Knowledge, attitudes, and practices with respect to epilepsy among primary and secondary school teachers in the city of Niamey, Niger

OBJECTIVE

We aimed firstly to evaluate knowledge, attitudes, and practices about epilepsy among primary and secondary school teachers in the city of Niamey and secondly to formulate targeted sensitization messages for these teachers.

MATERIALS AND METHODS

A descriptive cross-sectional survey was carried out among primary and secondary school teachers in the city of Niamey, capital of Niger, using a self-administered questionnaire including questions related to knowledge, attitudes, and practices about epilepsy.

RESULTS

One hundred and forty-five (145) teachers aged 27-69 (mean age: 39.57 ± 8.304 years) had answered the questionnaire (52 men and 93 women). In 62.1% of cases, respondents had a bachelor degree in education signifying a high level of education. Sixty-one respondents (42.1%) considered epilepsy as a brain disease, whereas it was considered as a psychiatric illness by 15.9% of respondents and as an impurity by 38.9%. Sixteen respondents (11%) considered it as a hereditary disease. Epilepsy was considered as a contagious disease by 46.2% of teachers, and the main transmission routes reported were contact with places of crisis (26.2%), physical contact with an epileptic person (16.6%), and contact with saliva (6.9%). It was considered as an incurable disease by 6.9% of teachers. Of the 115 respondents (79.3%) who considered epilepsy as a treatable condition, 46 of them believe that epilepsy is treated by traditional medicine. When someone has an epileptic seizure, 28.3% of respondents think that physical contact with him should be avoided and that the places of the crisis should be avoided.

CONCLUSION

Considering that epilepsy is common in school-age, the study results suggest the need to train teachers with respect to epilepsy to change misconceptions about epilepsy and to promote positive attitudes toward epileptic people to avoid the rejection of these people by the society responsible for problems of social integration.

Clinical and etiological characteristics of epilepsy in people from Niger: a hospital-based study from a tertiary care referral center of Niamey, Niger

OBJECTIVES

Epilepsy constitutes a major public health concern in the world particularly in developing countries, especially in sub-Saharan African countries. We designed this study to evaluate epilepsy management at a tertiary referral center in Niger to obtain a comprehensive understanding to determine the intrahospital deficiencies to improve and to make recommendations in terms to improve epilepsy management in Niger.

METHODS

We conducted a retrospective study at the Neurology Outpatient Clinic of the National Hospital of Niamey (Niger) between May 2013 and May 2018 (5 years), collecting all cases of patients diagnosed with epilepsy by the neurologists. From the registers of consultation, we collected for each patient the demographic, clinical, etiological, and therapeutic data, as well as the outcomes during follow-up visits.

RESULTS

Of the 4576 patients seen during the period of the study, 1350 patients consulted for epilepsy with a hospital frequency of 29.5%. The mean age of the patients was 18.55 ± 17.15 years (range: 3 months to 83 years) with a predominance of the male sex (sex ratio at 1.5). Patients younger than 20 years were the most represented (61.6%). All patients underwent EEG. Only 463 patients (35.2%) underwent brain imaging. Generalized tonic-clonic seizures were the most frequent (50%) followed by typical absences seizures (11.8%). Cerebrovascular disease, central nervous system infections, and head injuries were the main etiologies. First-generation AEDs were the most prescribed (99%). The proportion of patients with drug-resistance was 9.6%.

SIGNIFICANCE

Our study shows limited access to newer generation AEDs and diagnostic tests of epilepsy in Niger. Considerable efforts should be made to facilitate for people living with epilepsy the accessibility to diagnostic tests and newer generation AEDs in order to improve the quality of epilepsy management in Niger.