Problem of accessibility to antiepileptic drugs for patients suffering from epilepsy in Bangui. Central African Republic

Résumé

Abstract

Introduction : Epilepsy is the most frequent severe chronic neurological disease of various etiologies characterized by the repetition of seizures. It affects more than 50 million people worldwide. In developing countries (DEP), 80-90% of people do not have access to treatment, for several reasons.

Goal : Assess patient accessibility to antiepileptic drugs in Bangui.

Methodology : It was a 3-month cross-sectional prospective study, from October 1 to December 31, 2018, within all the pharmaceutical structures in Bangui, recognized by the Ministry of Health.

Results: We visited a total of 32 structures and interviewed a total of 32 people. The average age of the respondents was 29, with a female predominance of 65.6%. Most worked as cashiers or accountants. The majority had no epilepsy training (84.4%) and were only aware of the generalized tonic tone (65.6%). The main cause of epilepsy was brain damage (56.3 %). The non-contagiousness of the disease was recognized by 71.9% of the respondents. The majority of those surveyed considered epilepsy to be incurable (62.5%), even pharmacists. More than half of the structures were sales units (56.2%). Among the 32 structures visited, 19 had antiepileptic drugs (59.6%). Phenobarbital was the most available (53.1%) followed by Carbamazepine (37.5%), Valproic Acid (37.5%), and Phenytoin (9.4%). These 4 major antiepileptics were mostly found in pharmacies. Phenobarbital was the most prescribed and the most in short supply. Drug stockouts were frequent and it took a long time to restock them. The cost of antiepileptics was very high.

Conclusion : The lack of trained personnel, the inadequacy of pharmaceutical structures, the insufficient availability of antiepileptic drugs and their very high cost are factors limiting the accessibility of antiepileptic drugs for patients.

Keywords: Epilepsy, therapeutic accessibility, antiepileptics, pharmaceutical structures, Bangui, Central African Republic.