ABSTRACT
OBJECTIVE: To describe the feasibility of managing epilepsy in a rural setting in a developing country. METHODS: The project comprised four phases. After a study of the perception of epilepsy, we conducted a sensitization campaign in November 2001. The third phase was a survey, to detect epilepsy patients, in which 6249 persons were asked to complete a questionnaire. Persons with epilepsy were then examined, treated, mainly with phenobarbital, and followed up. RESULTS: The prevalence of epilepsy was estimated to be 15.7 per thousand. Ninety-two patients took antiepileptic drugs from 1 February 2002. By November 2005, 92.7% of all treated patients had achieved complete suppression of seizures, and 7.3% had reduced seizure frequency. CONCLUSIONS: Despite the stigma attached to epilepsy in many developing countries, it can be controlled by relatively simple measures. At present, 601 epilepsy patients are being followed up at the Nadoba health centre, where epilepsy is now the second commonest disease.
Subject(s)
Developing Countries , Epilepsy/therapy , Pregnancy Complications/therapy , Program Development , Rural Health Services/organization & administration , Adolescent , Adult , Child , Child, Preschool , Epilepsy/epidemiology , Feasibility Studies , Female , Humans , Infant , Male , Middle Aged , Pregnancy , Pregnancy Complications/epidemiology , Togo/epidemiologyABSTRACT
The expanded Programme on Immunization in the African region was launched in 1978 and by the mid-eighties, all countries had established national immunization programmes. A mid decade evaluation, conducted in 1985, indicates that the regional immunization coverage was still under 20% for all antigens. For this reason, member states agreed to accelerate the programme. They adopted a resolution declaring 1986 the "African Immunization Year" and pursued implementation of various accelerated efforts until 1990. During the acceleration phase, the political commitment was strong, with the involvement of top national officials and First Ladies in launching the immunization campaign in many countries. The resources required were supplied mainly from external funding agencies. As a result, sixteen countries reached the 80% immunization coverage rates for antigens administered to the infants and remarkable progress has been achieved in the control of the EPI priority diseases. Concerning polio eradication, at least fourteen countries, representing 20% of the regional population have reported zero incidence of poliomyelitis for two consecutive years, during the period 1991-1993. In five of these countries independent teams of international and national experts assessed the quality of the epidemiological surveillance and confirmed that polio cases may have been eliminated. This suggests that a polio-free zone has emerged in the southern part of Africa, where most of these countries are located. In the meantime, an outbreak of poliomyelitis (with 28 cases confirmed by isolation of type 1 poliovirus) was reported from one country (Namibia) where no cases had been reported for the last few years. It is still unclear whether poliovirus was imported or the virus continued to circulate without causing paralytic cases.(ABSTRACT TRUNCATED AT 250 WORDS)
