Epilepsy in refugee camps in Algeria: clinical characteristics, treatment gaps, and environmental challenges in a...

To describe the clinical and epidemiological characteristics of pediatric epilepsy in Sahrawi refugee camps and to explore treatment gaps and perceived environmental influences in a low-resource desert setting.

A cross-sectional observational study was conducted during a two-week humanitarian mission (April-May 2025) in two hospitals in Sahrawi Refugee Camps in the Tindouf desertic area (Algeria). Consecutive pediatric patients with suspected or confirmed seizures were enrolled (n = 63). Data were collected using a structured clinical record and the Pediatric Epilepsy Classification Questionnaire. Treatment gap was defined according to ILAE criteria. A semi-structured interview assessed caregivers' perceptions of climate-related effects on a subgroup. Descriptive and exploratory analyses were performed.

Sixty-three children with epilepsy were included (49 previously diagnosed, 14 newly diagnosed). Seizures were mainly focal. Among participants, 65% had undergone at least one EEG and 48% an MRI. Clinical-estimated epilepsy treatment gap was 38%, with higher prevalence in younger children. Valproic acid was the most used antiseizure medication, while access to alternative therapies depended largely on external supply routes. Medication availability was inconsistent and frequently dependent on humanitarian support. Among a sub-group of interviewed caregivers, most reported perceived seasonal or heat-related influences on seizures, particularly during summer, although responses were heterogeneous and not significantly associated with age or diagnosis. School attendance, used as a proxy for social integration, was not significantly associated with treatment gap.

According to our exploratory findings, children with epilepsy in Sahrawi refugee camps face substantial diagnostic and therapeutic barriers, compounded by unstable medication supply and environmental stressors. Limited access to investigations, specialist care, and follow-up contributes to persistent treatment gaps. Integrating standardized clinical tools, strengthening supply chains, and addressing climate-related vulnerabilities are essential to improve equity and continuity of care in protracted humanitarian settings.