Results of an action-research on epilepsy in rural Mali.

<h4>Purpose</h4>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 firs...

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Autores principales:	Elisa Bruno, Karamoko Nimaga, Ibrahima Foba, Philippe Vignoles, Pierre Genton, Ogobara Doumbo, Daniel Gérard, Pierre-Marie Preux, Guy Farnarier
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/293e2eec1ddc4253858e9ed8a1e389ba
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spelling	oai:doaj.org-article:293e2eec1ddc4253858e9ed8a1e389ba2021-11-18T07:06:47ZResults of an action-research on epilepsy in rural Mali.1932-620310.1371/journal.pone.0044469https://doaj.org/article/293e2eec1ddc4253858e9ed8a1e389ba2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22970109/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Purpose</h4>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.<h4>Methods</h4>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.<h4>Key findings</h4>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.<h4>Significance</h4>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.Elisa BrunoKaramoko NimagaIbrahima FobaPhilippe VignolesPierre GentonOgobara DoumboDaniel GérardPierre-Marie PreuxGuy FarnarierPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e44469 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Elisa Bruno Karamoko Nimaga Ibrahima Foba Philippe Vignoles Pierre Genton Ogobara Doumbo Daniel Gérard Pierre-Marie Preux Guy Farnarier Results of an action-research on epilepsy in rural Mali.
description	<h4>Purpose</h4>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.<h4>Methods</h4>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.<h4>Key findings</h4>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.<h4>Significance</h4>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.
format	article
author	Elisa Bruno Karamoko Nimaga Ibrahima Foba Philippe Vignoles Pierre Genton Ogobara Doumbo Daniel Gérard Pierre-Marie Preux Guy Farnarier
author_facet	Elisa Bruno Karamoko Nimaga Ibrahima Foba Philippe Vignoles Pierre Genton Ogobara Doumbo Daniel Gérard Pierre-Marie Preux Guy Farnarier
author_sort	Elisa Bruno
title	Results of an action-research on epilepsy in rural Mali.
title_short	Results of an action-research on epilepsy in rural Mali.
title_full	Results of an action-research on epilepsy in rural Mali.
title_fullStr	Results of an action-research on epilepsy in rural Mali.
title_full_unstemmed	Results of an action-research on epilepsy in rural Mali.
title_sort	results of an action-research on epilepsy in rural mali.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/293e2eec1ddc4253858e9ed8a1e389ba
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Results of an action-research on epilepsy in rural Mali.

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