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Epilepsie de l'enfant au Gabon : Aspects socioculturels et thérapeutiques

Abstract : Epilepsy occurs at any age, but the causes, clinical manifestations, complications and social impact, depend on the age of the subjects. In Sub-Saharan Africa epidemiological data, data on enrollment and the impact of the child's epilepsy are difficult to access. To assess the socio-cultural and therapeutic aspects of the child's epilepsy in Gabon, we conducted a review of the literature on child epilepsy in SSA and two cross-sectional surveys, one on knowledge, attitudes, practices and socio-cultural representations of childhood epilepsy in teachers and health workers, the other on the impact of epilepsy on the children with epilepsy and their parent. In SSA, the data on child epilepsy drowned in studies extended to the general community. The prevalence of childhood epilepsy varies from 2.04 to 297/1000 and its incidence from 17 to 930/100.000 person-years. Perinatal factors, febrile seizures and infectious factors are most described while genetic factors remain poorly studied. The care of the child remains limited due to the lack of human resources, diagnostic means and access to AEDs but also because of the persistence of prejudices and negative beliefs about epilepsy commonly found in teachers, school children and in the community. Children with epilepsy are a source of anxiety, disruption of socio-professional and academic activities for parents and their siblings. The surveys found a low level of knowledge, persistence of negative beliefs, including those that consider epilepsy as a contagious or communicable disease, psychiatric illness or mental retardation or a supernatural disease. These considerations found in urban and rural areas could be explained by the cultural conception of epilepsy that links the disease to an external cause, to an animal, or an evil spirit. In rural areas, children usually have no medical advice, but enrollment is still above 50% regardless of their living environment. Non-enrollment is related to comorbidities, the refractory attitude of parents and some school heads. Anxiety, behavioral disorders, cognitive disorders and disorders of sociability remain high. The quality of life of epileptic children's parents is impaired. This work will be extended to other areas to include more children with epilepsy and build a cohort. This cohort will be used to assess the attributable fraction of infections (including that of severe malaria) in the occurrence of epilepsy; to assess the stigma of epileptic children and their parents and to implement the therapeutic education programs and health promotion with families, teachers and health workers.
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Euloge Ibinga. Epilepsie de l'enfant au Gabon : Aspects socioculturels et thérapeutiques. Santé publique et épidémiologie. Université de Limoges; Université des sciences de la santé (Libreville-Owendo), 2015. Français. ⟨NNT : 2015LIMO0013⟩. ⟨tel-01262644⟩

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