. PLAIN LANGUAGE SUMMARY: Epilepsies is a chronic brain problem that is common in poorer settings. The daily lives of people with epilepsy are chaotic in Chad. The challenges are numerous, particularly those related to health infrastructures, due to the lack of adequate diagnostic means and the lack of neurologists. The cultural and language challenges, especially since epilepsy is still considered the devil's disease and the name differs according to the dialects. Stigmatization is also frequent and is often responsible for school dropout, refusal, or dismissal from work. Care and prevention are daily challenges that require government action. Social coverage is insufficient and almost absent in rural areas. It is urgent to prioritize epilepsy in future action plans and also to increase awareness of the conditions to overcome these challenges.
癫痫是一个重大的公共卫生问题。全球有超过5000万人患有癫痫，其中四分之三以上生活在低收入和中等收入国家。由于缺乏科学数据、技术设施不足、人力资源匮乏以及政府行动不力，乍得癫痫患者的情况难以评估。乍得卫生部和乍得神经学会期待将癫痫列为优先事项，并改善癫痫患者的生活条件。癫痫治疗问题也很棘手。大多数患者要么未接受治疗，要么药物治疗不足。可用的抗癫痫药物（ASMs）很少，尤其是卡马西平、苯巴比妥和丙戊酸。癫痫仍然鲜为人知，似乎不是决策者的优先事项。我们描述了乍得的现状，以改善癫痫治疗的条件。通俗易懂的总结：癫痫是一种慢性脑部疾病，在较贫困地区很常见。在乍得，癫痫患者的日常生活一片混乱。挑战众多，特别是与卫生基础设施相关的挑战，因为缺乏足够的诊断手段和神经科医生。文化和语言方面的挑战也存在，尤其是因为癫痫仍被视为恶魔之症，且名称因方言而异。污名化现象也很常见，常常导致患者辍学、被拒绝工作或被解雇。护理和预防是日常面临的挑战，需要政府采取行动。社会覆盖不足，农村地区几乎没有。迫切需要在未来的行动计划中优先考虑癫痫问题，并提高对相关情况的认识，以克服这些挑战。
