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Hajji EB, Traore B, Hassoune S, Bellakhdar S, Rafai MA, Lakhdar A. Antiseizure medication adherence and epilepsy surgery attitude in people with epilepsy in Morocco: A cross-sectional study. Epilepsy Behav Rep 2024; 26:100672. [PMID: 38770278 PMCID: PMC11103368 DOI: 10.1016/j.ebr.2024.100672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/22/2024] Open
Abstract
We determine the proportion of non-Antiseizure Medication Adherence (non-AMA) and refusal attitude towards Epilepsy Surgery (ES) and their associated factors in Moroccan People With Epilepsy (PWE). A cross-sectional study was conducted (December 2021-December 2022) among adult Moroccan PWE. PWE were interviewed for their reactions to AMA and the ES attitude. Their medical files were processed to complete their sociodemographic and clinical data. Data were analyzed by the Statistical Package for Social Sciences (SPSS) software 21.0. A Chi-square test was performed to compare variables and multivariate logistic regression was used to highlight associations. Statistical tests were considered significant at a p-value ≤ 0.05 for a Confidence Interval (CI) of 95 %. The median age of our sample (n = 294) was 38 years (IQR: 25.00-55.00). Non-AMA was noted in 24.5 % with indifference as the main reason (55.6 %). ES refusal was found in 33.3 %, attributed mostly to apprehension (61.2 %). In the multivariate analysis, male sex (aOR = 1.94; 95 %CI: 1.03-3.64) and the existence of a family history of epilepsy (aOR = 1.96; 95 %CI: 1.02-3.75) were the factors associated with the non-AMA, whereas the use of allopathic treatments (aOR = 2.32; 95 %CI: 1.20-4.51), exclusively focal or generalized (not combined) seizures (aOR = 2.66; 95 %CI: 1.36-5.21) and the combination of a generic with the originator ASM (aOR = 2.64; 95 %CI: 1.12-6.18) were the predictive factors with the ES refusal attitude. The proportions found of non-AMA and ES refusal were relatively low compared to other studies, which may indicate the effort that medical staff have devoted recently to raising awareness of the importance of PWE's therapeutic involvement.
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Affiliation(s)
- El Bachir Hajji
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Boubacar Traore
- Laboratory of Epidemiology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Direction de la Pharmacie et du Médicament (DPM), Bamako, Mali
| | - Samira Hassoune
- Laboratory of Epidemiology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Laboratory of Cellular and Molecular Pathology, Team “Epidemiology and Histology of Chronic and Cancerous Diseases”, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Salma Bellakhdar
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Department of Neurology, IBN ROCHD University Hospital, Casablanca, Morocco
| | - Mohammed Abdoh Rafai
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Department of Neurology, IBN ROCHD University Hospital, Casablanca, Morocco
| | - Abdelhakim Lakhdar
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Department of Neurosurgery, IBN ROCHD University Hospital, Casablanca, Morocco
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El Khamlichi A, El Ouazzani R, Melhaoui A, Arkha Y, Adeniran Bankole ND, Rifi L, Lahjouji F, Amor M, Jiddane M. Advocacy for Epilepsy Surgery in Africa: Moroccan Experience of 132 Cases. World Neurosurg 2024; 183:e421-e431. [PMID: 38154685 DOI: 10.1016/j.wneu.2023.12.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND In Africa, epilepsy is a real burden. Temporal lobe epilepsy is the most common drug-resistant focal epilepsy disorder, and temporal lobectomy is the most common effective treatment for patients with drug-resistant epilepsy. OBJECTIVE We aim to highlight the Moroccan experience in epilepsy surgery and to ascertain its long-term outcome. Through the results of surgical treatment in our series, we hope to raise awareness of the need for epilepsy surgery in Africa and contribute to its development. METHODS We present a retrospective study of 132 patients who underwent surgery for epilepsy from January 2005 to December 2021 at our institution. The presurgical evaluation was based on clinical screening, interictal electroencephalography, video-electroencephalography, neuropsychological tests, magnetic resonance imaging, and positron emission tomography in some cases. Data are presented as the median and ranges. For all analyses, P values <0.05 were considered statistically significant. RESULTS Our series includes 132 patients (69 males; 52.27%); the median age at surgery was 24 years (range, 1-64). One hundred and fifteen patients (87%) were operated on for temporal lobe epilepsy, of whom 98 (85%) had anterior temporal lobectomy and 17 (15%) had lesionectomy. Seventeen patients (13%) were operated on for extratemporal epilepsy, of whom 4 had lesionectomy, 7 functional hemispherotomy, and 5 Gamma Knife stereotactic radiosurgery. Our postoperative outcomes 3 months after surgery found 113 patients (85.6%) seizure-free (Engel class I), 16 with Engel class II (12.1%), and 3 with Engel class III (2.3%) in temporal lobe epilepsy. In extratemporal lobe epilepsy, 12 patients (70.5%) showed Engel class I, seizure-free, 4 Engel class II (23.5%), and 1 Engel class III (6%). CONCLUSIONS These results confirm that most patients with drug-resistant epilepsy may benefit from surgical treatment without submitting to preoperative invasive explorations. This finding should help develop epilepsy surgery widely in Africa.
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Affiliation(s)
- Abdeslam El Khamlichi
- Department of Neurosurgery, l'hôpital des spécialités; National Center for Rehabilitation and Neurosciences, CHU Ibn Sina, Mohammed V University of Rabat, Rabat, Morocco
| | - Reda El Ouazzani
- Department of Neurosurgery, l'hôpital des spécialités; National Center for Rehabilitation and Neurosciences, CHU Ibn Sina, Mohammed V University of Rabat, Rabat, Morocco
| | - Adyl Melhaoui
- Department of Neurosurgery, l'hôpital des spécialités; National Center for Rehabilitation and Neurosciences, CHU Ibn Sina, Mohammed V University of Rabat, Rabat, Morocco
| | - Yasser Arkha
- Department of Neurosurgery, l'hôpital des spécialités; National Center for Rehabilitation and Neurosciences, CHU Ibn Sina, Mohammed V University of Rabat, Rabat, Morocco
| | - Nourou Dine Adeniran Bankole
- Department of Neurosurgery, l'hôpital des spécialités; National Center for Rehabilitation and Neurosciences, CHU Ibn Sina, Mohammed V University of Rabat, Rabat, Morocco.
| | - Loubna Rifi
- Department of Neurosurgery, l'hôpital des spécialités; National Center for Rehabilitation and Neurosciences, CHU Ibn Sina, Mohammed V University of Rabat, Rabat, Morocco
| | - Fatiha Lahjouji
- Department of Neurosurgery, l'hôpital des spécialités; National Center for Rehabilitation and Neurosciences, CHU Ibn Sina, Mohammed V University of Rabat, Rabat, Morocco
| | - Mourad Amor
- Department of Neurosurgery, l'hôpital des spécialités; National Center for Rehabilitation and Neurosciences, CHU Ibn Sina, Mohammed V University of Rabat, Rabat, Morocco
| | - Mohamed Jiddane
- Department of Neurosurgery, l'hôpital des spécialités; National Center for Rehabilitation and Neurosciences, CHU Ibn Sina, Mohammed V University of Rabat, Rabat, Morocco
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Bachir Hajji E, Traore B, Hassoune S, Bellakhdar S, El Imane Issam Salah N, Abdoh Rafai M, Lakhdar A. Knowledge, attitudes and practices towards epilepsy in morocco: A cross-sectional study. Epilepsy Behav 2024; 150:109567. [PMID: 38096661 DOI: 10.1016/j.yebeh.2023.109567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/01/2023] [Accepted: 11/26/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND This study aims to assess knowledge, practices and attitudes of the general Moroccan population towards epilepsy and to highlight predictive factors. METHOD A cross-sectional study was conducted in the Casablanca-Settat Moroccan region. A questionnaire was used to collect sociodemographic data and item answers from 400 people with epilepsy (PWE) and without epilepsy caregivers on dependent variables: knowledge, attitudes, and practices towards epilepsy. Bivariate and logistic regression analyses were performed using IBM SPSS Statistics 21.0. Statistical significance was set when P value < 0.05. RESULTS The rates of poor knowledge, practices, and attitudes toward epilepsy were 11.5 %, 41 %, and 66.6 %, respectively. In the multivariate analysis, the risk of having poor knowledge about epilepsy was favored by lack of education (ORa = 4.31;CI95%:1.83-10.13;p = 0.001) and the absence of familiarity with epilepsy (ORa = 4.05;CI95%:1.92-8.54;p < 0.001). The risk of preferring allopathic practices to treat epilepsy was associated with lack of education (ORa = 2.21;CI95%:1.01-4.82;p = 0.046), residence in a city outside Casablanca (ORa = 2.33;CI95%:1.06-5.15;p = 0.035), age over 59 years (ORa = 2.50;CI95%:1.26-4.95; p = 0.008), residence in a rural areas (ORa = 4.41;CI95%:2.61-7.47;p < 0.001) and absence of familiarity with epilepsy (ORa = 4.08;CI95%:2.33-7.15;p < 0.001). Predictors of stigma towards epilepsy were female sex (ORa = 3.05;CI95%:2.04-4.56;p < 0.001) and the tendency to abandon anti-seizure medication for allopathic alternatives (ORa = 3.98;CI95%:2.21-7.17;p < 0.001), whereas advanced age was a protective factor (ORa = 0.57;CI95%:0.36-0.89;p = 0.014[39-59 years vs 18-29 years];ORa = 0.44;CI95%:0.23-0.82;p = 0.011[>59 years vs 18-29 years]). CONCLUSIONS The rate of poor attitudes and treatment-seeking behavior was high. This socio-cultural context certainly impacts the quality of life and care of Moroccan PWE. These results should be considered to raise awareness in the Moroccan population.
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Affiliation(s)
- El Bachir Hajji
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - Boubacar Traore
- Laboratory of Epidemiology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Samira Hassoune
- Laboratory of Epidemiology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Salma Bellakhdar
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco; Department of Neurology, IBN ROCHD University Hospital, Casablanca, Morocco
| | - Nour El Imane Issam Salah
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mohammed Abdoh Rafai
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco; Department of Neurology, IBN ROCHD University Hospital, Casablanca, Morocco
| | - Abdelhakim Lakhdar
- Laboratory of Research on Neurologic, Neurosensorial Diseases and Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco; Department of Neurosurgery, IBN ROCHD University Hospital, Casablanca, Morocco
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Mofatteh M, Mashayekhi MS, Arfaie S, Adeleye AO, Jolayemi EO, Ghomsi NC, Shlobin NA, Morsy AA, Esene IN, Laeke T, Awad AK, Labuschagne JJ, Ruan R, Abebe YN, Jabang JN, Okunlola AI, Barrie U, Lekuya HM, Idi Marcel E, Kabulo KDM, Bankole NDA, Edem IJ, Ikwuegbuenyi CA, Nguembu S, Zolo Y, Bernstein M. Awake Craniotomy in Africa: A Scoping Review of Literature and Proposed Solutions to Tackle Challenges. Neurosurgery 2023; 93:274-291. [PMID: 36961213 PMCID: PMC10319364 DOI: 10.1227/neu.0000000000002453] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/10/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to reduce associated complications and costs. A significant resource limitation in low- and middle-income countries constrains the usage of AC. OBJECTIVE To review the published literature on AC in African countries, identify challenges, and propose pragmatic solutions by practicing neurosurgeons in Africa. METHODS We conducted a scoping review under Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Scoping Review guidelines across 3 databases (PubMed, Scopus, and Web of Science). English articles investigating AC in Africa were included. RESULTS Nineteen studies consisting of 396 patients were included. Egypt was the most represented country with 8 studies (42.1%), followed by Nigeria with 6 records (31.6%). Glioma was the most common lesion type, corresponding to 120 of 396 patients (30.3%), followed by epilepsy in 71 patients (17.9%). Awake-awake-awake was the most common protocol used in 7 studies (36.8%). Sixteen studies (84.2%) contained adult patients. The youngest reported AC patient was 11 years old, whereas the oldest one was 92. Nine studies (47.4%) reported infrastructure limitations for performing AC, including the lack of funding, intraoperative monitoring equipment, imaging, medications, and limited human resources. CONCLUSION Despite many constraints, AC is being safely performed in low-resource settings. International collaborations among centers are a move forward, but adequate resources and management are essential to make AC an accessible procedure in many more African neurosurgical centers.
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Affiliation(s)
- Mohammad Mofatteh
- School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | | | - Saman Arfaie
- School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Belfast, UK
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Amos Olufemi Adeleye
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Nathalie C. Ghomsi
- Neurosurgery Department, Felix Houphouet Boigny Unversity Abidjan, Cote d’Ivoire
| | - Nathan A. Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ahmed A. Morsy
- Department of Neurosurgery, Zagazig University, Zagazig, Egypt
| | - Ignatius N. Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
| | - Tsegazeab Laeke
- Neurosurgery Division, Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ahmed K. Awad
- Faculty of Medicine, Ain-shams University, Cairo, Egypt
| | - Jason J. Labuschagne
- Department of Neurosurgery, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Ruan
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Yared Nigusie Abebe
- Department of Neurosurgery, Haramaya University Hiwot Fana Comprehensive Specialized Hospital, Harar, Ethiopia
| | | | - Abiodun Idowu Okunlola
- Department of Surgery, Federal Teaching Hospital Ido Ekiti and Afe Babalola University, Ado Ekiti, Nigeria
| | - Umaru Barrie
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Hervé Monka Lekuya
- Department of Neurosurgery, Makerere University/Mulago Hospital, Kampala, Uganda
| | - Ehanga Idi Marcel
- Department of Neurosurgery, College of Surgeons of East, Central and Southern Africa/Mulago Hospital, Kampala, Uganda
| | - Kantenga Dieu Merci Kabulo
- Department of Neurosurgery, Jason Sendwe General Provincial Hospital, Lubumbashi, Democratic Republic of the Congo
| | - Nourou Dine Adeniran Bankole
- Department of Neurosurgery, Hôpital Des Spécialités, WFNS Rabat Training Center For Young, African Neurosurgeons, Faculty of Medicine, Mohammed V University, Rabat, Morocco
| | - Idara J. Edem
- Department of Surgery, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | | | - Stephane Nguembu
- Department of Neurosurgery, Higher Institute of Health Sciences, Université des Montagnes, Bangangté, Cameroon
| | - Yvan Zolo
- Global Surgery Division, University of Cape Town, Cape Town, South Africa
| | - Mark Bernstein
- Division of Neurosurgery, Department of Surgery, University of Toronto, University Health Network, Toronto, Ontario, Canada
- Temmy Latner Center for Palliative Care, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
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Teuwen DE, Sebera F, Murekeyiteto A, Garrez I, Sanchez-Iriso E, Umwiringirwa J, Umuhoza G, Boon PAJM, Dedeken P. Epilepsy-Related Direct Medical and Direct Non-Medical Cost in Adult Patients Living with Epilepsy at a Tertiary Neurology Center in Rwanda. Clinicoecon Outcomes Res 2023; 15:15-27. [PMID: 36660476 PMCID: PMC9843617 DOI: 10.2147/ceor.s382030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/07/2022] [Indexed: 01/12/2023]
Abstract
Objective Up to one in four patients living with epilepsy (PwE) mentions financial constraints as a reason for loss to follow-up at the Ndera tertiary neuropsychiatry hospital. Therefore, we evaluated the annual direct medical cost (DMC) and direct non-medical cost (DnMC) of epilepsy and calculated costs assuming different follow-up frequency. Materials and Methods DMC data were obtained from a descriptive retrospective study of medical records, pharmacy dispensation and hospital logs of PwE, following their initial consultation in 2018 and who adhered to the normal clinical practice of monthly consultations for one year. DnMC data were collected through structured interviews of PwE in a cross-sectional cohort in August 2020. DnMC included biomedical care costs (eg, transportation, hospitality) and non-biomedical costs (traditional healer visits). We report weighted means for total costs, health insurance costs, and out-of-pocket costs (OoP). Results Mean annual total cost was 389.4 US$, of which 226.2 US$ was covered by the Rwandan Health Insurance co-payment for DMC and 163.2 US$ was OoP paid by patients. Mean weighted annual DMC (n = 55) was 248.9 US$. Mean weighted annual DMC for medical consultations and antiseizure medication accounted for 30.7 US$ and 161.7 US$, respectively. Based on structured interviews (n = 69), mean weighted annual DnMC for biomedical care was 73.0 US$. Mean DnMC for traditional healer care was 67.6 US$. Weighted annual total OoP was 163.2 US$ or 20% of the GDP per capita. OoP consisted of 14% DMC co-payment, 45% biomedical DnMC, and 41% traditional healer DnMC. Conclusion Epilepsy-related costs at a tertiary center are an important economic burden for PwE and Rwandan Health Insurance. Biomedical and traditional healer DnMC constitute 86% of total OoP. Future prospective studies should evaluate outcomes and costs of reduced visit frequency, indirect costs, and costs of comorbidities.
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Affiliation(s)
- Dirk E Teuwen
- Department of Neurology, Ghent University Hospital, Ghent, Belgium,4Brain, Ghent University Hospital, Ghent, Belgium,Correspondence: Dirk E Teuwen, Email
| | - Fidele Sebera
- Department of Neurology, Ghent University Hospital, Ghent, Belgium,Neurology Department, CARAES Neuro-Psychiatric Hospital, Kigali, Rwanda,Neurology Department, Centre Hospitalier Universitaire (CHU-K), Kigali, Rwanda
| | | | - Ieme Garrez
- Department of Neurology, Ghent University Hospital, Ghent, Belgium,4Brain, Ghent University Hospital, Ghent, Belgium
| | | | | | - Georgette Umuhoza
- Neurology Department, CARAES Neuro-Psychiatric Hospital, Kigali, Rwanda
| | - Paul A J M Boon
- Department of Neurology, Ghent University Hospital, Ghent, Belgium,4Brain, Ghent University Hospital, Ghent, Belgium
| | - Peter Dedeken
- Department of Neurology, Ghent University Hospital, Ghent, Belgium,4Brain, Ghent University Hospital, Ghent, Belgium,Department of Neurology, Heilig Hart Ziekenhuis, Lier, Belgium
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Souirti Z, Lamkaddem A, Ben El Bouazzaoui M, Abiza M, Hmidani H, Janati Idrissi A, Boutchich M, Lahjouji F, Chahidi A, Kissani N, Ouazzani R. The modern terminology of epilepsy adopted by the Moroccan League Against Epilepsy. Epilepsy Behav 2021; 122:108177. [PMID: 34274746 DOI: 10.1016/j.yebeh.2021.108177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/12/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Z Souirti
- Sidi Mohammed Ben Abdellah University of Fez, Morocco; Moroccan League against Epilepsy, Morocco; Moroccan Society of Neurophysiology Morocco.
| | - A Lamkaddem
- Sidi Mohammed Ben Abdellah University of Fez, Morocco; Moroccan Society of Neurophysiology Morocco
| | | | - M Abiza
- Sidi Mohammed Ben Abdellah University of Fez, Morocco
| | - H Hmidani
- Sidi Mohammed Ben Abdellah University of Fez, Morocco
| | - A Janati Idrissi
- Sidi Mohammed Ben Abdellah University of Fez, Morocco; Moroccan Society of Neurophysiology Morocco
| | - M Boutchich
- Moroccan League against Epilepsy, Morocco; Moroccan Society of Neurophysiology Morocco
| | - F Lahjouji
- Moroccan League against Epilepsy, Morocco; Mohammed V University of Rabat, Morocco; Moroccan Society of Neurophysiology Morocco
| | - A Chahidi
- Moroccan Society of Neurophysiology Morocco
| | - N Kissani
- Moroccan League against Epilepsy, Morocco; Moroccan Society of Neurophysiology Morocco; Cadi Ayyad University, Marrakech, Morocco
| | - R Ouazzani
- Moroccan League against Epilepsy, Morocco; Mohammed V University of Rabat, Morocco; Moroccan Society of Neurophysiology Morocco
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Garg K. Prevalence of Major Mental and Neurological Disorders in India. Neurol India 2021; 69:302-303. [PMID: 33904438 DOI: 10.4103/0028-3886.314556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kissani N, Nafia S, El Khiat A, Bengamara N, Maiga Y, Sogoba Y, Ahmed A Ibrahim E, Agbetou M, Massi Daniel G, Assogba K, Matar Gaye N, Kuate Tegueu C, Hussein Ragab A, Razafimahefa J, Wilmshurst J, Naidoo A, Jabang JN, Watila M. Epilepsy surgery in Africa: state of the art and challenges. Epilepsy Behav 2021; 118:107910. [PMID: 33744795 DOI: 10.1016/j.yebeh.2021.107910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Epilepsy is an important public health problem representing 0.6% of the global burden of disease that particularly impacts people living in the lowest income countries where epilepsy incidence may be 10 fold more than in the developed world. The battery of treatments designed to counteract the clinical manifestations of this disease are various and range from a wide spectrum of antiseizure medicationand specific diets, to surgical techniques for resection of the epileptogenic focus. The aim of our study was to describe the State of the art of Epilepsy Surgery (ES) in Africa and examine ways to deal with the high surgical treatment gap. METHODOLOGY In an observational study, we prospectively disseminated questionnaires via email or directly administered to main epileptologists and neurologists involved in epilepsy care, in key African countries. We also conducted a literature search using PubMed, Google scholar on ES in all the African countries. RESULTS We received responses from the majority of African countries, which allowed us to identify 3 levels of care for ES in African countries, a first level that uses ES with invasive presurgical evaluation, a second level that uses ES but without invasive presurgical evaluation, and a third level that does not use ES, and we summarized these results on a map. DISCUSSION This paper studied the availability of ES as a treatment modality in several African countries. We aimed to establish optimal pathways for initiating ES with noninvasive Electroencephalography and readily available investigations. This could be achieved through collaboration with epilepsy programs in developed countries directly or by using telemedicine.
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Affiliation(s)
- Najib Kissani
- Laboratory of Clinical and Experimental Neuroscience. Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco; Department of Neurology. University Teaching, Hospital Mohammed VI, Marrakesh, Morocco.
| | - Sanaa Nafia
- Laboratory of Clinical and Experimental Neuroscience. Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco
| | - Abdelaati El Khiat
- Laboratory of Clinical and Experimental Neuroscience. Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco
| | | | | | - Youssouf Sogoba
- Neurosurgery Department, Hospital Gabriel Touré, Bamako, Mali
| | - Eetedal Ahmed A Ibrahim
- Neurology Department. Alneelain University, National Centre for Neurological Centre, Khartoum, Sudan
| | | | | | - Komi Assogba
- Neurology Department, University Hospital, Campus of Lome, Togo
| | | | | | | | | | - Jo Wilmshurst
- Head of Paediatric Neurology, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - Ansuya Naidoo
- Head of Clinical Unit and Consultant Neurologist (Greys Academic Hospital) Clinical Lecturer, South Africa
| | - John N Jabang
- Neurosurgery Unit, Department of Surgery, Edward Francis Small Teaching Hospital, Banjul, Gambia
| | - Musa Watila
- Neurology Unit, Department of Medicine, University of Maiduguri Teaching Hospital, PMB 1414, Maiduguri, Borno State, Nigeria
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