Prevalence Of Epilepsy And General Knowledge About Neurocysticiercosis At Nkalukeni Village, South Africa

摘要

Fourteen medical students from the University of Transkei medical school set out to make a community diagnosis of Ncalukeni Village. Our chief objectives were to evaluate the socio-economic status of the community, to identify major risk factors in the community, to discover the prevalence of epilepsy in the community and to learn valuable research and communication skills.Setting: Nkalukeni community, is located at 80 km away from Umtata (Capital of the former Transkei).The project was run by Department of Community Medicine. This department employs a Problem Based Learning and a Community Based Education learning structure. This means that students are presented with real-life problems in real communities and are forced to find solutions. This structure is part of the Unitra medical school mission to train doctors that are capable of dealing with real-life situations.Design: A two-stage design study was used. The first stage involved screening of the general population on door-to-door basis by interviewing peoples living in 100 household selected by block-randomization procedure, and using an internationally validated questionnaire for detecting epilepsy and knowledge about some associated diseases. The second stage consisted of a neurological assessment of the peoples who screened positive.The questionnaire covered four main areas: Demographics and Socio-economics; Main Risk Factors; Health Services and Traditional Medicine; Knowledge about cysticercosis and Prevalence of epilepsy in the community. The data was captured onto Microsoft Excel.Results: A total of 2076 adults were screened. The prevalence of active epilepsy in these adults was 18,2. Only 12% of epileptic patients were under regular anti-epileptic treatment, 94% of the total population had not idea about NCC, and 67% of them did not know the cause of AIDS.Our findings revealed that Ncalukeni village was a low socio-economic area. Unemployment was high, incomes were low, education level was mostly to high school, and housing was mostly of poor quality and crowded. There was a problem with the supply of water in the area. Few people actually boiled their water. There was much indoor pollution from cooking. Toilets were unhygienic and there were no flush toilets. Food storage was a risk for diseases as there was no electricity. Many people still used traditional healers and there was a general lack of knowledge regarding major illnesses.Conclusions: The prevalence of epilepsy is high compared with a similar location but a poor utilization of anti-epileptic treatment is cause for concern. NCC and HIV/AIDS awareness campaign at the rural locations in the former Transkei should be made as soon as possible while permanent solutions are implemented. Introduction Neurocisticercosis (NCC) is an infection of central nervous system (CNS) caused by the larval stage (Cysticercus cellulosae) of the pig tapeworm Taenia solium. This is the most common helminthes to produce CNS infection in human being. The occurrence of acquired epilepsy or the syndrome of raised intracranial pressure in a person living in or visiting a region where taeniasis is endemic or even in one living in close contact with people who have taeniasis should suggest a diagnosis of cysticercosis; patients with NCC may remain asymptomatic for months to years, and commonly a diagnosis is made incidentally when neuroimaging is performed, many symptomatic forms can predominate. Symptoms and signs are related both to the parasite, which can show a different biological behavior from one place to another, and different inflammatory-inmunological responses on different hosts. NCC is the most common cause of acquired epilepsy worldwide and most of the patients taking phenytoin or carbamazepine for a proper control of their seizures, respond very well. 1 2 3 4 5 Other aspects related to NCC from our region are also available on line 6 7 this study was designed for Nkalukeni location which is situated at the former Tran