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Uwishema O, Frederiksen KS, Correia IFS, Mahmoud A, Onyeaka H, Dost B. The impact of COVID-19 on patients with neurological disorders and their access to healthcare in Africa: A review of the literature. Brain Behav 2022; 12:e2742. [PMID: 35951730 PMCID: PMC9480907 DOI: 10.1002/brb3.2742] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/24/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic has hampered the progress of neurological healthcare services for patients across Africa. Before the pandemic, access to these services was already limited due to elevated treatment costs among uninsured individuals, shortage of medicines, equipment, and qualified personnel, immense distance between residing areas and neurological facilities, and a limited understanding of neurological diseases and their presentation by both the health workers and the African population. METHODOLOGY The databases PubMed, Google Scholar, Science Direct, and the National Library of Medicine were searched for literature. All articles on neurological disorders in Africa were considered. AIM This review article explores the challenges of providing the best services for patients suffering from neurological disorders in Africa amid the COVID-19 pandemic and provides evidence-based recommendations. RESULTS As Africa's governments made more resources available to support patients affected by COVID-19, neurological care received less priority and the capacity and competency to treat patients with neurological disorders thus suffered substantially. Both short-term and long-term strategies are needed to improve the quality of neurological services after the pandemic in the region. CONCLUSION To strengthen Africa's neurological services capability during and after the COVID-19 pandemic, African governments must ensure appropriate healthcare resource allocation, perform neurology management training, and increase health security measures in medication supply. Long-term strategies include incorporating responsible finance and resource procurement and advancement of tele-neurology. International collaboration is essential to promote the sustainable improvement of neurological services in Africa.
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Affiliation(s)
- Olivier Uwishema
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,Department of Projects and Research, Clinton Global Initiative University, New York City, New York, USA.,Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | | | - Inês F Silva Correia
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,School of Medicine, Faculty of Health, Education, Medicine & Social Care, Anglia Ruskin University, Chelmsford, UK
| | - Ashraf Mahmoud
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda.,Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Helen Onyeaka
- School of Chemical Engineering, University of Birmingham, Edgbaston, UK
| | - Burhan Dost
- Department of Anaesthesiology, School of Medicine, Ondokuz Mayis University, Kurupelit, Turkey
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Gwedela MNV, Terai H, Lampiao F, Matsunami K, Aizawa H. Anti-seizure effects of medicinal plants in Malawi on pentylenetetrazole-induced seizures in zebrafish larvae. JOURNAL OF ETHNOPHARMACOLOGY 2022; 284:114763. [PMID: 34688800 DOI: 10.1016/j.jep.2021.114763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Medicinal plants are used to manage and treat epilepsy in Malawi because of traditional beliefs and barriers to conventional anti-seizure drugs. Among the plants prescribed by traditional medical practitioners are Margaritaria discoidea, Dalbergia boehmii, Dalbergia nitidula, Catunaregam spinosa, and Lannea discolor. Despite the wide use of these plants, there is a lack of scientific evidence to support their anti-seizure efficacy. AIM OF THE STUDY This study used the pentylenetetrazole (PTZ)-induced larval zebrafish seizure model to screen for anti-seizure effects of a collection of medicinal plants traditionally used in Malawi. MATERIALS AND METHODS Zebrafish larvae were incubated in decoctions at maximum tolerated concentrations for 18 h and exposed to PTZ. As a primary screen, the effects of the decoctions on seizure-induced locomotor activity were determined. Decoctions that significantly reduced total distance traveled were further checked for effects on seizure latency and frequency, brain activity, immediate early gene expression, and c-fos protein expression. RESULTS M. discoidea male leaves, D. boehmii roots, and D. nitidula leaves showed significant anti-seizure effects in the primary screen and were selected for further study. Electrophysiological and immediate early gene analyses corroborated anti-seizure effect of D. boehmii and D. nitidula. The results of c-fos protein expression further suggested that the anti-seizure effects in the larval brain may be mediated by the suppression of neurons localized in midbrain regions. CONCLUSIONS These findings provide pioneering scientific evidence of the presence of anti-seizure activity in M. discoidea, D. boehmii, and D. nitidula, prescribed by traditional Malawian medical practitioners. Further studies are needed to identify and isolate compounds responsible for such biological activities and elucidate the possible mechanisms of action.
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Affiliation(s)
- Mayeso Naomi Victoria Gwedela
- Department of Neurobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Haruhi Terai
- Department of Neurobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Fanuel Lampiao
- Africa Centre of Excellence in Public Health and Herbal Medicine, Kamuzu University of Health Sciences, Private Bag 360, Blantyre, Malawi
| | - Katsuyoshi Matsunami
- Department of Pharmacognosy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Hidenori Aizawa
- Department of Neurobiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan.
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Dedeken P, Muhumuza SN, Sebera F, Umwiringirwa J, Bitunguhari L, Tierens H, Teuwen DE, Boon PAJM. Long-Term Impact of Single Epilepsy Training on Knowledge, Attitude and Practices: Comparison of Trained and Untrained Rwandan Community Health Workers. Int J Public Health 2021; 66:645598. [PMID: 34867136 PMCID: PMC8636829 DOI: 10.3389/ijph.2021.645598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 10/20/2021] [Indexed: 01/26/2023] Open
Abstract
Objectives: To close the epilepsy treatment gap and reduce related stigma, eradication of misconceptions is importantIn 2014, Community Health Workers (CHWs) from Musanze (Northern Rwanda) were trained on different aspects of epilepsy. This study compared knowledge, attitude and practices (KAPs) towards epilepsy of trained CHWs 3 years after training, to untrained CHWs from Rwamagana (Eastern Rwanda). Methods: An epilepsy KAP questionnaire was administered to 96 trained and 103 untrained CHWs. Demographic and intergroup KAP differences were analysed by response frequencies. A multivariate analyses was performed based on desired and undesired response categories. Results: Epilepsy awareness was high in both groups, with better knowledge levels in trained CHWs. Negative attitudes were lowest in trained CHWs, yet 17% still reported misconceptions. Multivariate analysis demonstrated the impact of the training, irrespective of age, gender and educational level. Knowing someone with epilepsy significantly induced more desired attitudes. Conclusion: Despite demographic differences between trained and untrained CHWs, a single epilepsy training resulted in significant improvement of desired KAPs after 3 years. Nation-wide CHW training programs with focus on training-resistant items, e.g., attitudes, are recommended.
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Affiliation(s)
- Peter Dedeken
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
- Department of Neurology, Heilig Hart Ziekenhuis, Lier, Belgium
- UCB Pharma, Brussels, Belgium
| | - Stephen N. Muhumuza
- School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Kabgayi District Hospital, Kabgayi, Rwanda
| | - Fidele Sebera
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
- CARAES Neuro-psychiatric Hospital, Brothers of Charity, Department of Neurology, Kigali, Rwanda
- Centre Hospitalier Universitaire (CHU-K), Kigali, Rwanda
| | - Josiane Umwiringirwa
- CARAES Neuro-psychiatric Hospital, Brothers of Charity, Department of Neurology, Kigali, Rwanda
| | | | | | - Dirk E. Teuwen
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
- UCB Pharma, Brussels, Belgium
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ERGİN D, DEMİRBAĞ S, ESER E, POLAT M, BAYDUR H. Psychometric Properties of the Turkish Version of the Epilepsy Module of the KINDL Quality of Life Scale. Noro Psikiyatr Ars 2021; 59:210-217. [PMID: 36160078 PMCID: PMC9466634 DOI: 10.29399/npa.27916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/14/2021] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION This study aims to present the psychometric properties of the Turkish version of the KINDLE quality of life scale, epilepsy module. METHOD The psychometric properties of the KINDL Epilepsy module were evaluated from the aspect of internal consistency, reliability, and construct validity on an inpatient sample of 159 Turkish children (mean age 10.84±2.77 years) who had epilepsy. RESULTS The KINDL Epilepsy module (36 items) showed acceptable αcoefficients ranging from 0.80 (social well-being) to 0.55 (treatment) for each domain. EFA suggested three sub-dimensions that we named as Physical, Mental and Social Well-being sub-dimensions. Root Mean Square Error of Approximation was found as 0.053, and Comparative Fit Index was 0.95. Good known groups results supported the construct validity of the instrument. Correlations between the income perception, family support and Duration of Epilepsy and the domains of its Epilepsy module were significantly high, indicating a satisfactory convergent validity. CONCLUSION The Turkish version of the KINDL Epilepsy module showed module is a promising tool in this study. However, further research on the versions of the module in other languages is needed for its global use.
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Affiliation(s)
- Dilek ERGİN
- Manisa Celal Bayar University, Faculty of Health Sciences, Department of Child Health and Illness Nursing, Manisa, Turkey
| | - Selin DEMİRBAĞ
- Manisa Celal Bayar University, Faculty of Health Sciences, Department of Child Health and Illness Nursing, Manisa, Turkey
| | - Erhan ESER
- Manisa Celal Bayar University, Faculty of Medicine, Department of Public Health, Manisa, Turkey
| | - Muzaffer POLAT
- Manisa Celal Bayar University, Faculty of Medicine, Department of Child Neurology, Manisa, Turkey
| | - Hakan BAYDUR
- Manisa Celal Bayar University, Faculty of Health Sciences, Department of Social Work, Manisa, Turkey
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Kassie AM, Abate BB, Kassaw MW, Getie A, Wondmieneh A, Tegegne KM, Ahmed M. Quality of life and its associated factors among epileptic patients attending public hospitals in North Wollo Zone, Northeast Ethiopia: A cross-sectional study. PLoS One 2021; 16:e0247336. [PMID: 33621251 PMCID: PMC7901738 DOI: 10.1371/journal.pone.0247336] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/05/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Epilepsy is thought to be caused by witchcraft, evil spirit, and God's punishment for sins in many developing countries. As a result, people with epilepsy and their families usually suffer from stigma, discrimination, depression, and other psychiatric problems. Thus, this study aimed to assess the quality of life and its associated factors among epileptic patients attending public hospitals in North Wollo Zone, Northeast Ethiopia. METHODS An institution-based cross-sectional study design was employed in this study. A simple random sampling technique was utilized. Health-related quality of life was measured based on the total score of the Quality of Life in Epilepsy Inventory (QOLIE-31) instrument. Data were entered into Epi-data 3.1 statistical package and exported to SPSS Version 20 for further analysis. Linear regression models were used to assess the relationship between quality of life and the independent variables. Statistically significant values were declared at a P-value of < 0.05. RESULTS A total of 395 patients participated in the study making the response rate 98.5%. The mean age of the participants was 32.39 ±10.71 years. More than half, 199 (50.4%) of epileptic patients had an overall weighted average health related quality of life score of mean and above. Male sex (B = 4.34, 95%CI, 0.41, 8.27, P = 0.03), higher educational status (B = 7.18, 95%CI, 1.39, 13.00, P = 0.015) and age at onset of epilepsy (B = 0.237, 95%CI, 0.02, 0.45, P = 0.035) were associated with increased health related quality of life score. On the other hand, family history of epilepsy (B = -4.78, 95%CI,-9.24,-0.33, P = 0.035), uncontrolled seizure (B = -11.08, 95%CI,-15.11,-7.05, P < 0.001), more than 5 pre-treatment number of seizures (B = -4.86, 95%CI,-8.91,-0.81, P = 0.019), poor drug adherence (B = -11.65, 95%CI,-16.06,-7.23, P < 0.001), having moderate (B = -4.526, 95%CI,-8.59,-0.46, P = 0.029) to sever (B = -12.84, 95%CI,-18.30,-7.37, P < 0.001) anxiety and depression, believing that epilepsy is caused by evil spirit (B = -7.04, 95%CI,-11.46,-2.61, P = 0.002), drinking alcohol (B = -5.42, 95%CI,-10.72,-0.13, P = 0.045), and having other co-morbidities (B = -9.35, 95%CI,-14.35,-4.36, P < 0.001) were significantly negatively associated with the health related quality of life score among epileptic patients. CONCLUSIONS Only around half of the epileptic patients have a good health-related quality of life. In addition, multiple variables including family history, uncontrolled seizure, and poor drug adherence were associated with quality of life among epileptic patients. Hence, targeting these variables in epilepsy management is recommended.
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Affiliation(s)
| | - Biruk Beletew Abate
- School of Nursing, College of Health Sciences, Woldia University, Woldia, Amhara, Ethiopia
| | - Mesfin Wudu Kassaw
- School of Nursing, College of Health Sciences, Woldia University, Woldia, Amhara, Ethiopia
| | - Addisu Getie
- School of Nursing, College of Health Sciences, Woldia University, Woldia, Amhara, Ethiopia
| | - Adam Wondmieneh
- School of Nursing, College of Health Sciences, Woldia University, Woldia, Amhara, Ethiopia
| | - Kindie Mekuria Tegegne
- School of Nursing, College of Health Sciences, Woldia University, Woldia, Amhara, Ethiopia
| | - Mohammed Ahmed
- School of Public Health, College of Health Sciences, Woldia University, Woldia, Amhara, Ethiopia
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Qi Y, Qian R, Jia L, Fei X, Zhang D, Zhang Y, Jiang S, Fu X. Overexpressed microRNA-494 represses RIPK1 to attenuate hippocampal neuron injury in epilepsy rats by inactivating the NF-κB signaling pathway. Cell Cycle 2020; 19:1298-1313. [PMID: 32308116 DOI: 10.1080/15384101.2020.1749472] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The effects of microRNAs (miRNAs) have been identified in epilepsy (Ep) in recent years, our research was focused on the functions of miR-494 in Ep and its inner mechanisms. METHODS The Ep modeled rats induced by lithium chloride-pilocarpine were treated with agomir-miR-494 or RIPK1-siRNA. The pathology of rat hippocampal tissues was observed. Expression of miR-494, receptor-interacting protein kinase 1 (RIPK1) and nuclear factor-kappaB (NF-κB) p65 was assessed by RT-qPCR and Western blot analysis. The hippocampal neurons of epileptic rats were successfully modeled, which were transfected with miR-494 mimics or RIPK1-siRNA to determine neurons' proliferation ability and cell apoptosis. The target relation between miR-494 and RIPK1 was measured by bioinformatics website and dual luciferase gene reporter assay. RESULTS The expression of miR-494 was reduced, while the expression of RIPK1 and NF-κB p65 was amplified in hippocampus of Ep rats. Elevated miR-494 repressed the expression of RIPK1 to ameliorate the hippocampal neuron injury, accelerate neuronal proliferation, and restrain neuronal apoptosis via inactivating the NF-κB signaling pathway, causing a deceleration of Ep development. Furthermore, amplified RIPK1 was able to reverse the amelioration of neuronal injury in Ep rats which was contributed by upregulated miR-494. CONCLUSION We found in this study that elevated miR-494 repressed RIPK1, causing an inactivation of the NF-κB signaling pathway and acceleration of cell proliferation, and suppression of apoptosis of hippocampal neurons in Ep rats, thereby attenuating the neuron injury and Ep development. Our research may provide novel targets for the therapy of Ep.
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Affiliation(s)
- Yinbao Qi
- Department of Nuerosurgery, Shandong University , Jinan, Shandong Province, P. R. China.,Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China , Hefei, Anhui Province, P. R. China.,Department of Neurosurgery, Anhui Provincial Institute of Stereotactic Neurosurgery , Hefei, Anhui Province, P. R. China
| | - Ruobing Qian
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China , Hefei, Anhui Province, P. R. China.,Department of Neurosurgery, Anhui Provincial Institute of Stereotactic Neurosurgery , Hefei, Anhui Province, P. R. China
| | - Li Jia
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China , Hefei, Anhui Province, P. R. China.,Department of Neurosurgery, Anhui Provincial Institute of Stereotactic Neurosurgery , Hefei, Anhui Province, P. R. China
| | - Xiaorui Fei
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China , Hefei, Anhui Province, P. R. China.,Department of Neurosurgery, Anhui Provincial Institute of Stereotactic Neurosurgery , Hefei, Anhui Province, P. R. China
| | - Dong Zhang
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China , Hefei, Anhui Province, P. R. China.,Department of Neurosurgery, Anhui Provincial Institute of Stereotactic Neurosurgery , Hefei, Anhui Province, P. R. China
| | - Yiming Zhang
- Department of Neurosurgery, Anhui Provincial Hospital Affiliated to Anhui Medical University , Hefei, Anhui Province, P. R. China
| | - Sen Jiang
- Department of Neurosurgery, Anhui Provincial Hospital Affiliated to Anhui Medical University , Hefei, Anhui Province, P. R. China
| | - Xianming Fu
- Department of Nuerosurgery, Shandong University , Jinan, Shandong Province, P. R. China.,Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China , Hefei, Anhui Province, P. R. China.,Department of Neurosurgery, Anhui Provincial Institute of Stereotactic Neurosurgery , Hefei, Anhui Province, P. R. China
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