Consensus formalisé: recommandations de pratiques cliniques pour la prise en charge de la migraine du patient adulte africain

Abstract

La migraine est une céphalée primaire (selon les derniers critères de l'International Headache Society) qui affecte environ 8% de la population africaine. Les femmes sont plus fréquemment touchées que les hommes et les crises apparaissent le plus souvent avant l’âge de 40 ans. Bien qu'un certain nombre de traitements, de mesure hygiéno-diététiques, et d'autres méthodes non pharmacologiques permettent de limiter l'intensité et la fréquence des crises, la prise en charge médicamenteuse de la crise de migraine est très souvent nécessaire. La disponibilité des traitements et l'accès aux soins diffèrent sur le continent africain et ont conduit à la réalisation du 1er consensus d'experts pour la prise en charge du patient adulte africain. Destiné aux praticiens, ce travail collaboratif multinational a pour objectif de fournir 16 recommandations de pratiques cliniques simples, fondées sur les preuves, et adaptées aux conditions de l'exercice médical en Afrique.

Knowledge, Attitudes, and Management of General Practitioners of the Hospital Districts of Ouagadougou about Migraine (Burkina Faso)

“…According to prophylactic treatment, the majority of GPs thought that it should be started when the acute treatment has failed (66.4%), worse impact on daily life (63.8%), and increase of migraine attacks (62.9%). These conditions correspond to the recommendations of the African guideline [ 11 ]. However, GPs in comparison with neurologists tend to institute prophylactic treatment for lower thresholds [ 25 ].…”

“…There have been few studies investigating how to improve migraine education in the primary care setting [ 8 – 10 ]. There are African recommendations on the management of migraine in adults [ 11 ]. To our knowledge, there are not yet studies on the evaluation on the migraine management of GPs in Sub-Saharan Africa, as in Burkina Faso.…”

Barriers to headache care in low- and middle-income countries

“…Of the 117 responding countries, 108 (92%) reported consistent availability of at least one medication in primary care and 110 (94%) at hospital level [11]. The Pan-African Medical Journal published a formal consensus statement developed by a multinational group of authors on widely available medications for acute first and second-line headache treatment, as well as prophylaxis [16]. This first expert consensus making recommendations for the management of migraine in African adult patients was created as a practical guideline for healthcare practitioners to adapt to the medical resources most commonly available in their local settings within SSA.…”