Pandemics and Burden of Stroke and Epilepsy in Sub-Saharan Africa: Experience from a Longstanding Health Programme

Leone, Massimo; Ciccacci, Fausto; Orlando, Stefano; Petrolati, Sandro; Guidotti, Giovanni; Majid, Noorjehan; Tolno, Victor Tamba; Thole, Darlington; Corsi, Fabio; Bartolo, Michelangelo; Marazzi, Maria Cristina

doi:10.3390/ijerph18052766

Cited by 14 publications

(6 citation statements)

References 56 publications

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“…In response, health service provision underwent a significant reorganization to address COVID-19 pressures. The impact on services for people with non-communicable diseases, especially those with associated risk, has been considerable [8] , [9] , [10] .…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study

Andraus

Thorpe

Tai

et al. 2021

Epilepsy & Behavior

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The COVID-19 pandemic has had an unprecedented impact on people and healthcare services. The disruption to chronic illnesses, such as epilepsy, may relate to several factors ranging from direct infection to secondary effects from healthcare reorganization and social distancing measures. Objectives As part of the COVID-19 and Epilepsy (COV-E) global study, we ascertained the effects of COVID-19 on people with epilepsy in Brazil, based on their perspectives and those of their caregivers. We also evaluated the impact of COVID-19 on the care delivered to people with epilepsy by healthcare workers. Methods We designed separate online surveys for people with epilepsy and their caregivers. A further survey for healthcare workers contained additional assessments of changes to working patterns, productivity, and concerns for those with epilepsy under their care. The Brazilian arm of COV-E initially collected data from May to November 2020 during the country's first wave. We also examined national data to identify the Brazilian states with the highest COVID-19 incidence and related mortality. Lastly, we applied this geographic grouping to our data to explore whether local disease burden played a direct role in difficulties faced by people with epilepsy. Results Two hundred and forty-one people returned the survey, 20% were individuals with epilepsy ( n = 48); 22% were caregivers ( n = 53), and 58% were healthcare workers ( n = 140). Just under half (43%) of people with epilepsy reported health changes during the pandemic, including worsening seizure control, with specific issues related to stress and impaired mental health. Of respondents prescribed antiseizure medication, 11% reported difficulty taking medication on time due to problems acquiring prescriptions and delayed or canceled medical appointments. Only a small proportion of respondents reported discussing significant epilepsy-related risks in the previous 12 months. Analysis of national COVID-19 data showed a higher disease burden in the states of Sao Paulo and Rio de Janeiro compared to Brazil as a whole. There were, however, no geographic differences observed in survey responses despite variability in the incidence of COVID-19. Conclusion Our findings suggest that Brazilians with epilepsy have been adversely affected by COVID-19 by factors beyond infection or mortality. Mental health issues and the importance of optimal communication are critical during these difficult times. Healthcare services need to find nuanced approaches and learn from shared international experiences to provide optimal care for people with epilepsy as the direct burden of COVID-19 improves in some countries. In contrast, others face resurgent waves of the pandemic.

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Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study

Andraus

Thorpe

Tai

et al. 2021

Epilepsy & Behavior

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“…There is a pressing need to invest in relevant training to improve health, social, quality of life and economic outcomes in sub-Saharan Africa [19].…”

Section: Discussionmentioning

confidence: 99%

Perceptions about mental healthcare for people with epilepsy in Africa

Gilkinson

Kinney

Olaniyan³

et al. 2022

Epilepsy & Behavior

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Background: Mental illness is commonly comorbid with epilepsy. In sub-Saharan Africa there exists limited access to neurological and psychiatric services predisposing to a ''treatment gap" in epilepsy and mental healthcare. Aims: To understand healthcare providers' knowledge, attitudes, and management practices toward epilepsy and comorbid mental illness in sub-Saharan Africa. Methods: A cross-sectional online survey following the STROBE guidance was conducted among healthcare providers in sub-Saharan Africa. Eleven questions looking to ascertain clinician demographics, knowledge of epilepsy, and comorbid mental illness as well as management practices were developed. Findings: Of 203 responses most (92%) respondents recognized a bi-directional relationship between mental health and epilepsy. However, mental illness screening in people newly diagnosed with epilepsy was infrequently performed (14%). Only 1 in 7 (16%) respondents had high confidence in their clinical competence at managing psychiatric comorbidities. Most would value further training (74%) and improvements to be made in current management practices within their local healthcare settings (94%). Conclusions: This pilot study highlights the need to improve the awareness of management of mental disorders in populations with epilepsy within sub-Saharan Africa in health providers there.

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“…Moreover, in SSA, about 22.9 million people are living with HIV (57/100 million); a study has shown that 4%‐17% of people living with HIV develop new seizures. 88 …”

Section: About Tropical Epilepsymentioning

confidence: 99%

Status of epilepsy in the tropics: An overlooked perspective

et al. 2023

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Epilepsy is one of the most common serious chronic neurological diseases affecting people of all ages globally. It is characterized by recurrent seizures. About 50 million people worldwide have epilepsy. Indubitably, people with epilepsy (PWE) may be without access to appropriate treatment. Many studies have examined the molecular mechanisms and clinical aspects of epilepsy; nonetheless, the treatment gap exists in some special areas. In the tropics, the specific geographical and ecological conditions and a lack of medical resources result in neglect or delay of diagnosis for PWE. Herein, we summarized the epidemiology of epilepsy in the tropics and discussed the disease burden and existing problems, aiming to offer a medical environment for patients in need and highlight the importance of reducing the epileptic disease burden in tropical countries.

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Pandemics and Burden of Stroke and Epilepsy in Sub-Saharan Africa: Experience from a Longstanding Health Programme

Cited by 14 publications

References 56 publications

Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study

Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study

Perceptions about mental healthcare for people with epilepsy in Africa

Status of epilepsy in the tropics: An overlooked perspective

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