Development and Evaluation of a Pediatric Epilepsy Training Program for First Level Providers in Zambia

Abstract

Introduction. The developing world continues to face challenges in closing the large treatment gap for epilepsy, due to a high burden of disease and few experienced providers to manage the condition. Children with epilepsy are susceptible to higher rates of developmental impairments and refractory disease due to delays or absence of appropriate management as a result. We demonstrated that a structured education intervention on pediatric epilepsy can improve knowledge, confidence, and impact clinical practice of first level providers in Zambia. Methods. Three first-level facilities across Zambia were included. After initial pilot versions and revisions, the final course was implemented at each site. Pre- and post-intervention knowledge and confidence assessments were performed. Additionally, chart reviews were conducted prior to intervention and 4 months after completion of training at each site to assess change on management. Results. Twenty-three of the original 24 participants from all 3 sites completed the training; 48% clinical officers, 43% nurses, 9% other expertise. Of the 15 concepts tested by knowledge assessment, 12 showed trends in improvement, 7 of which were significant ( P < .05). Chart reviews demonstrated significant improvement in documentation of seizure description ( P = .008), seizure frequency ( P = .00), and possible causes of seizures/epilepsy ( P = .034). Discussion. Key elements of success to this program included hands on clinical skills building and case-based teaching, development of a program with direct and ongoing input from the target audience, and inclusion of assessments to monitor impact on clinical practice. Future studies looking at health outcomes are necessary to determine sustained impact.

Access to Pediatric Neurology Training and Services Worldwide

“…The points noted will be included in the subsequent development of concepts to upscale child neurology clinician training. 17,18 The US collaboration in Armenia highlights similar issues and the need to be innovative through the onsite mentorship by visiting specialists. 19 Limitations: Our survey dissemination included a targeted sampling frame and the EPNS survey pooled data.…”

Reducing epilepsy diagnostic and treatment gaps: Standardized paediatric epilepsy training courses for health care professionals

“…20 A single-country evaluation of a paediatric epilepsy course from Zambia was published. 21 In 2012, the World Health Organization initiated an epilepsy training programme for non-specialist health care providers, but with only single-country evaluations published. 22,23 A study of paediatric resuscitation training reported high participant numbers (n > 13 000).…”

“…The authors used different assessments across each study 20 . A single‐country evaluation of a paediatric epilepsy course from Zambia was published 21 . In 2012, the World Health Organization initiated an epilepsy training programme for non‐specialist health care providers, but with only single‐country evaluations published 22, 23 .…”

Seizure Safari: Bridging the Treatment Gap in Rural Tanzania and Shaking Up Epilepsy Care

“…Thus, new and innovative models are required for task sharing, education, and continuous specialty care. 13 Telemedicine can enable a continuous or semi-continuous presence of a neurologist in LMIC. The usual barrier in resource-poor settings is the lack of fast and reliable internet connections.…”

“…Thus, new and innovative models are required for task sharing, education, and continuous specialty care. 13 …”