2nd African Epilepsy Congress

Cape Town, South Africa

22 - 24 May 2014

Opening ceremony, Grotte Schur nurses choir
Opening ceremony, Grotte Schur nurses choir

The 2nd African Epilepsy Congress was held in Cape Town, South Africa 22nd to 24th May 2014. The title of the congress was Epilepsy in Africa: Bridging the Gap – much fruitful discussion was undertaken over the 2.5 days with regard to the current position of epilepsy care in Africa. The Congress was attended by 287 delegates from 59 countries, including 88 from South Africa. The programme was diverse and varied, and quality of talks excellent, with good attendance throughout. A total of 57 posters were presented from centres around Africa, ranging from in vitro assessment of traditional remedies to epilepsy service development.

The opening ceremony included remarks from the ILAE President, Emilio Perucca, IBE President Athanosis Covanis. Congress Organisers Amadou Gallo Diop (ILAE) and Anthony Zimba (IBE), President of the South African Chapter of the ILAE Dali Magazi and Phindi Mnguni (EpSA). There was subsequent traditional singing from the Grotte Schur nurses choir.

The opening topic on the first day was "Bridging the Gap in Africa" with talks summarising the current position of epilepsy in Africa, including epidemiology. Another reviewed "Strengthening the epilepsy organizations in Africa through capacity building" emphasising the necessity of training to recognize and treat epilepsy. This session also included a talk on the UN Convention on the Rights of Persons with Disabilities and current action in Africa. Specifics of epilepsy care should be tailored to local communities. One limitation remains the high cost and low availability of antiepileptic medication. However raising awareness amongst communities, as well as training of local expertise remains the way forward, from health care workers to neurologists. The greatest need remains that of personnel available and trained to medically recognise and treat epilepsy.

Anthony Zimba
Anthony Zimba

A session on causes of epilepsy with relevance to Africa consisted of four diverse talks. HIV and parasitic causes may be thought to be specifically prevalent in Africa. Angelina Kakooza (Uganda) updated the audience on Nodding Syndrome, a relatively recently described condition. Although genetic causes of epilepsy are likely to be important in this setting, testing is more difficult. However an overview of the role of genetics and relevance to the African situation was addressed by Riadh Gouider from Tunisia. This was followed by a session on treatment options, and another on investigations.

What was apparent throughout the congress, and with a further session in the Epilepsy and Society meeting on the Saturday afternoon, was the role for traditional healers in the care of individuals with epilepsy in Africa. It is evident they are likely to be the first line of contact with easier access for many patients, for a variety of reasons including accessibility, payment and traditional beliefs. They have a more holistic approach and occasionally visit the family for history taking. Even when the family does not have money, the patient will be treated and the family will thank the traditioal healer later. They may initiate assessment and advice, but may work closely with health care workers to ensure appropriate management pathways. However, with appropriate training, the mobile phone with the use of video will greatly enhance the diagnosis of epilepsy in this community, particularly where there is limited availability of other investigations.

Congress attendees
Congress attendees

At the end of each day, two round table discussions were held on various topics. These included epilepsy surgery in resource poor settings, the role of EEG, educational programmes in epilepsy and epilepsy management guidelines and their implementation. Each were led lectures from key note speakers, with a range of panellists from within and outside Africa. The plan was to engage more in audience interaction to obtain views from the floor. The latter two discussions particularly stimulated participation from the attendees. Guidelines are often written with no specific consideration for the population to which they are targeted, and the role of evidence base even if limited was questioned.

The satellite symposium sponsored by Sanofi had several speakers highlighting the way forward in Access to Medicines in resource poor countries. Several speakers from around the world spoke of programmes in progress designed to enhance availability of antiepileptic medications, including presentations from South America and Laos,  and how this may be tackled further. The Chapter Convention, though impromptu due to a planning glitch, was well-attended with great interest shown by countries yet to develop an ILAE Chapter. Amadou Gallo Diop introduced the newly elected Commission for African Affairs, in addition to the ILAE management committee members present. He emphasised the desire for as much communication as possible, with a mission to enhance epilepsy education through Africa. New chapter applications were encouraged, and contact made with at least six further countries; 14 countries in Africa are currently ILAE members.

In the participation in Epilepsy and Society Day Seminar striking was the importance of family involvement and the creation of support groups as well as the right of PWE to education. With the closing ceremony, the over-riding messages of this Congress were "never give up" and "stand up for epilepsy", ensuring everyone believes that we can all do something to improve the lives of people with epilepsy in Africa.

Overall, each session was well attended, and network opportunities throughout the conference plentiful. The time allowed for posters was on this occasion inadequate, and something to consider for the future. As we await expressions of interest for the venue of the 3rd Congress to be held in 2016, we look forward to more countries becoming members of the ILAE, and to increasing attendance over time.

Helen Cross
Secretary General, ILAE

Certificates of Appreciation presented by Emilio Perucca

More photos from the Second African Epilepsy Congress