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BackgroundMost of the studies on epilepsy in Kenya and indeed the sub-Saharan region of Africa mainly focus on prevalence, psychiatric profile, and factors associated with increased seizure burden. This being the first Kenyan and sub-Saharan African study assessing quality of life among people living with epilepsy, it will identify their ‘intangible’ needs and enable evidence-based intervention that would ultimately lead to a comprehensive management and better outcome.MethodsDesign: A cross-sectional comparative study, using the World Health Organization Quality of Life questionnaire, a socio-demographic questionnaire, seizure burden and characteristics, drug and treatment profile questionnaires and the Mini-Mental state examination, among PLWE and those accompanying them, herein referred to as the normal healthy controls, attending the neurology clinic at Kenyatta National Hospital, Nairobi.Setting and subjects: Study was carried out between October 2006 and February 2007 at the neurology clinic in the hospital where three hundred consecutive subjects who satisfied the inclusion criteria and gave consent were recruited.Statistical tests used: Descriptive statistics were used to compute means, standard deviations as well as frequencies. Significance of associations was tested using the Chi square test statistic (x2), an independent samples t-test, analysis of variance (ANOVA) and a step-wise (forward) regression analysis. A p < 0.05 was considered statistically significant.ResultsThe mean quality of life among people living with epilepsy (49.90%) was significantly (p < 0.01) lower than that of the normal controls (77.60%) accompanying them and significantly impaired as compared to the hypothesized mean of 75±2.5%. Factors significantly (p < 0.05) associated with impairment of quality of life in those living with epilepsy were a low level of education, higher seizure burden, low annual income, unemployment, unskilled employment, and living in a rural residence.ConclusionsThe mean quality of life of people living with epilepsy at Kenyatta National Hospital was significantly impaired and lower than that of the normal controls accompanying them. A comprehensive epilepsy management program is recommended to address this problem and its associated risk factors for the people living with epilepsy in Kenya.

Objectives: To estimate the prevalence and pattern of substance use among patients attending primary health centres in urban and rural areas of Kenya. Design: A descriptive cross-sectional prevalence survey. Setting: Urban health centres of Jericho and Kenyatta University (KU) and rural health centres in Muranga district. Subjects: One hundred and fifty adult patients (seventy eight males and seventy two females) were included in the study. Intervention: Semi-structured questionnaires and the DSM IV diagnostic criteria were used to record the socio-demographic data and to determine substance dependence or abuse. Results: The substances commonly used in descending order of frequency were alcohol, tobacco, khat and cannabis. Only alcohol and tobacco were extensively used. Lifetime prevalence rates of alcohol use for the two urban health centres were 54% and 62% compared to 54% for the rural health centres. For tobacco the lifetime prevalence rates were 30% for Jericho, 28% for KU and 38% for Muranga. The differences between the rural and urban samples were not statistically significant. More males than females had used alcohol (average lifetime use 80.8% for males compared to 30.6% for females: p<0.05) and tobacco (average lifetime use 56.4% for males compared to 5.6% for females p<0.05). Conclusion: The rates of substance abuse were generally low with the exception of alcohol and tobacco. Socio-cultural factors might be responsible for the differences noted. It is suggested that preventive measures and education should be emphasised at the primary care level.

IV). Results: The mean age was 34.63 ± 12.71 years (range 18-65). Overall, the prevalence rate of PTSD was 13.3%. None of the cases had been previously diagnosed as having PTSD. Females had a higher rate of 17.9% (n = 67), compared to the males 11.7% (n=197). The majority of those with PTSD (42.9%) were young, 20-29 years. Other risk factors were having post-primary education (62.9%), experiencing the first motor vehicle accident (14.1%), previous psychiatric illness, and other medical illnesses. The type of accident, role/status and immediate reactions to the accident were not significant. Conclusions: PTSD following motor vehicle accidents is common. Although the MVA survivors do develop significant rates of PTSD, it is not easy to identify those at risk but some of the parameters documented in this study may help. A multi disciplinary approach is therefore essential in the management of the RTA survivors at the orthopaedic and trauma clinics if their physical and psychological needs are to be adequately addressed

Objectives: To estimate the prevalence and pattern of psychiatric disorders among children and young persons appearing in the Nairobi juvenile court, Kenya. Design: A point prevalence survey. Setting: The Nairobi Juvenile Court, Kenya. Subjects: Ninety (sixty-four males and twenty-six females) children and young persons aged 8 to 18 years classified as criminal offenders, group I (60), and those for protection and discipline, group II (30), were selected. Method: A socio-demographic questionnaire, reporting questionnaire for children (RQC), follow-up interview for children (FIC), present state examination (PSE) and clinical interview were administered to the subjects. International Classification of Diseases, 10th Edition (ICD-10) diagnostic criteria were used. Results: The crude psychiatric morbidity (CPM) rate was 44.4%. ICD-10 documented psychiatric disorders detected in those with CPM were conduct disorders 45%, mixed disorders of conduct and emotion 20%, emotional disorders with onset specific to childhood 20%, mood disorders 12.5% and hyperkinetic disorders 2.5%. Conclusion: This study has shown a high presence of psychiatric morbidity in children and young persons appearing in the Nairobi Juvenile Court. These juveniles need and would benefit from mental treatment as recommended in section 18 of Cap 141 of the laws of Kenya; The Children's and Young Persons Act.