ABSTRACT
Background Early presentation and initiation of appropriate anticonvulsants help in controlling epilepsy and reducing morbidity and mortality associated with epilepsy. Objectives This study aimed to assess the health-seeking behavior for pediatric epilepsy among caregivers in Southeast Nigeria and the associated sociodemographic factors. Methodology This study was a cross-sectional descriptive and questionnaire-based study. The participants were recruited consecutively. Results Majority of the caregivers were mothers, had some formal education, and were employed. While 50% of these caregivers did not seek any home treatment for seizures, the other half offered various types of unorthodox home treatments. Treatments in primary and secondary levels of care were the most common form of first point of care outside the home. The most common reasons for the choice of care outside the home were advice from relations and belief in the efficacy of care offered. About 45% of the caregivers presented to tertiary level of care within 6 months of seizure onset. The major motivators for seeking care in tertiary level of care were health workers and families of children with epilepsy. Conclusion There is a need to strengthen the primary and secondary levels of care through continuous medical education of health workers in these levels of care for effective management of epilepsy. This will help in making prompt and correct diagnosis, classification, and initiation of appropriate therapy in epilepsy.
ABSTRACT
BACKGROUND: Congenital malaria, which is caused by vertical transmission of malaria parasites, is a potentially fatal condition. Despite Africa's high malaria burden, congenital malaria is not routinely screened for, and thus may go undiagnosed. Malaria, if not treated promptly, can quickly progress to severe forms and result in death. Severe congenital malaria is believed to be uncommon in neonates due to maternal antibodies, fetal haemoglobin, and the placenta's sieving effect. The majority of reported cases were classified as having severe anaemia. Following a thorough review of the literature, only one case of congenital cerebral malaria (CCM) has been reported, and it was misdiagnosed. CASE PRESENTATION: A 5-day-old Nigerian neonate born to an apparently healthy mother initially displayed characteristics consistent with neonatal sepsis and severe neonatal hyperbilirubinaemia. He quickly developed characteristics consistent with meningitis. Surprisingly, the peripheral blood film revealed evidence of malaria parasites, which was immediately confirmed by Giemsa-stained thick and thin blood film microscopy for malaria. The patient was diagnosed with congenital cerebral malaria. The medication was modified to parenteral artesunate followed by oral artemisinin combination therapy. The neonate recovered fully and had no neurological deficits on follow up. CONCLUSION: Because CCM and infant meningitis have similar clinical presentations, CCM could be misdiagnosed and lead to death if there isn't a high index of suspicion.
