Profile of Neurological admissions at the University of Nigeria Teaching Hospital Enugu

Background: The burden of Neurological diseases may be on the increase especially in developing countries. Improved outcome in these settings may require appreciation of the spectrum of Neurological diseases and the impediments to their management. We aim to determine the profile of neurological admissions and the challenges of managing these diseases at the University of Nigeria Teaching Hospital Enugu South East Nigeria.Methods: Analysis of Neurological admissions into the medical wards of the University of Nigeria Teaching Hospital Enugu from January 2003 to December 2007.Results: Neurological admissions comprise about 14.8% of medical admissions. There were 640 (51%) males and 609 (49%) females. The spectrum of neurological diseases were stroke 64.9%, central nervous system infections (21.8% ), HIVrelated neurological diseases 3.5%, hypertensive encephalopathy (3.4%), dementia (3%), subarachnoid haemorrhage (2.2%), Guillian Barre syndrome (1.2%), Parkinson's disease (1.1%), myasthenia gravis (1.0%), motor neurone disease and peripheral neuropathy and accounted for 0.8% and 0.6% respectively. Overall, non infectious disease accounted for 78.2% of neurological admissions while infectious diseases accounted for 21.8%.Conclusion: A wide spectrum of neurological diseases occurs in our setting. The high incidence of CNS infections indicates that efforts should be geared towards preventive measures. A major challenge to be addressedin the management of neurological diseases in our setting is the lack of specialized facilities.Key words: Profile, neurological admissions, Enug

Knowledge, attitude and practice towards epilepsy among secondary school students in Enugu, South East Nigeria

AbstractPurposeThe purpose of this study was to determine the knowledge and attitude of secondary school students to epilepsy and its treatment that could pose as barriers in the treatment and care of epilepsy patients within the community.MethodsThis study was cross-sectional and descriptive in design using a self administered custom designed multiple choice questionnaire with sections on general information on epilepsy, awareness and perception of epilepsy, treatment of epilepsy/seizures and attitude towards people living with epilepsy.ResultsOut of 969 questionnaires analyzed, the majority of the students (87.6%) had heard of epilepsy as a disease. The commonest sources of information were the electronic media (36.4%) and family members (25.6%). More than half (59.4%) had witnessed a convulsion in the past and 8.9% had a family member with epilepsy. Jerking (50.6%) and loss of consciousness (47.4%) were identified as the commonest manifestations of epilepsy. Epilepsy was considered a psychiatric disorder by 51.9% and as an infectious disease by 40.6%. About 39.3% considered epilepsy to be due to spiritual causes, old age or poisoning/bad blood. A total of 63.1% regarded orthodox medicine and prayers as the best means to treat epilepsy, while 6.8% chose herbal remedies. Concerning first aid treatment, 50.6% agreed that an object should be inserted into the mouth, while 49.5% would call for medical help and 28.8% would remove the person from harm. On attitude, 64.9% would not keep a friend with epilepsy, 69.1% would not play with someone with epilepsy, 84.2% would not marry someone with epilepsy. 41.1% of the students said that people with epilepsy should neither marry while 42.2% say they should not have children. Only 39.1.5% had an overall positive attitude towards people living with epilepsy.ConclusionsThere is a persisting poor knowledge, attitude and practice of epilepsy among secondary school students in SE Nigeria. Efforts should be made to include basic facts about disorders with social consequences such as epilepsy in school health education curriculum

Knowledge of medical students about epilepsy: Need for a change

Purpose: Though most doctors in their professional life will provide care for people with epilepsy, many will not get further training in their professional life. There may be other barriers, perceived or not, to providing care to people living with epilepsy by doctors which need to be approached in the medical undergraduate curriculum and medical continuing education. The aim of this study was to determine the knowledge gaps of medical students on basic issues regarding epilepsy that could be useful in preparing training material for the students and continuous medical education for doctors working in the community.Materials and Methods: This cross-sectional and descriptive study was carried out in one of the medical schools in Enugu metropolis. Data collection was done using a semi-structured validated questionnaire.Results: Seizure was regarded as a movement disorder by 10.3% of the students. The rank of causes of epilepsy given by respondents was brain injury (88%), brain tumor (87%) genetics (62.3%), and strokes (55.1%). Significantly more students who did neurology posting correctly answered that stroke is a risk factor (P < 0.001), disagreed that sleep deprivation is a risk factor (P = 0.04), and recognized different seizure types (P < 0.001–0.002). The mean score was 17.8 ± 2.3% (71.2 ± 9.2%); significantly higher in those who did neurology posting. Students scored lowest on questions regarding risk factors and duration of treatment.Conclusion: The content of medical curriculum in Africa should emphasize not only the content of lectures on epilepsy but also the need for students to go through neurology posting during their training. The outcome would be both better knowledge and improved physician–patient relations.Keywords: Epilepsy, knowledge, medical students, Nigeri