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Epilepsy-associated neurocognitive disorders (EAND) in an onchocerciasis-endemic rural community in Cameroon : A population-based case–control study

  • Njamnshi, Alfred K. Department of Neurology, Central Hospital Yaoundé, Yaoundé, Cameroon - Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
  • Chokote, Eric-Samuel Department of Neurology, Central Hospital Yaoundé, Yaoundé, Cameroon - Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
  • Ngarka, Leonard Department of Neurology, Central Hospital Yaoundé, Yaoundé, Cameroon - Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
  • Nfor, Leonard N. Department of Neurology, Central Hospital Yaoundé, Yaoundé, Cameroon - Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
  • Tabaha, Earnest N. Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon - Ministry of Public Health, Yaoundé, Cameroon
  • Basseguin Atchou, Jonas G. Department of Neurology, Central Hospital Yaoundé, Yaoundé, Cameroon - Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
  • Angwaforbe, Samuel A. Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon
  • Nkouonlack, Cyrille Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Department of Neurology, Regional Hospital Buea, Buea, Cameroon - Department of Clinical Sciences, Faculty of Health Sciences, University of Buea, Buea, Cameroon
  • Mengnjo, Michel K. Department of Neurology, Central Hospital Yaoundé, Yaoundé, Cameroon - Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
  • Njamnshi, Wepnyu Y. Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon - Department of Neurology and Neuropsychology, University of Fribourg, Fribourg, Switzerland
  • Demaa, Fidèle Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Ministry of Public Health, Yaoundé, Cameroon
  • Tataha, Godwin Y. Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Neurology Department, CH Saint-Nazaire, Saint-Nazaire, France.
  • Zoung-KanyiBissek, Anne-Cecile Faculty of Medicine & Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon - Department of Health Operations Research, Ministry of Public Health, Yaoundé, Cameroon
  • Annoni, Jean-Marie Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon & Geneva, Switzerland - Department of Neurology and Neuropsychology, University of Fribourg, Fribourg, Switzerland
  • Ruffieux, Nicolas Department of Special Education, University of Fribourg, Fribourg, Switzerland
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    01.11.2020
Published in:
  • Epilepsy & Behavior. - 2020, vol. 112, p. 107437
English Epilepsy affects at least 50 million individuals worldwide, especially in sub-Saharan Africa (sSA). Cognitive impairment is common in people with epilepsy (PWE) yet, little is known on the burden of cognitive impairment in people with epilepsy in sSA. This study was thus designed to assess cognitive impairment in PWE or epilepsy- associated neurocognitive disorders (EAND) in a rural population in Cameroon.Methods: This was a case–control study including PWE and age/sex- matched healthy controls from July to September 2017 in Bilomo, a village in the Mbam and Kim Division. The Montreal Cognitive Assessment (MoCA), International HIV Dementia Scale (IHDS), Dubois' Five Word testing, Frontal Assessment Battery (FAB), Isaac's Set Test and the Clock drawing test were administered to the study participants to evaluate global and specific cognitive functions.Results: Eighty participants were included (40 cases and 40 controls) with a mean age of 25.78 years. Using the MoCA, 87.5% of cases had cognitive impairment, against 37.5% of controls (p < 0.001; OR 11.67; CI 3.40–45.09). Using the IHDS, the prevalence of global cognitive impairment was 84.6% among the cases against 40% for the controls (p = < 0.001; OR 7.07; CI 2.29–29.19). Specifically, executive function deficits (92.5% of cases vs 40.0% of controls p = < 0.001 OR = 18.50 CI; 4.48–105.08) and decreased verbal fluency (100% of cases against 45% of controls p < 0.001) were the most affected cognitive domains. Longer duration of epilepsy and higher seizure frequency were associated with global cognitive impairment. Low level of education was associated with both decreased verbal fluency and executive dysfunction while a longer stay in Bilomo correlated with poor results on the Isaac's Set Test.Conclusion: The prevalence of cognitive impairment appears to be much higher in PWE in the Mbam valley, particularly decreased executive function and verbal fluency, than in people without epilepsy. Longer disease duration, higher seizure frequency, low level of education and length of stay in Bilomo are associated with poorer cognitive performance. More studies are needed to refine evaluation tools to better characterize and manage EAND in sSA.
Faculty
Faculté des sciences et de médecine
Department
Médecine 3ème année
Language
  • English
Classification
Biological sciences
License
License undefined
Identifiers
Persistent URL
https://folia.unifr.ch/unifr/documents/309369
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