Purpose: To characterize the reasons, extent, and impact of traditional medicine use among people with epilepsy (PWE) in the Republic of Guinea.Methods: Guinea is a low-income country in sub-Saharan Africa (SSA) with limited healthcare resources. PWE and their caregivers were seen at a public referral hospital in Conakry, the capital city, where they completed semi-structured interviews with physicians regarding their beliefs about epilepsy, medical care, and engagement with traditional healers.Results: Of 132 participants (49% children, 44% female, 55% with a university-educated head of household), 79% had seen a traditional healer, and 71% saw a traditional healer before seeing a medical provider for their epilepsy. Participants were treated by a traditional healer for a mean of 39 months before seeing a medical provider. By contrast, 58% of participants reported taking AEDs regularly, 46% reported having undergone a head CT, 58% reported having had an electroencephalogram, and 4% reported having had a brain MRI. Conclusions:Traditional healers in Guinea provide frontline care for PWE in Guinea with considerable delays in AED initiation, even among a cohort of PWE actively seeking medical care. Engaging with these healers is critical for both influencing community perceptions and appropriately managing epilepsy throughout the country.

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Introduction- Spondyloarthritis is classically considered rare in sub-Saharan Africa where the majority of the population is considered HLA-B27 negative.The objective of this study was to describe the profile of spondyloarthritis in the rheumatology department of the Ignace Deen National Hospital in Conakry, Guinea. Patients and method -This was a descriptive and analytical cross-sectional study, with both prospective and retrospective data collection over a 4-year period. The diagnosis of SpA was made in accordance with the ASAS (Assessment of Spondyloarthrisis) and modified New York criteria. Results -During the study period, we evaluated 275 patients with spondyloarthritis. The mean age was 39.7 ±11 years with extremes (20 and 75 years), 150 patients (54.5%) were men. A history of familial SpA was present in 95 (34.5%) of the patients. The mean time to diagnosis was 8 ± 4 years. Axial involvement was dominated by involvement of the lumbar spine 225 (82%). Ankylosing spondylitis was the most common form in 198 (72%) of the cases. Extra-articular manifestations were dominated by uveitis in 55 (20%) of cases. HLA-B27 phenotyping was performed in 125 patients, 62 patients were HLA-B27 positive (49.6%). The treatment was based on nonsteroidal anti-inflammatory drugs 225 (81.8%). Conclusion -SpA are growing in Guinean hospitals, the HLA-B27 antigen is increasingly found in African series. Treatment is mainly based on non-steroidal anti-inflammatory drugs.

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