COMPREHENSIVE PRIMARY HEALTH-CARE ANTIEPILEPTIC DRUG-TREATMENT PROGRAM IN RURAL AND SEMIURBAN KENYA
COMPREHENSIVE PRIMARY HEALTH-CARE ANTIEPILEPTIC DRUG-TREATMENT PROGRAM IN RURAL AND SEMIURBAN KENYA
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DOI：
10.1016/0140-6736(91)91176-u
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发表时间：
1991-02-16
期刊：
影响因子：
168.9
通讯作者：
SHORVON, SD
中科院分区：
文献类型：
--
作者：
FEKSI, AT;KAAMUGISHA, J;SHORVON, SD
对肯尼亚农村和城乡结合部地区的抗癫痫治疗计划进行了评估。 全身强直阵挛性癫痫发作的患者根据两种简单药物方案之一进行治疗。 卫生工作者对社区主要知情人报告的病例进行了筛查。 在卫生工作者确定的 529 名患有活动性癫痫发作的患者中，精神科医生招募了 302 名 6-65 岁的患者接受卡马西平或苯巴比妥治疗。 治疗主要由初级卫生工作者监督，该计划由一个研究小组监督，该小组评估治疗的有效性。 在完成研究的 249 名患者中，53% 的患者在治疗后 6 个月内癫痫发作消失，另外 26% 的患者癫痫发作比治疗前 6 个月大幅减少（减少 50% 或更多）。 这些研究结果与发达国家新诊断患者的相似性、低退出率、低因不良反应而退出的比率以及可接受的治疗依从性表明卫生工作者可以充分监测治疗。 大多数患者在开始癫痫治疗之前已经延迟了几年，但他们的反应良好——这一发现并不支持“如果不及早治疗，这种疾病就会变得顽固”的观点。
A programme of antiepileptic treatment in a rural and semi-urban region in Kenya was assessed. Patients with generalised tonic-clonic seizures were treated according to one of two simple drug protocols. Health workers screened cases reported by key informants in the community. From the 529 patients identified by health workers as having active seizures 302 patients aged 6-65 years were recruited by a psychiatrist for therapy with carbamazepine or phenobarbitone. Treatment was supervised largely by primary health workers, and the programme was monitored by a research team, which assessed the effectiveness of treatment. Of the 249 patients who completed the study, 53% became seizure-free in the second 6 months of therapy, and another 26% had substantially (50% or more reduction) fewer seizures than in the 6 months before therapy. The similarity of these findings to those obtained in newly diagnosed patients in the developed world, the low drop-out rate, the low rate of withdrawal due to adverse effects, and the acceptable compliance with therapy indicate that health workers can monitor therapy adequately. Most patients had had several years of delay before starting therapy for their epilepsy, yet they responded well - a finding that does not support the suggestion that the disorder becomes intractable if not treated early.