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
INTRODUCTION: Neurological manifestations can occur during coronavirus disease 19 (COVID-19). Several pathogenic mechanisms have been hypothesized, without conclusive results. In this study, we evaluated the most frequent neurological symptoms in a cohort of hospitalized COVID-19 patients, and also investigated the possible relationship between plasmatic inflammatory indices and olfactory disorders (ODs) and between muscle pain and creatine kinase (CK). METHODS: We consecutively enrolled hospitalized COVID-19 patients. A structured questionnaire concerning typical and neurological symptoms, focusing on headache, dizziness, ODs, taste disorders (TDs), and muscle pain, was administrated by telephone interviews. RESULTS: Common neurological symptoms were reported in the early phase of the disease, with a median onset ranging from 1 to 3 days. Headache showed tension-type features and was more frequently associated with a history of headache. Patients with ODs less frequently needed oxygen therapy. Inflammatory indices did not significantly differ between patients with and without ODs. Muscle pain did not show any association with CK level but was more frequently associated with arthralgia and headache. CONCLUSION: In our cohort, ODs were an early symptom of COVID-19, more frequently reported by patients with milder forms of disease. Headache in association with arthralgia and muscle pain seems to reflect the common symptoms of the flu-like syndrome, and not COVID-19 infection-specific.