RESUMO
Epilepsy is one of the leading paediatric neurological disorders in Nigeria and many other parts of the world. There is very little documented on the economic costs of epilepsy in Nigeria and other countries in sub-Saharan Africa. This study was carried out to estimate the total cost of childhood epilepsy in a cohort of Nigerian children and therefore provide essential information on the economic burden of childhood epilepsy in Nigeria. A cost of illness study was performed on a cohort of 215 consecutive cases of epilepsy seen and treated at the University College Hospital, Ibadan, Nigeria. Data on demographics, clinical characteristics, utilization of resources and costs were collected. The total annual cost of epilepsy ranged from Nigerian naira (N)23 200 (US$155) to N3 298 500 (US$21,900) with a median of N107 600 (US$717) per patient per year. Direct medical and non-medical costs accounted for 71.8% of the total mean annual cost of epilepsy. Anti-epileptic drug therapy and in-patient care accounted for 21.8% and 33.0% of the mean total annual cost respectively and more than half of the families expended over 20% of their total family income on the care of the child with epilepsy. The economic burden of childhood epilepsy in Nigeria is enormous with very high out-of-pocket expenses.
RESUMO
Holoprosencephaly is a rare congenital malformation resulting from failure of cleavage of midline structures of the forebrain and face. It affects 0.49-1.2 in 10,000 births around the world. The nature of this condition in African children is not well documented in literature. We present a cluster of three cases of holoprosencephaly with varying degrees of facial and intracranial malformations seen within a 6 month period at the University College Hospital, Ibadan, Nigeria.