Treatment with phenobarbital and monitoring of epileptic patients in rural Mali

OBJECTIVE: To assess the efficacy of phenobarbital treatment for epileptic patients in rural Mali. METHODS: Epileptic patients were treated at home with phenobarbital at daily dosages ranging from 50 mg for children to 200 mg for adults and their condition was monitored. Advice was given to patients...

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Main Authors: Nimaga K., Desplats D., Doumbo O., Farnarier G.
Format: Article
Language:English
Published: The World Health Organization 2002-01-01
Series:Bulletin of the World Health Organization
Subjects:
Online Access:http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002000700004
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author Nimaga K.
Desplats D.
Doumbo O.
Farnarier G.
author_facet Nimaga K.
Desplats D.
Doumbo O.
Farnarier G.
author_sort Nimaga K.
collection DOAJ
description OBJECTIVE: To assess the efficacy of phenobarbital treatment for epileptic patients in rural Mali. METHODS: Epileptic patients were treated at home with phenobarbital at daily dosages ranging from 50 mg for children to 200 mg for adults and their condition was monitored. Advice was given to patients, their families, and the village authorities in order to achieve compliance. An uninterrupted supply of generic phenobarbital was provided and a rural physician made two follow-up visits to each village to ensure that the drug was taken in the correct doses. The physician gave information to the population, distributed the phenobarbital in sufficient quantities to cover the periods between visits, and monitored the patients' responses to treatment. During the first year the physician visited the patients every two months. The frequency of visits was subsequently reduced to once every four months. FINDINGS: In the six months preceding treatment the average rate of seizures among patients exceeded four per month. After a year of treatment, 80.2% of the patients experienced no seizures for at least five months. A total of 15.7% of patients experienced a reduction in seizures. In many cases no further seizures occurred and there were improvements in physical health, mental health and social status. There were very few side-effects and no cases of poisoning were reported. The cost of treatment per patient per year was US$ 7 for generic phenobarbital and US$ 8.4 for logistics. CONCLUSION: Low doses of phenobarbital were very effective against epilepsy. However, there is an urgent need for programmes involving increased numbers of physicians in rural areas and, at the national level, for the inclusion of epilepsy treatment in the activities of health care facilities. Internationally, an epilepsy control programme providing free treatment should be developed.
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spelling doaj.art-82dca02462644558b8617feffe995ab92024-03-02T14:32:11ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862002-01-01807532537Treatment with phenobarbital and monitoring of epileptic patients in rural MaliNimaga K.Desplats D.Doumbo O.Farnarier G.OBJECTIVE: To assess the efficacy of phenobarbital treatment for epileptic patients in rural Mali. METHODS: Epileptic patients were treated at home with phenobarbital at daily dosages ranging from 50 mg for children to 200 mg for adults and their condition was monitored. Advice was given to patients, their families, and the village authorities in order to achieve compliance. An uninterrupted supply of generic phenobarbital was provided and a rural physician made two follow-up visits to each village to ensure that the drug was taken in the correct doses. The physician gave information to the population, distributed the phenobarbital in sufficient quantities to cover the periods between visits, and monitored the patients' responses to treatment. During the first year the physician visited the patients every two months. The frequency of visits was subsequently reduced to once every four months. FINDINGS: In the six months preceding treatment the average rate of seizures among patients exceeded four per month. After a year of treatment, 80.2% of the patients experienced no seizures for at least five months. A total of 15.7% of patients experienced a reduction in seizures. In many cases no further seizures occurred and there were improvements in physical health, mental health and social status. There were very few side-effects and no cases of poisoning were reported. The cost of treatment per patient per year was US$ 7 for generic phenobarbital and US$ 8.4 for logistics. CONCLUSION: Low doses of phenobarbital were very effective against epilepsy. However, there is an urgent need for programmes involving increased numbers of physicians in rural areas and, at the national level, for the inclusion of epilepsy treatment in the activities of health care facilities. Internationally, an epilepsy control programme providing free treatment should be developed.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002000700004Phenobarbital/therapeutic usePhenobarbital/administration and dosageEpilepsy/drug therapyEpilepsy/epidemiologyPatient complianceTreatment outcomeCase managementRural populationMali
spellingShingle Nimaga K.
Desplats D.
Doumbo O.
Farnarier G.
Treatment with phenobarbital and monitoring of epileptic patients in rural Mali
Bulletin of the World Health Organization
Phenobarbital/therapeutic use
Phenobarbital/administration and dosage
Epilepsy/drug therapy
Epilepsy/epidemiology
Patient compliance
Treatment outcome
Case management
Rural population
Mali
title Treatment with phenobarbital and monitoring of epileptic patients in rural Mali
title_full Treatment with phenobarbital and monitoring of epileptic patients in rural Mali
title_fullStr Treatment with phenobarbital and monitoring of epileptic patients in rural Mali
title_full_unstemmed Treatment with phenobarbital and monitoring of epileptic patients in rural Mali
title_short Treatment with phenobarbital and monitoring of epileptic patients in rural Mali
title_sort treatment with phenobarbital and monitoring of epileptic patients in rural mali
topic Phenobarbital/therapeutic use
Phenobarbital/administration and dosage
Epilepsy/drug therapy
Epilepsy/epidemiology
Patient compliance
Treatment outcome
Case management
Rural population
Mali
url http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002000700004
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