Comprehensive management of epilepsy in onchocerciasis-endemic areas:lessons learnt from community-based surveys  

作　　者：Joseph Nelson Siewe Fodjo Marieke C.J.Dekker Richard Idro Michel Ndahura Mandro Pierre-Marie Preux Alfred K.Njamnshi Robert Colebunders 

机构地区：[1]Global Health Institute,University of Antwerp,Antwerp,Belgium Full list of author information is available at the end of the article [2]不详

出　　处：《Infectious Diseases of Poverty》2019年第1期98-98,共1页贫困所致传染病（英文）

摘　　要：Background:Onchocerciasis-endem ic regions are known to have a high epilepsy prevalence.Limited resources in these areas and poor access to healthcare by persons with epilepsy(PWE)result in a wide anti-epileptic treatment gap,poor seizure control and a high burden of seizure-related complications.Recent comm unity-based surveys highlight the need for epilepsy managem ent strategies suitable for remote onchocerciasis-endemic villages to ensure better health outcom es for PWE.In this paper,we propose a feasible approach to manage PWE in such settings.Main text:Improved management of PWE in onchocerciasis-endemic areas may be achieved by decentralizing epilepsy care.Simplified approaches for the diagnosis and treatment of epilepsy may be used by non-physicians,under the supervision of physicians or specialists.To reduce the treatment gap,a regular supply of subsidized anti-epileptic drugs(AED)appropriate for different types of onchocerciasis-associated epilepsy should be instituted.Setting up a communitybased epilepsy surveillance system will enable early diagnosis and treatment of PWE thereby preventing complications.Community awareness programs on epilepsy must be implemented to reduce stigma and facilitate the social rehabilitation of PWE.Finally,strengthening onchocerciasis elimination programs by optimizing community-directed treatment with iverm eain(CDTI)and considering alternative treatment strategies might reduce the incidence of epilepsy.Conclusions:A community-based approach with task-shifting of epilepsy care from specialists to non-physician health workers will reduce epilepsy-associated morbidity.Increased advocacy and collaboration with various stakeholders is needed to establish a sustainable,cost-effective chronic care model for epilepsy that will significantly improve the quality of life of PWE in onchocerciasis-endemic regions.

关 键 词：EPILEPSY ONCHOCERCIASIS Community-based approach Comprehensive management 

分 类 号：R74[医药卫生—神经病学与精神病学]