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Epilepsy in a health district in North-West Cameroon: Clinical characteristics and treatment gap

Angwafor, SA; Bell, GS; Ngarka, L; Otte, WM; Tabah, EN; Nfor, LN; Njamnshi, TN; ... Njamnshi, AK; + view all (2021) Epilepsy in a health district in North-West Cameroon: Clinical characteristics and treatment gap. Epilepsy & Behavior , 121 , Article 107997. 10.1016/j.yebeh.2021.107997. Green open access

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Abstract

INTRODUCTION: Epilepsy is a common yet misunderstood condition in Cameroon, including in the Batibo Health district. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Type: Article
Title: Epilepsy in a health district in North-West Cameroon: Clinical characteristics and treatment gap
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.yebeh.2021.107997
Publisher version: https://doi.org/10.1016/j.yebeh.2021.107997
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Batibo, Convulsions, Cysticercosis, Injury, Onchocerciasis, Treatment
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery.ucl.ac.uk/id/eprint/10128429
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