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Neurologia. 2019 May 4. pii: S0213-4853(19)30052-0. doi: 10.1016/j.nrl.2019.02.004. [Epub ahead of print]

Identifying areas for improvement in epilepsy management in developing countries: An experience of neurocooperation in Cameroon.

[Article in English, Spanish]

Author information

1
Servicio de Neurología, Hospital Clínico Universitario San Carlos, Madrid, España.
2
Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España. Electronic address: davilink@hotmail.com.
3
HM-CINAC, HM Hospital Universitario Puerta del Sur, Móstoles, Madrid, España; Departamento de Anatomía, Histología y Neurociencia, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España.
4
Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España.
5
Unidad de Trastornos del Movimiento, Departamento de Neurología, Hospital Ruber Internacional, Madrid, España.
6
Unidad de Epilepsia, Servicio de Neurología, Hospital Clínico Universitario San Carlos, Madrid, España; Programa de Epilepsia, Servicio de Neurología, Hospital Ruber Internacional, Madrid, España.

Abstract

INTRODUCTION:

Epilepsy is especially prevalent in developing countries: incidence and prevalence rates are at least twice as high as in our setting. Epilepsy is also highly stigmatised, and few resources are available for its management.

MATERIAL AND METHODS:

We performed a descriptive observational study in December 2016, distributing a questionnaire on epilepsy management to healthcare professionals from 3 different hospitals in Cameroon. Data are presented as means or percentages.

RESULTS:

Thirty-eight healthcare providers participated in the survey; 42.1% were female and mean age was 40.1 years (range, 22-62). Regarding the causes of epilepsy, 68.4% considered it a psychiatric condition, 34.2% a degenerative disease, 28.9% a hereditary condition, and 21.1% secondary to infection. In terms of management, 23.7% considered that thorough clinical history is sufficient to establish a diagnosis. Only 60.5% considered the clinical interview to be important for diagnosis, 52.6% considered EEG to be necessary, and 28.9% considered laboratory analyses to be important. Only 13.2% mentioned neuroimaging. In the treatment of pregnant women, 36.8% recommended folic acid supplementation, 65.8% believed antiepileptic treatment should be maintained, and only 39.5% recommended breastfeeding. Concerning treatment, the participants knew a mean of 2 antiepileptic drugs: phenobarbital was the best known (81.6%), followed by carbamazepine (55.3%) and valproic acid (28.9%).

CONCLUSIONS:

There is a need among healthcare professionals for education and information on the disease, its diagnosis, and management options, in order to optimise management and consequently improve patients' quality of life.

KEYWORDS:

Developing; Educación; Education; Embarazo; En vías de desarrollo; Epilepsia; Epilepsy; Pregnancy; Tratamiento; Treatment

PMID:
31064664
DOI:
10.1016/j.nrl.2019.02.004
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