The social and economic impacts of epilepsy on women in Nigeria

Komolafe, Morenikeji; Sunmonu, Taofiki; Afolabi, Olusegun T.; Komolafe, E O; Fabusiwa, Festus O.; Groce, Nora; Kett, Maria; Disu, Jimoh O; Ajiboye, J.K.; Olaniyan, Stephen O.

doi:10.1016/j.yebeh.2011.11.019

Cited by 33 publications

(35 citation statements)

References 34 publications

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“…Gender (Bishop, 2004;Gopinath et al, 2011;Jacoby, 1995;Komolafe et al, 2012;Lim et al, 2013a;Lim et al, 2013b;Sillanpaa and Schmidt, 2010;Varma et al, 2007) Gender (Al-Saad et al, 2001;Bautista and Wludyka, 2007;Chaplin, 1992;Elwes et al, 1991;George et al, 2009;Haag et al, 2010;Majkowska-Zwolinska et al, 2012) Seizure control (Al-Saad et al, 2001;Baker et al, 1997;Benifla et al, 2008;Callaghan et al, 1992;Chin et al, 2007;De Boer, 2005;Elwes et al, 1991;Geerts et al, 2011;Herodes et al, 2001;Holland et al, 2009;Jacoby et al, 2005;Koponen et al, 2007;Lazow et al, 2012;Lee, 2005;Lim et al, 2013c;Maganti et al, 2003;Majkowska-Zwolinska et al, 2012;Rätsepp et al, 2000;Scambler and Hopkins, 1980;Schwartz et al, 1968) (Reeves et al, 1997;Sillanpaa et al, 2004;…”

Section: Socio-demographic Factors (N = 42 Papers)mentioning

confidence: 99%

Employability in people with epilepsy: A systematic review

Lim

Choo

et al. 2015

Epilepsy Research

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Section: Socio-demographic Factors (N = 42 Papers)mentioning

confidence: 99%

Employability in people with epilepsy: A systematic review

Lim

Choo

et al. 2015

Epilepsy Research

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“…In several developing countries there is still evidence of social stigma attached to women with epilepsy (WWE). In Nigeria, WWE have been found to have worse social and economic status in comparison with women not suffering from epilepsy (Komolafe et al, 2012). In a study conducted in India, more than half of WWE concealed their history of epilepsy prior to their wedding, fearing social stigma and breakdown of the marriage negotiations (Santosh et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Women with epilepsy: clinically relevant issues

Bangar¹,

Shastri²,

El‐Sayeh³

et al. 2016

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SummaryWomen with epilepsy (WWE) face specific challenges throughout their lifespan due to the effects of seizures and antiepileptic drugs on hormonal function, potentially affecting both sexual and reproductive health. This review article addresses the most common issues of practical relevance to clinicians treating WWE: epidemiology and clinical presentations (including catamenial epilepsy), contraception, reproductive and sexual dysfunction, pregnancy, lactation, menopause-related issues (including bone health), and mental health aspects. Awareness of these gender-specific issues and implementation/adaptation of effective interventions for WWE results in significantly improved health-related quality of life in this patient population.

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“…Cultural beliefs in evil spirits may be associated with epilepsy, and this may have negative consequences for PWE and their quality of, and opportunities in, life. 59,60 When ethnic groups represent multiple small diverse minorities as they do in the UK, their special needs may not be recognised, as has been described for other conditions. 61 Our research group 54 found that, after diagnosis by a neurologist, the median score for PWE using Jarvie et al's 62 epilepsy knowledge questionnaire was 43 out of a maximum of 55, with a wide range of 12-51.…”

Section: Male 59 Yearsmentioning

confidence: 99%

“…However, there is evidence from research in West Africa, from where many of the black Africans originate, of PWE suffering discrimination, stigmatisation and social deprivation, and of women in particular suffering physical and sexual abuse because of their epilepsy. 59,138 This might also be experienced to a lesser degree by black ethnic minority PWE living in the UK, as a consequence of past experience, or through the influence of family or friends. This could be an important barrier to black ethnic minority PWE acquiring the knowledge and skills necessary for self-management.…”

Section: Health Economics Of Emergency Department Usementioning

confidence: 99%

Can an epilepsy nurse specialist-led self-management intervention reduce attendance at emergency departments and promote well-being for people with severe epilepsy? A non-randomised trial with a nested qualitative phase

Ridsdale

McCrone

Morgan

et al. 2013

Health Services and Delivery Research

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ObjectivesTo (1) describe the characteristics and service use of people with established epilepsy (PWE) who attend the emergency department (ED); (2) evaluate the economic impact of PWE who attend the ED; (3) determine the effectiveness and cost-effectiveness of an epilepsy nurse specialist (ENS)-led self-management intervention plus treatment as usual (TAU) compared with TAU alone in reducing ED use and promoting well-being; (4) describe patients' views of the intervention; and (5) explore their reasons for attending the ED.DesignNon-randomised trial with nested qualitative study.SettingThe EDs of three inner London hospitals. The EDs each offer similar services and support a similar local population, which made a comparison of patient outcomes reasonable.ParticipantsAdults diagnosed with epilepsy for ≥ 1 year were prospectively identified from the EDs by presenting symptom/discharge diagnosis. We recruited 85 of 315 patients with 44 forming the intervention group and 41 the comparison group.InterventionIntervention participants were offered two one-to-one outpatient sessions delivered by an ENS who aimed to optimise self-management skills and knowledge of appropriate emergency service use. The first session lasted for 45–60 minutes and the second for 30 minutes.Main outcome measuresThe primary outcome was the number of ED visits that participants reported making over the 6 months preceding the 12-month follow-up. Secondary outcomes were visits reported at the 6-month follow-up and scores on psychosocial measures.ResultsIn the year preceding recruitment, the 85 participants together made 270 ED visits. The frequency of their visits was positively skewed, with 61% having attended multiple times. The mean number of visits per participant was 3.1 [standard deviation (SD) 3.6] and the median was two (interquartile range 1–4). Mean patient service cost was £2355 (SD £2455). Compared with findings in the general epilepsy population, participants experienced more seizures and had greater anxiety, lower epilepsy knowledge and greater perceived stigma. Their outpatient care was, however, consistent with National Institute for Health and Clinical Excellence recommendations. In total, 81% of participants were retained at the 6- and 12-month follow-ups, and 80% of participants offered the intervention attended. Using intention-to-treat analyses, including those adjusted for baseline differences, we found no significant effect of the intervention on ED use at the 6-month follow-up [adjusted incidence rate ratio (IRR) 1.75, 95% confidence interval (CI) 0.93 to 3.28] or the 12-month follow-up (adjusted IRR 1.92, 95% CI 0.68 to 5.41), nor on any psychosocial outcomes. Because they spent less time as inpatients, however, the average service cost of intervention participants over follow-up was less than that of TAU participants (adjusted difference £558, 95% CI –£2409 to £648). Lower confidence in managing epilepsy and more felt stigma at baseline best predicted more ED visits over follow-up. Interviews revealed that patients generally attended because they had no family, friend or colleague nearby who had the confidence to manage a seizure. Most participants receiving the intervention valued it, including being given information on epilepsy and an opportunity to talk about their feelings. Those reporting most ED use at baseline perceived the most benefit.ConclusionsAt baseline, > 60% of participants who had attended an ED in the previous year had reattended in the same year. In total, 50% of their health service costs were accounted for by ED use and admissions. Low confidence in their ability to manage their epilepsy and a greater sense of stigma predicted frequent attendance. The intervention did not lead to a reduction in ED use but did not cost more, partly because those receiving the intervention had shorter average hospital stays. The most common reason reported by PWE for attending an ED was the lack of someone nearby with sufficient experience of managing a seizure. Those who attended an ED frequently and received the intervention were more likely to report that the intervention helped them. Our findings on predictors of ED use clarify what causes ED use and suggest that future interventions might focus more on patients' perceptions of stigma and on their confidence in managing epilepsy. If addressed, ED visits might be reduced and efficiency savings generated.Trial registrationCurrent Controlled Trials ISRCTN06469947.FundingThis project was funded by the NIHR Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 1, No. 9. See the HSDR programme website for further project information.

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The social and economic impacts of epilepsy on women in Nigeria

Cited by 33 publications

References 34 publications

Employability in people with epilepsy: A systematic review

Employability in people with epilepsy: A systematic review

Women with epilepsy: clinically relevant issues

Can an epilepsy nurse specialist-led self-management intervention reduce attendance at emergency departments and promote well-being for people with severe epilepsy? A non-randomised trial with a nested qualitative phase

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