Background: Epilepsy is a chronic brain disorder. It often leads to disabilities and handicaps. In Africa, epilepsy is almost exclusively treated by general practitioners (GPs) because of a shortage of epilepsy specialists. It is therefore important to know the level of knowledge about epilepsy among GPs in order to improve their skills. Objectives: To assess the level of knowledge about the management of anti-epileptic drug treatment among GPs in Brazzaville; to investigate the relationship between demographic factors and GPs’ knowledge. Methods: This was a cross-sectional analytical study. It was conducted from 20 July to 1 September 2021. It focused on GPs working in public hospitals and private care centers in Brazzaville. Information on treatment aspects was collected through a standardized 11-item questionnaire. Results: Among the 137 participants, there were 84 (61.3%) men and 53 (38.7%) women. Of these participants, 36 (26.3%) were trained in Congo versus 101 (73.7%) in other countries. Only 21 (15.3%) GPs had good knowledge about the management of anti-epileptic drug treatment. The overall average knowledge score among GPs was low (31.4%). No significant associations were found between low and good levels of knowledge and gender (OR = 1.03; 95% CI = 0.40 - 2.68; p = 1.000), age groups (OR < 1; 95% CI = 0.08 - 1.02; p > 0.05), training country (OR = 0.62; 95% CI = 0.19 - 1.98; p = 0.591), practice hospital (OR = 0.40; 95% CI = 0.05 - 3.20; p = 0.695) and duration of professional experience (OR < 1; 95% CI = 0.04 - 2.82; p > 0.05). Conclusion: The study population has insufficient knowledge about the management of anti-epileptic drug treatment. Demographic factors have no impact on GPs’ knowledge. Epilepsy education programs are needed to improve GPs’ knowledge and skills.
Fisher, R.S., Acevedo, C., Arzimanoglou, A., Bogacz, A., Cross, J.H., Elger, C.E., Engel, J., Forsgren, L., French, J.A., Glynn, M., Hesdorffer, D.C., Lee, B.I., Mathern, G.W., Moshé, S.L., Perucca, E., Scheffer, I.E., Tomson, T., Watanabe, M. and Wiebe, S. (2014) ILAE Official Report: A Practical Clinical Definition of Epilepsy. Epilepsia, 55, 475-482. https://doi.org/10.1111/epi.12550
Scheuer, M.L. and Pedley, T.A. (1990) The Evaluation and Treatment of Seizures. New England Journal of Medicine, 323, 1468-1474. https://doi.org/10.1056/NEJM199011223232107
von Wendt, L., Rantakallio, P., Saukkonen, A.L. and Mäkinen, H. (1985) Epilepsy and Associated Handicaps in a 1 Year Birth Cohort in Northern Finland. European Journal of Pediatrics, 144, 149-151. https://doi.org/10.1007/BF00451901
Sillanpää, M. (1992) Epilepsy in Children: Prevalence, Disability, and Handicap. Epilepsia, 33, 444-449. https://doi.org/10.1111/j.1528-1157.1992.tb01689.x
Lopez, K. and Xu, Y. (2021) Epilepsy at the Intersection of Disability, Gender, and Culture: A Duoethnography. Epilepsy & Behavior, 122, Article ID: 108121. https://doi.org/10.1016/j.yebeh.2021.108121
Ferraro, T.N., Dlugos, D.J. and Buono, R.J. (2006) Role of Genetics in the Diagnosis and Treatment of Epilepsy. Expert Review of Neurotherapeutics, 6, 1789-1800. https://doi.org/10.1586/14737175.6.12.1789
Mefford, H.C. and Mulley, J.C. (2010) Genetically Complex Epilepsies, Copy Number Variants and Syndrome Constellations. Genome Medicine, 2, Article No. 71. https://doi.org/10.1186/gm192
Zagaria, M.A.E. (2010) Common Causes of Drug-Induced Seizures. US Pharmacist, 35, 20-23.
Shorvon, S.D. (2011) The Etiologic Classification of Epilepsy. Epilepsia, 52, 1052-1057. https://doi.org/10.1111/j.1528-1167.2011.03041.x
Shorvon, S., Guerrini, R., Trinka, E. and Schachter, S. (2019) The Causes of Epilepsy: Diagnosis and Investigation. Cambridge University Press, Cambridge. https://doi.org/10.1017/9781108355209
Pavone, P., Pappalardo, X.G., Parano, E., Falsaperla, R., Marino, S.D., Fink, J.K. and Ruggieri, M. (2022) Fever-Associated Seizures or Epilepsy: An Overview of Old and Recent Literature Acquisitions. Frontiers in Pediatrics, 10, Article ID: 858945. https://doi.org/10.3389/fped.2022.858945
Christensen, J., Kjeldsen, M.J., Andersen, H., Friis, M.L. and Sidenius, P. (2005) Gender Differences in Epilepsy. Epilepsia, 46, 956-960. https://doi.org/10.1111/j.1528-1167.2005.51204.x
Forsgren, L., Beghi, E., Oun, A. and Sillanpää, M. (2005) The Epidemiology of Epilepsy in Europe—A Systematic Review. European Journal of Neurology, 12, 245-253. https://doi.org/10.1111/j.1468-1331.2004.00992.x
McHugh, J.C. and Delanty, N. (2008) Epidemiology and Classification of Epilepsy: Gender Comparisons. International Review of Neurobiology, 83, 11-26. https://doi.org/10.1016/S0074-7742(08)00002-0
Hu, Y., Shan, Y., Du, Q., Ding, Y., Shen, C., Wang, S., Ding, M. and Xu, Y. (2021) Gender and Socioeconomic Disparities in Global Burden of Epilepsy: An Analysis of Time Trends from 1990 to 2017. Frontiers in Neurology, 12, Article ID: 643450. https://doi.org/10.3389/fneur.2021.643450
Holmes, G.L. (2012) Consequences of Epilepsy through the Ages: When Is the Die Cast? Epilepsy Currents, 12, 4-6. https://doi.org/10.5698/1535-7511-12.4s.4
Ochoa-Gómez, L., López-Pisón, J., Moros, C.L., Rodrigo, C.F., Martínez, R.F., Samper-Villagrasa, P., Monge-Galindo, L., Peña-Segura, J.L. and García-Jiménez, M.C. (2017) A Study of Epilepsy According to the Age at Onset and Monitored for 3 Years in a Regional Reference Paediatric Neurology Unit. Anales de Pediatría, 86, 11-19. https://doi.org/10.1016/j.anpedi.2016.05.002
Beghi, E. and Giussani, G. (2018) Aging and the Epidemiology of Epilepsy. Neuroepidemiology, 51, 216-223. https://doi.org/10.1159/000493484
Thijs, R.D., Surges, R., O’Brien, T.J. and Sander, J.W. (2019) Epilepsy in Adults. The Lancet, 393, 689-701. https://doi.org/10.1016/S0140-6736(18)32596-0
Auvin, S. and Dozières-Puyravel, B. (2020) Epilepsies de l’enfant. La Revue du Praticien, 70, 421-426.
Sander, J.W. and Shorvon, S.D. (1996) Epidemiology of the Epilepsies. Journal of Neurology, Neurosurgery and Psychiatry, 61, 433-443. https://doi.org/10.1136/jnnp.61.5.433
Sander, J.W. (2003) The Epidemiology of Epilepsy Revisited. Current Opinion in Neurology, 16, 165-170. https://doi.org/10.1097/00019052-200304000-00008
Fiest, K.M., Sauro, K.M., Wiebe, S., Patten, S.B., Kwon, C.-S., Dykeman, J., Pringsheim, T., Lorenzetti, D.L. and Jetté, N. (2017) Prevalence and Incidence of Epilepsy: A Systematic Review and Meta-Analysis of International Studies. Neurology, 88, 296-303. https://doi.org/10.1212/WNL.0000000000003509
Keikelame, M.J., Hills, R.M., Naidu, C., de Sá, A. and Zweigenthal, V. (2012) General Practitioners’ Perceptions on Management of Epilepsy in Primary Care Settings in Cape Town, South Africa: An Exploratory Pilot Study. Epilepsy & Behavior, 25, 105-109. https://doi.org/10.1016/j.yebeh.2012.06.003
Newton, C.R. and Garcia, H.H. (2012) Epilepsy in Poor Regions of the World. The Lancet, 380, 1193-1201. https://doi.org/10.1016/S0140-6736(12)61381-6
Kouassi, E.S., Bissouma, A.-C., Adon, K.P. and Botthy, L.M. (2018) Représentations sociales de l’épilepsie et itinéraires thérapeutiques des parents d’enfants à Abidjan. Santé Publique, 30, 703-712. https://doi.org/10.3917/spub.186.0703
Serragui, S., Errguig, L., Nchinech, N., Ahid, S., Tanani, S.D., Lachhab, Z. and Cherrah, Y. (2019) Déficit thérapeutique de l’épilepsie au Maroc. African Journal of Neurological Sciences, 38, 38-43.
Trinka, E., Kwan, P., Lee, B. and Dash, A. (2018) Epilepsy in Asia: Disease Burden, Management Barriers, and Challenges. Epilepsia, 60, 7-21. https://doi.org/10.1111/epi.14458
Krumholz, A., Wiebe, S., Gronseth, G.S., Gloss, D.S., Sanchez, A.M., Kabir, A.A., Liferidge, A.T., Martello, J.P., Kanner, A.M., Shinnar, S., Hopp, J.L. and French, J.A. (2015) Evidence-Based Guideline: Management of an Unprovoked First Seizure in Adults: Report of the Guideline Development Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology, 84, 1705-1713. https://doi.org/10.1212/WNL.0000000000001487
Haute Autorité de Santé (2020) Epilepsies: Prise en charge des enfants et des adultes. Haute Autorité de Santé, Saint-Denis. https://www.has-sante.fr
Pachlatko, C. (2003) Epilepsy Centres in Europe. Seizure, 12, S2-S3. https://doi.org/10.1016/S1059-1311(02)00286-8
Labiner, D.M., Bagic, A.I., Herman, S.T., Fountain, N.B., Walczak, T.S. and Gumnit, R.J. (2010) Essential Services, Personnel, and Facilities in Specialized Epilepsy Centers: Revised 2010 Guidelines. Epilepsia, 51, 2322-2333. https://doi.org/10.1111/j.1528-1167.2010.02648.x
Gschwind, M. and Seeck, M. (2016) Modern Management of Seizures and Epilepsy. Swiss Medical Weekly, 146, w14310. https://doi.org/10.4414/smw.2016.14310
McCabe, P.H. (2000) New Anti-Epileptic Drugs for the 21st Century. Expert Opinion on Pharmacotherapy, 1, 633-674. https://doi.org/10.1517/14656566.1.4.633
Montouris, G.D. (2000) How Will Primary Care Physicians, Specialists, and Managed Care Treat Epilepsy in the New Millennium? Neurology, 55, S42-S44.
Bialer, M., Johannessen, S.I., Koepp, M.J., Levy, R.H., Perucca, E., Perucca, P., Tomson, T. and White, H.S. (2020) Progress Report on New Antiepileptic Drugs: A Summary of the Fifteenth Eilat Conference on New Antiepileptic Drugs and Devices (EILAT XV). I. Drugs in Preclinical and Early Clinical Development. Epilepsia, 61, 2340-2364. https://doi.org/10.1111/epi.16725
Perry, M.S. (2020) New and Emerging Medications for Treatment of Pediatric Epilepsy. Pediatric Neurology, 107, 24-27. https://doi.org/10.1016/j.pediatrneurol.2019.11.008
Riva, A., Guglielmo, A., Balagura, G., Marchese, F., Amadori, E., Iacomino, M., Minassian, B.A., Zara, F. and Striano, P. (2020) Emerging Treatments for Progressive Myoclonus Epilepsies. Expert Review of Neurotherapeutics, 20, 341-350. https://doi.org/10.1080/14737175.2020.1741350
Perucca, E. (2021) The Pharmacological Treatment of Epilepsy: Recent Advances and Future Perspectives. Acta Epileptologica, 3, Article No. 22. https://doi.org/10.1186/s42494-021-00055-z
Riva, A., Golda, A., Balagura, G., Amadori, E., Vari, M.S., Piccolo, G., Iacomino, M., Lattanzi, S., Salpietro, V., Minetti, C. and Striano, P. (2021) New Trends and Most Promising Therapeutic Strategies for Epilepsy Treatment. Frontiers in Neurology, 12, Article ID: 753753. https://doi.org/10.3389/fneur.2021.753753
Bialer, M., Johannessen, S.I., Koepp, M.J., Levy, R.H., Perucca, E., Perucca, P., Tomson, T. and White, H.S. (2022) Progress Report on New Antiepileptic Drugs: A Summary of the Sixteenth Eilat Conference on New Antiepileptic Drugs and Devices (EILAT XVI): I. Drugs in Preclinical and Early Clinical Development. Epilepsia, 63, 2865-2882. https://doi.org/10.1111/epi.17373
Bordet, R. (2002) Pharmacologie des antiépileptiques: D’une génération à l’autre. La Lettre du Pharmacologue, 16, 35-41.
Thomas, P. (2004) Traitement médical des épilepsies. EMC-Neurologie, 1, 390-414. https://doi.org/10.1016/j.emcn.2004.06.001
Dupont, S. (2014) Traitement médical de l’épilepsie de l’adulte. EMC-Neurologie, 11, 1-14. [Article 17-045-A-50].
Vallée, L. (2016) Nouveaux et anciens antiépileptiques: Ce que le pédiatre doit connaitre. Réalités Pédiatriques, 203, 14-20.
Diatewa, J.E., Kwama-Matiti, C.O., Mpandzou, G.A., Motoula-Latou, D.H.B., Sounga-Banzouzi, E.P.G. and Ossou-Nguiet, P.M. (2022) Knowledge about Stroke among Workers in Public and Private Enterprises in Brazzaville and Their Attitudes towards Stroke Victims. World Journal of Neuroscience, 12, 163-180. https://doi.org/10.4236/wjns.2022.124018
Giuliano, L., Cicero, C.E., Padilla, S., Camargo, M., Sofia, V., Zappia, M., Bartoloni, A., Crespo Gómez, E.B. and Nicoletti, A. (2018) Knowledge, Attitudes, and Practices towards Epilepsy among General Practitioners in Rural Bolivia: Results before and after a Training Program on Epilepsy. Epilepsy & Behavior, 83, 113-118. https://doi.org/10.1016/j.yebeh.2018.02.030
Frith, J.F., Harris, M.F. and Beran, R.G. (1994) Management and Attitudes of Epilepsy by a Group of Sydney General Practitioners. Epilepsia, 35, 1244-1247. https://doi.org/10.1111/j.1528-1157.1994.tb01795.x
Leblond, V., Hartemann, A. and Autran, B. (2014) Les femmes médecins aujourd’hui: L’avenir de la médecine? Tribunes de la Santé, 44, 43-49. https://doi.org/10.3917/seve.044.0043
Ministère de la Santé et de la Population (2018) Plan national de développement sanitaire 2018-2022 de la République du Congo). Rapport d’étude, Ministère de la Santé et de la Population, Brazzaville.
Ngono Atangana, V. (2021) Le Congo veut combler son déficit en personnel de santé grace à la coopération avec le Cuba. https://www.agenceecofin.com/formation/1907-90231-le-congo-veut-combler-son-deficit-en-personnel-de-sante-grace-a-la-cooperation-avec-le-cuba
da Mota Gomes, M. (2000) Doctor’s Perspectives and Practices Regarding Epilepsy. Arquivos de Neuro-Psiquiatria, 58, 221-226. https://doi.org/10.1590/S0004-282X2000000200003
Moore, J.L., McCauley, J.W., Mott, D., Reeves, A.L. and Bussa, B. (2005) Referral Characteristics of Primary Care Physicians for Seizure Patients. Epilepsia, 41, 744-748. https://doi.org/10.1111/j.1528-1157.2000.tb00237.x
Sharobeam, A., Mamun, A., Kwok, A., Zandiehvakili, M. and Beran, R.G. (2019) Management and Attitudes toward Patients with Epilepsy in General Practice: How Far Have We Come in Three Decades? Epilepsy & Behavior, 97, 92-95. https://doi.org/10.1016/j.yebeh.2019.05.020
Averis, A.K. (1997) Epilepsy Management: The General Practitioner’s Perspective. Seizure, 6, 81-85. https://doi.org/10.1016/S1059-1311(97)80059-3
Elliott, J. and Shneker, B. (2008) Patient, Caregiver, and Health Care Practitioner Knowledge of, Beliefs about, and Attitudes toward Epilepsy. Epilepsy & Behavior, 12, 547-556. https://doi.org/10.1016/j.yebeh.2007.11.008
Pérez-Pérez, J., Sosa, A.M. and González-Casanova, S. (2005) Conocimientos, control clínico y actitudes de los médicos de Atención Primaria frente a los pacientes epilépticos. Resultados previos [The Knowledge, Clinical Control and Attitudes of Primary Care Physicians when Dealing with Epileptic Patients. Preliminary Findings]. Revista de Neurologia, 40, 385-393. https://doi.org/10.33588/rn.4007.2004416
Beran, R.G., Jennings, V.R. and Read, T. (1981) Doctors’ Perspectives of Epilepsy. Epilepsia, 22, 397-406. https://doi.org/10.1111/j.1528-1157.1981.tb06150.x
Beran, R.G. and Read, T. (1983) A Survey of Doctors in Sydney, Australia: Perspectives and Practices Regarding Epilepsy and Those Affected by It. Epilepsia, 24, 79-104. https://doi.org/10.1111/j.1528-1157.1983.tb04869.x
Vodougnon, C., Gérard, D., Bruand, P.E., Auditeau, E., Boumédiène, F., Zohoun, I.Y., Gnonlonfoun, D., Houinato, D. and Preux, P.M. (2019) Knowledge, Attitudes, and Practices of Health Sciences Students Regarding Epilepsy at the End of Their Curriculum in Benin. Epilepsy & Behavior Case Reports, 92, 165-170. https://doi.org/10.1016/j.yebeh.2018.12.020
Firth-Cozens, J. (1989) Stress in Medical Undergraduates and House Officers. British Journal of Hospital Medicine, 41, 161-164.
Kendall, M.L., Hesketh, E.A. and Macpherson, S.G. (2005) The Learning Environment for Junior Doctor Training—What Hinders, What Helps. Medical Teacher, 27, 619-624. https://doi.org/10.1080/01421590500069710
Cohen, D., Winstanley, S., Palmer, P., Allen, J., Howells, S., Greene, G. and Rhydderch, M. (2013) Factors That Impact on Medical Student Wellbeing—Perspectives of Risks. Individual Support Programme & Centre for Psychosocial & Disability Research, Cardiff University, Cardiff.
Stalmeijer, R.E., Dolmans, D.H., Snellen-Balendong, H.A., van Santen-Hoeufft, M., Wolfhagen, I.H. and Scherpbier, A.J. (2013) Clinical Teaching Based on Principles of Cognitive Apprenticeship: Views of Experienced Clinical Teachers. Academic Medicine, 88, 861-865. https://doi.org/10.1097/ACM.0b013e31828fff12
Kötter, T., Wagner, J., Brüheim, L. and Voltmer, E. (2017) Perceived Medical School Stress of Undergraduate Medical Students Predicts Academic Performance: An Observational Study. BMC Medical Education, 17, Article No. 256. https://doi.org/10.1186/s12909-017-1091-0
Lases, L.S.S., Arah, O.A., Busch, O.R.C., Heineman, M.J. and Lombarts, K.M.J.M.H. (2019) Learning Climate Positively Influences Residents’ Work-Related Well-Being. Advances in Health Sciences Education: Theory and Practice, 24, 317-330. https://doi.org/10.1007/s10459-018-9868-4
Isaacs, A.N. and Spencer, B.A. (2022) Factors Affecting Learning during Internship: A Qualitative Study of Junior Doctors. Australian Journal of General Practice, 51, 83-89. https://doi.org/10.31128/AJGP-02-21-5821
Harimanana, A., Chivorakul, P., Souvong, V., Preux, P.M. and Barennes, H. (2013) Is Insufficient Knowledge of Epilepsy the Reason for Low Levels of Healthcare in the Lao PDR? BMC Health Services Research, 13, Article No. 41. https://doi.org/10.1186/1472-6963-13-41
Bhalla, D., Chea, K., Hun, C., Chan, V., Huc, P., Chan, S., Sebbag, R., Gérard, D., Dumas, M., Oum, S., Druet-Cabanac, M. and Preux, P.M. (2013) épilepsie au Cambodge—Aspects du traitement et implications politiques: Une enquête représentative basée sur la population. PLOS ONE, 8, e74817. https://doi.org/10.1371/journal.pone.0074817
Koba Bora, B., Lez, D.M., Luwa, D.O., Baguma, M.B., Katumbay, D.T., Kalula, T.K. and Mesu’a Kabwa, P.L. (2015) Living with Epilepsy in Lubumbashi (Democratic Republic of Congo): Epidemiology, Risk Factors and Treatment Gap. Pan African Medical Journal, 21, Article No. 303. https://doi.org/10.11604/pamj.2015.21.303.5580
Kissani, N., Cherkaoui Rhazouani, O., Souirti, Z., Khramaz, M., Meryem, C., Mebrouk, Y. and Ouazzani, R. (2020) Epilepsy in Morocco: Realities, Pitfalls and Prospects. Epilepsia Open, 6, 13-21. https://doi.org/10.1002/epi4.12440
Riz, D.R., Sakadi, F., Tassiou, N.R., Vogel, A.C., Hamani, A.B.D., Bah, A.K., García, A., Patenaude, B.N., Cissé, A.F. and Mateen, F.J. (2020) Socioeconomic Associations of Poorly Controlled Epilepsy in the Republic of Guinea: Cross-Sectional Study. Tropical Medicine & International Health, 25, 813-823. https://doi.org/10.1111/tmi.13407
Gélineau, A., Grimaud, J. and de Toffol, B. (2008) Connaissances, attitudes et pratiques du médecin généraliste d’Eure-et-Loir face au patient épileptique: Etude qualitative à partir de 11 entretiens semi-dirigés. Revue Neurologique (Paris), 164, 156-161. https://doi.org/10.1016/j.neurol.2007.10.005