Gaps in treatment of epileptic seizures in a Zambian rural area
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Gaps in treatment of epileptic seizures in a Zambian rural area. / Mambo, Richard; Phiri, Andrew M.; Trevisan, Chiara; Zulu, Gideon; Mubanga, Chishimba M.; Mwelwa, Chembensofu; Phiri, Isaac K.; Schmidt, Veronika; Magnussen, Pascal; Dorny, Pierre; Gabriël, Sarah; Winkler, Andrea S.; Mwape, Kabemba E.
In: Neurological Sciences, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Gaps in treatment of epileptic seizures in a Zambian rural area
AU - Mambo, Richard
AU - Phiri, Andrew M.
AU - Trevisan, Chiara
AU - Zulu, Gideon
AU - Mubanga, Chishimba M.
AU - Mwelwa, Chembensofu
AU - Phiri, Isaac K.
AU - Schmidt, Veronika
AU - Magnussen, Pascal
AU - Dorny, Pierre
AU - Gabriël, Sarah
AU - Winkler, Andrea S.
AU - Mwape, Kabemba E.
N1 - Publisher Copyright: © The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - Background: Epilepsy is a multifactorial neurological disorder, including parasitic infections of the brain such as neurocysticercosis (NCC). People with epileptic seizures (PWES) in low and middle-income countries often do not receive appropriate treatment, which besides epileptic seizures, may also lead to reduced quality of life and possibly death. The objective of this study was to describe gaps in treatment of epileptic seizures in a Zambian rural area. Methods: A cross-sectional study was conducted in Sinda district of Zambia between August and October 2018. PWES identified from clinic records and with the help of community healthcare workers were recruited. Two questionnaires, one to PWES and the other to local healthcare workers, were administered to describe the treatment gap. Results: A total of 146 PWES and 43 healthcare workers were interviewed. Of the 146 PWES, 131 had taken anti-seizure medication (ASM) at some point since their seizure onset, of which 49.6% were on current treatment. Only 18.3% were on continuous ASM, an overall treatment gap of 83.6%. Over 55% of healthcare workers did not know the relationship between epilepsy and NCC. The risk factors associated with lack of appropriate treatment were stock-outs of ASMs, lack of diagnostic equipment, poor patient follow-up, and PWES opting for traditional medicine. Conclusion: The treatment gap is substantial in Sinda district. The causes are multifactorial, involving shortcomings at the level of healthcare facilities, communities, and individuals. Directed training of healthcare workers and significant improvements in the supply and dispensing of ASMs will be key in substantially reducing the gap.
AB - Background: Epilepsy is a multifactorial neurological disorder, including parasitic infections of the brain such as neurocysticercosis (NCC). People with epileptic seizures (PWES) in low and middle-income countries often do not receive appropriate treatment, which besides epileptic seizures, may also lead to reduced quality of life and possibly death. The objective of this study was to describe gaps in treatment of epileptic seizures in a Zambian rural area. Methods: A cross-sectional study was conducted in Sinda district of Zambia between August and October 2018. PWES identified from clinic records and with the help of community healthcare workers were recruited. Two questionnaires, one to PWES and the other to local healthcare workers, were administered to describe the treatment gap. Results: A total of 146 PWES and 43 healthcare workers were interviewed. Of the 146 PWES, 131 had taken anti-seizure medication (ASM) at some point since their seizure onset, of which 49.6% were on current treatment. Only 18.3% were on continuous ASM, an overall treatment gap of 83.6%. Over 55% of healthcare workers did not know the relationship between epilepsy and NCC. The risk factors associated with lack of appropriate treatment were stock-outs of ASMs, lack of diagnostic equipment, poor patient follow-up, and PWES opting for traditional medicine. Conclusion: The treatment gap is substantial in Sinda district. The causes are multifactorial, involving shortcomings at the level of healthcare facilities, communities, and individuals. Directed training of healthcare workers and significant improvements in the supply and dispensing of ASMs will be key in substantially reducing the gap.
KW - Adherence
KW - Anti-seizure medications
KW - Epilepsy
KW - Neurocysticercosis
KW - People with epileptic seizures
KW - Treatment gap
UR - http://www.scopus.com/inward/record.url?scp=85188834311&partnerID=8YFLogxK
U2 - 10.1007/s10072-024-07456-1
DO - 10.1007/s10072-024-07456-1
M3 - Journal article
C2 - 38538925
AN - SCOPUS:85188834311
JO - Neurological Sciences
JF - Neurological Sciences
SN - 1590-1874
ER -
ID: 388044470