چکیده
Background: There is documented evidence that the use of complementary and alternative medicines (CAM) has been on the increase worldwide.
Methods: A standardized questionnaire was administered to caregivers of children with epilepsy to evaluate the prevalence and pattern of CAM use.
Results: One hundred and seventy five caregivers of 175 children with epilepsy were studied. Ninety nine (56.6%) of the caregivers gave a history of CAM use. The forms of CAM used were herbal preparations (39.4%), spiritual/prayer healing (34.3%), scarifications (17.1%) and special vitamins (6.1%). Seventy (40%) of the 175 children had received CAM ever before seeking Western Medicine for the treatment of epilepsy. Of the 99 children with history of CAM use, 33 (33.3%) continued to use CAM in combination with the prescribed anti-epileptic drug (AED). Adverse effects werereported in 17 (17.1%) cases. There was no statistically significant relationship between the type of epilepsy and the use of CAM (p= 0.229, OR 1.655, 95% CI 0.608- 4.508). There was a statistically significant inverse relationship between social class of the family (p=0.043, OR 0.354, 95% CI 1.087-2.489) and mother’s level of education (p=0.013, OR 2.618, 95% CI 1.173-5.844) and the
use of CAM. Only 30 (30.3%) of the 99 caregivers had spontaneously volunteered the history of the use of CAM to the attending physician and the leading reason for not giving the history was that the attending physician did not ask for the information.
Conclusion: Children with epilepsy frequently use CAM and attending physicians often fail to ask about use of CAM in the routine evaluation of patients. There is a need to routinely ask caregivers and patients about the use of CAM in management of their disease.
Keywords: Complementary, alternative, treatment, childhood, epilepsy
Résumé
Introduction: Il existe des preuves documentées que l’utilisation de médecines complémentaires et alternatives (MCA) a été à la hausse dans le monde entier.
Méthodologie: Un questionnaire standardisé a été administré aux pédiatres (médecins en charge des enfants) atteints d’épilepsie afin d’évaluer la prévalence et les fréquences d’utilisation MCA.
Résultats:Cent soixante-quinze (175) enfants atteints d’épilepsie ont été étudiés. L’utilisation des MCA était documente chez quatrevingt-dix-neuf (56,6%) des enfants par des tradi-praticiens. Les formes de MCA utilisés étaient des préparations à base de plantes (39,4%), spirituel / prière de guérison (34,3%), scarifications (17,1%) et des vitamines spéciales (6,1%). Soixante-dix (40%) des 175
enfants qui avaient reçu MCA n’avaient jamais cherché la médecine occidentale pour le traitement de l’épilepsie. Sur les 99 enfants ayant des antécédents d’utilisation MCA, 33 (33,3%) ont continué à utiliser MCA en combinaison avec les médicaments antiépileptiques prescrit (AED). Les effets indésirables ont été rapportés chez 17 (17,1%) des cas. Il n’y avait pas de relation statistiquement significative entre le type d’épilepsie et l’utilisation des MCA (P = 0,229, OR 1,655, IC à 95% de 0,608 à 4,508). Il y avait une relation inverse statistiquement significative entre la classe sociale de la famille (P = 0,043, OR 0,354, IC à 95% de 1,087 à 2,489), le niveau de scolarisation de la mère (P=0.013, OR 2.618, 95% CI 1.173-5.844) et l’usage des MCA. Seulement 30 (30,3%) des 99 enfants en charge s’étaient spontanément portés volontaires pour donner l’histoire de l’utilisation des MCA au médecintraitant, et la principale raison pour ne pas donner l’histoire, c’est que le médecin n’a pas demandé de l’information.
Conclusion: Les enfants atteints d’épilepsie utilisent fréquemment des MCA et les médecins ne parviennent souvent pas à poser des questions sur leur utilisation dans la routine évaluation des patients. Il est nécessaire d’informer systématiquement les médecins par les patients sur l’utilisation des MCA dans la gestion de leur maladie.
Correspondence: Dr. I.A. Lagunju, Department of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail: ilagunju@yahoo.co.uk
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