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

Abstract

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.

Clinical and etiological profile of epilepsy at the regional hospital center of Tahoua (Niger): A 4‐year retrospective study

“…A Nigerian study also reported the prescription of only the first‐generation AEDs (Igwe et al., 2014). As in the study carried out at the National Hospital of Niamey (Assadeck et al., 2019), VPA was the most AED used in the present study. In Mali, a study reported phenytoin as the most AED used (Nimaga et al., 2002).…”

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

“…In this study, we evaluate knowledge, attitudes, and practices about epilepsy among primary and secondary school teachers in the city of Niamey, capital of Niger. Because epilepsy mainly affects people younger than 20 years in Niger (Assadeck et al, ), we have chosen to specifically conduct the survey among primary and secondary school teachers who are responsible for the social and educational development of people in this age group and to transmit them targeted awareness messages about epilepsy so that they can transmit these messages to a larger number of students to avoid the rejection of epileptic students by their peers. The majority of teachers (62.1%) who completed the questionnaire had a bachelor degree in education signifying a high level of education.…”

“…In Niger, epilepsy is poorly studied, and there is no study realized in the general population determining the incidence and prevalence of this condition. However, a recent study reports a hospital frequency of epilepsy of 29.5%, affecting mainly men and people younger than 20 years (Assadeck et al, ). In sub‐Saharan Africa, epilepsy remains a major public health concern with significant economic and socio‐cultural consequences.…”

Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series

“…Seizure disorders comprised 6.4% of NDs in the series and were significantly associated with HIV infection, OR 15.7. A high burden of seizure disorders with frequencies ranging from 6–12.6% is reported in similar hospital based studies in adults in SSA 3 , 5 , 52 . The added burden of seizures in HIV in SSA is reflected by their reported high frequency in HIV infection, occurring in up to 10% of patients presenting with advanced immunosuppression, with OIs as their main cause 5 , 15 , 53 , 54 .…”