ABSTRACT
Background and aims: Epilepsy burden in sub-Saharan Africa (SSA) has increased dramatically in the last 20 years. People with epilepsy (PWE) are estimated to be over 20 millions, with about 1 neurologist every 3-5 millions inhabitants, meaning more than 90% of epileptic patients are managed by health workers (HW) with insufficient education in Epilepsy, and 75% of them have no access to treatments. Moreover COVID-19 pandemic is affecting epilepsy management in SSA through care disruption. Teleneurology has the potential to improve this situation, although poor education of HW is associated with its underutilization. We measured the changes of teleneurology requests from primary cares in SSA after an education program on epilepsy. Methods: Global Health Telemedicine (GHT) offers remote advices and education to HW of the Disease Relief through Excellent and Advanced Means (DREAM) program active in 10 SSA countries. GHT-DREAM recently started an epilepsy program in Malawi and Central African Republic (CAR) with education and training courses delivered both locally and remotely. Results: In Malawi and CAR DREAM follows 18,770 patients, 569 (3,0%) suffering from epilepsy. The total number of teleneurology requests increased from 91 in 2019 to 141 in 2020 to 802 in 2021;>90% were for PWE. Conclusion: Education and training in epilepsy increased the number of tele-requests by improving knowledge and communication between SSA HW and European neurologists. Partnerships can bring neurologists where there are none, contributing to limit COVID-19 care disruption thus reducing the treatment gap in SSA. Our results move towards the Intersectoral Global Action Plan 2022-2031 in SSA. (Figure Presented).
ABSTRACT
Covid-19 pandemic has posed unprecedented challenges to individual resilience, especially among children who are the most affected by its psychological consequences. We aim to investigate temperament profiles that might constitute a potential risk factor for the development of psychopathology and low levels of resilience in children experiencing Covid-19 quarantine. Through a snowball sampling from the general population, we recruited parents of 158 Italian children aged 5 to 10 years (48% boys, M = 7.4, SD = 1.8). Parents completed questionnaires to assess their children's temperament, psychopathological symptoms, and resilience, respectively through the Junior Temperament and Character Inventory, the Strengths and Difficulties Questionnaire, and the Child and Youth Resilience Measure. Profile Analysis was employed to outline temperament differences between stress-resilient and stress-affected children. Results evidenced that resilient children displayed high levels of persistence and reward dependence, and low levels of novelty seeking. Behavioral difficulties were associated with low levels of persistence and reward dependence, and high levels of novelty seeking. Internalizing symptoms were more likely among children with high harm avoidance and low persistence. These findings underscore the importance of examining different temperament dimensions and their associations, especially when profiling phenotypes in trying to identify the links among temperament, vulnerability to psychopathology and resilience during stressful periods. © 2021 by the authors.