By Nathelia Bim
Wikimedia commons
Epilepsy is a neurologic disease characterized by seizures due to abnormal electrical activity in the brain. There are many causes of seizures, including but not limited to head injury, infections of the central nervous system, and genetic disorders. Various factors, such as poor sanitation, inadequate nutrition, and lack of appropriate healthcare services and medicines, make it hard for the people of Africa to be diagnosed or treated properly when they have epilepsy. In addition to medical challenges, people with epilepsy have to live with numerous social stigmas in Africa.
Prevalence of Epilepsy Worldwide
About 50 million people worldwide are thought to suffer from epilepsy with half of that population residing in Africa. In more economically developed countries, the expected annual incidence rate for epilepsy is 49 per 100,000 individuals, but in less-developed countries, that number can be as high as 139 per 100,000 inhabitants due mainly to an increased number of accidents, birth-related injuries, weak medical infrastructure, and endemic diseases.
Causes of Epilepsy
While there are many potential causes of epilepsy, in Niger, common risk factors are infections of the central nervous system like neurocysticercosis (NCC), cerebral malaria, and bacterial meningitis.
NCC is a parasitic brain infection caused by consuming contaminated water and/or tapeworm-infected pork. In some sub-Saharan communities, the association between NCC and epilepsy can be up to 70%. However, the prevalence of NCC in Niger is low, which can be attributed to the cultural and religious practices that limit pork consumption in the diet of the predominantly Muslim population.
Cerebral Malaria in Niger
Epilepsy is a significant public health concern, especially in rural areas and mainly among young people. A study was conducted on patients with epilepsy at the Regional Hospital Center in Tahoua, Niger. The central nervous system infections identified were mostly cerebral malaria and bacterial meningitis. There were many undetermined cases, but further investigation into diagnoses was incomplete.
Cerebral malaria, a severe consequence of malaria, occurs in patients infected by the malaria parasite from a mosquito carrier. The predominance of cerebral malaria in Niger could be explained by the prevalence of stagnant waters in which mosquitoes reproduce. This neurological form of malaria is a potential cause of epilepsy in malaria-endemic regions of the world.
Niger’s Treatment Limitations
The actual prevalence of epilepsy is still unknown, which can be explained by the fact that people with epilepsy or their families do not have access to the proper testing. In poor, remote settings where the disease is present, epilepsy is difficult to diagnose and treat, which causes significant stigma, especially in girls and women, where it is commonly associated with witchcraft or demonic possession.
Niger has less than a dozen neurologists available to care for people with epilepsy—too few to serve the population. Typically, people with epilepsy are treated by nurse technicians and general practice medical physicians who have little access to sophisticated diagnostics such as electroencephalograms.
Reducing Malaria in Niger with Clean Water
The Demographic and Health Program in Sub-Saharan Africa studied the effects of water and sanitation and the risk of malaria. Across all of the surveys they conducted, unprotected water was associated with increased malaria risks. Malaria affects people with low socioeconomic status and limited access to clean drinking water sources. Storing unimproved drinking water creates stagnant water sources, thus increasing mosquito breeding near households.
The study determined that access to improved water, sanitation, hygiene practices, and malaria prevention procedures influenced the level of malaria risk. Improving water and sanitation conditions could be a potential intervention for long-term malaria prevention. This can decrease the risk of developing cerebral malaria and epilepsy.
Wells Bring Hope’s mission of providing Nigeriens of all ages with clean, safe water dramatically reduces the risk of contracting water-borne diseases and may also be key to reducing the incidence of malaria and thereby the rates of epilepsy.
