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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Results of an Action-Research on Epilepsy in Rural Mali
PLoS ONE, Volume 7, No. 8, Article e44469, Year 2012
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Description
Purpose: To evaluate the RARE (Réseau Action-Recherche sur l'Epilepsie) program, a model of managing and treating people with epilepsy (PWE) at a primary health-care level in rural areas of Mali, we assessed treatment efficacy and compliance of patients who underwent the first year follow-up. Methods: A network of rural general practitioners (GPs) settled in six rural districts of the regions of Koulikoro, Segou and Sikasso, was involved in the diagnosis, evaluation and monitoring of all the identified PWE and in the distribution of phenobarbital (PB). All the participants were included in a prospective database and followed-up by GPs at 4 months intervals during the first year. Seizure frequency, treatment doses and appearance of adverse events (AEs) were systematically recorded. Efficacy was evaluated in terms of reduction of seizures frequency while noncompliance in terms of time to study withdrawal for any cause. Key findings: 596 patients treated with PB were included in the analysis. Of these, 74.0% completed the first year follow-up. At the final visit, 59.6% were seizure-free: 31.0% for 12 months, 10.2% for 8 months and 18.4% for 4 months. Adults and patients with convulsive seizures were the most drug-resistant (p<0.002). Few AEs were recorded. The multivariate analysis showed that being a woman, presenting convulsive seizures, having more than 5 seizures/month and had never be treated were predictors of withdrawal (p≤0.05) at 12 months. Significance: This study showed a good response and compliance to the treatment and allowed the identification of some factors associated with failure of management in a setting very near to clinical practice. Awareness campaigns are needed to assure a broader accessibility to treatment and to improve the compliance and continuity with treatment programs. © 2012 Bruno et al.
Authors & Co-Authors
Bruno, Elisa
France, Limoges
Institut D’epidémiologie Neurologique et de Neurologie Tropicale
Italy, Catania
Università Degli Studi Di Catania
Nimaga, Karamoko
Mali, Bamako
Association Des Médecins de Campagne/reseau Action-recherche Sur L'epilepsie Rare Network
Foba, Ibrahima
Mali, Bamako
Association Des Médecins de Campagne/reseau Action-recherche Sur L'epilepsie Rare Network
Mali, Bamako
University of Bamako Faculty of Medicine, Pharmacy and Odonto-stomatology
Vignoles, Philippe
France, Limoges
Institut D’epidémiologie Neurologique et de Neurologie Tropicale
Genton, Pierre
Mali, Bamako
Non-governmental Organisation Santé Diabète
France, Gentilly
Sanofi S.a.
France, Marseille
Hôpital Nord Ap-hm
Doumbo, Ogobara K.
Mali, Bamako
University of Bamako Faculty of Medicine, Pharmacy and Odonto-stomatology
Mali, Bamako
Non-governmental Organisation Santé Diabète
Gérard, Daniel A.
France, Gentilly
Sanofi S.a.
Preux., Pierre Marie
France, Limoges
Institut D’epidémiologie Neurologique et de Neurologie Tropicale
Farnarier, Guy
Mali, Bamako
Non-governmental Organisation Santé Diabète
France, Gentilly
Sanofi S.a.
France, Marseille
Hôpital Nord Ap-hm
Statistics
Citations: 20
Authors: 9
Affiliations: 7
Identifiers
Doi:
10.1371/journal.pone.0044469
e-ISSN:
19326203
Research Areas
Health System And Policy
Study Design
Cohort Study
Study Locations
Mali
Participants Gender
Female