[Persistent neurological sequelae due to cerebral malaria in a cohort of children from Mali]. / Séquelles neurologiques persistantes dues au paludisme cérébral dans une cohorte d'enfants au Mali.

INTRODUCTION: Several neurological complications are associated with cerebral malaria (CM). However, few long-term data from childhood survivors have been published. METHODS: A cross-sectional study was carried out in Mali among children followed from 1999 to 2002 after serious and complicated malaria. Our aim was to evaluate the persistent neurological sequelae associated with CM. RESULTS: This study concerned 101 subjects who had had CM. Mean age was 5.6+/-3.6 years. Twenty-eight children presented persistent neurological sequelae (27.7p.cent). Among them eight (7.9p.cent) children had developed these sequelae just after CM and 20 (19.8p.cent) a few months later: headaches, mental retardation, speech delay, bucco-facial dyspraxia, diplegia and frontal syndrome (one case each), dystonia (two cases), epilepsy (five cases) and behavior and attention disorders (15 cases). CONCLUSIONS: In this study, we show that neurological signs due to CM can persist in the long run. Long-term follow-up and proper management after CM are essential.

[Management of epilepsy in developing countries]. / Prise en charge de l'épilepsie dans les pays en développement.

Epilepsy is a major public health problem in developing countries. In addition to the high prevalence of epilepsy in some regions, there is an acute shortage of trained personnel, clinical equipment, and antiepileptic drugs. As a result of these problems, most patients do not have access to adequate treatment. Despite wake-up calls from the WHO, LICE, and BIE in 2001 using the slogan "Bring epilepsy out of the shadows", few national epilepsy control programs have been implemented in developing countries. Nevertheless reports describing several recent pilot projects have demonstrated that effective screening and management of the disease is feasible through primary health care systems. Phenobarbital should be the first choice for treatment of epilepsy in developing countries.

[Epidemiology of epilepsy in sub-Saharan Africa: a review]. / Epidémiologie de l'épilepsie en Afrique subsaharienne : une revue de la littérature.

Epilepsy is, above all tropical, moreover, very african in its frequency and gravity. Data on the prevalence of epilepsy shows it to be two or three times more prevalent in tropical zones than in industrialized countries in non tropical areas, however it is rare to find data on the incidence and prognosis of epilepsy in sub-Saharan Africa. It is difficult to determine the relative contribution of each of the causes of epilepsy. Only a few case-control studies have been carried out in sub-Saharan Africa. Infectious diseases, in particular parasitic diseases such as neurocysticercosis or cerebral malaria, seem to be the cause of the majority of the cases of epilepsy. However it is necessary to do additional epidemiological studies to determine the etiologies of epilepsy more precisely in sub-Saharan Africa.