Treatment of Epilepsy in Rural Ethiopia: 2 Year Follow-up

Berhanu, Shibru; Prevett, Martin

doi:10.4314/ejhd.v18i1.9862

Cited by 13 publications

(12 citation statements)

References 11 publications

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“…Although phenobarbital monotherapy can provide impressive improvements in seizure control, there is a high default rate in Ethiopia and about half of patients are lost to follow-up within 1 year 34. Similar default rates are reported from Nigeria 48.…”

Section: Overcoming the Treatment Gapsupporting

confidence: 56%

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Epilepsy in sub-Saharan Africa

Prevett

2013

Pract Neurol

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Over 10 million people in Africa have epilepsy of which most have no access to appropriate treatment. Epilepsy in Africa is different- the incidence is higher, and the causes and cultural attitudes towards it differ. This article examines the epidemiology, causes and treatment of epilepsy in sub-Saharan Africa and looks at the challenges to improve access to treatment and potential solutions and the implications for neurologists in more developed countries.

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Section: Overcoming the Treatment Gapsupporting

confidence: 56%

“…In northern Ethiopia, patients typically have to walk 4–5 h to receive treatment 34. Among traditional rural societies, epilepsy is often attributed to supernatural causes and it is commonly believed that epilepsy is due to possession by evil spirits 35.…”

Section: The Challenges To Providing Effective Treatmentmentioning

confidence: 99%

Epilepsy in sub-Saharan Africa

Prevett

2013

Pract Neurol

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“…Despite the availability, of phenobarbitone, a cheap and effective treatment, more than 90% of patients living in rural areas remain untreated. Potential reasons for this include cultural factors, lack of awareness of medical treatment and inaccessibility of medical services (4). Adherence to long-term therapy for chronic illnesses in developed countries averages 50%.…”

Section: Introductionmentioning

confidence: 99%

Medication adherence in epilepsy and potential risk factors associated with non adherence in tertiary care teaching hospital in southwest Ethiopia

Getachew¹,

Dekema²,

Awol³

et al. 2014

Gaziantep Med J

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Medication non-adherence to antiepileptic medications is detrimental to the perceived outcome of treatment. Non-adherence to medication regimen accounts for substantial worsening of disease, death and increased health care costs. In this study, we aimed to determine adherence rate to antiepileptic medications and identify the potential risk factors associated with non-adherence in Jimma University Specialized Hospital/JUSH. A hospital based cross-sectional study was conducted on 265 patients using patients self report and pharmacy refill record. The self report involved the structured patient interview after verbal informed consent was obtained. Data were analyzed using SPSS for windows version 16.0. Chi-square test was used to observe the association of variables with adherence. The adherence rate of patients (n=265) to antiepileptic drugs/AED was found to be 63.2% based on their refill records, compliant fill rate. On the basis of patient's self report for their pattern of drug use, 155 (58.5%) patients reported that they had never missed (neither daily dose nor time of taking), 78 (29.4%) missed daily dose some times, 12 (4.5%) missed only time of taking, and 7.5% (n=20) missed both time of taking and daily dose sometimes. The most common reasons for missing dose were forgetfulness (31.8%) followed by being busy (20.9%). Sedation (39.4%) was the commonest side effect faced by the patient. The rate of adherence absorbed in this study was low. Pill burden, co-morbid conditions and appointment missing were found to affect adherence. The high rate of non-adherence, in this study calls for further research and due consideration in planning appropriate strategies to improve the existing conditions. ÖzetAntiepileptik tedavilere uyulmaması tedaviden beklenen sonuca zarar verir. Tedavi rejimine uyulmaması hastalığın daha da kötüleşmesine, ölüme ve sağlık sigorta harcamalarına mal olmaktadır. Bu çalışmada antiepileptik tedavilere uyum oranını ve Jimma Üniversitesi Özelleşmiş Hastanesi/JUSH'ta tedaviye uyulmamasına bağlı potansiyel risk faktörlerini belirlemeyi amaçladık. Hastane temelli kesitsel bir çalışma 265 hastanın hasta bilgileri ve eczane ilaç kayıtları kullanılarak gerçekleştirildi. Hasta bilgileri kademeli hasta ile mülakat bilgilerini ve bilgilendirildikten sonra alınan sözlü onayı içermektedir. Veriler SPSS for Windows v.16 kullanılarak analiz edildi. Ki-kare testi uyuma bağlı değişkenlerin gözlenmesinde kullanıldı. Eczane ilaç kayıtlarına bağlı olarak ve kullanım oranları ile uyumlu olarak hastaların (n=265) antiepileptik ilaçlara tedavi uyum oranları %63.2 olarak tespit edildi. Hastaların ilaç kullanım şekli ile ilgili kendi ifadelerine göre 155 hasta (%58.5) asla doz aksatmadığını (ne günlük dozu ne de doz zamanını), 78 hasta (%29.4) günlük dozu bazen aksattığını, 12 hasta (%4.5) sadece doz alım zamanını aksattığını ve 20 hasta (%7.5) hem doz zamanını ve günlük dozu bazen aksattığını belirtmişlerdir. En sık görülen doz aksatma nedenleri unutkanlık (%31.8) ve onu takip eden işinin çok olması (%20.9) idi. Ha...

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“…There are few longitudinal studies of epilepsy in low-income and middle-income countries,11–13 and we could not find any other longitudinal epilepsy studies specifically focused on children in these settings. This is only the second study in the Asia Pacific region to assess the adequacy of seizure control over time and the perceptions and aspects of quality of life for children with epilepsy and their families; the other study was a cross-sectional study from Malaysia 14.…”

Section: Discussionmentioning

confidence: 86%

Epilepsy in Papua New Guinea: a longitudinal cohort study

Duke

Vince

2019

Arch Dis Child

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Epilepsy affects up to 1-4% of children living in low income and middle countries, however there are few studies of the problems faced by children with epilepsy in such settings. We aimed to document the situation for children with epilepsy in Port Moresby, an urban area in Papua New Guinea, a low-middle income country in the Western Pacific region. We conducted longitudinal cohort study using mixed methods, with serial data collected over 2 years which assessed seizure control, neurodevelopment, and structured interviews with children and parents. For quantitative data descriptive statistics are reported; for qualitative data common responses, themes, experiences and perceptions were grouped and reported in narrative. Forty-seven children with epilepsy were followed for a median of 18 months. Twenty six (55%) children had some associated neurodevelopmental disability. Children gave detailed and vivid descriptions of their experience of seizures. Most children and parents had a positive view of the future but faced many challenges including financial difficulties, fear of having seizures especially at school, restriction of activity that isolated them from peers, and significant stigma and discrimination. Seizure control improved over time for some children, but inconsistent supply of phenobarbitone hindered better control. Comprehensive care for children with epilepsy requires a good knowledge of the individual patient —including their seizure type and comorbidities, their family, and their strengths and vulnerabilities. Children with epilepsy face many problems that can lead to isolation, discrimination and restricted opportunities.

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Treatment of Epilepsy in Rural Ethiopia: 2 Year Follow-up

Cited by 13 publications

References 11 publications

Epilepsy in sub-Saharan Africa

Epilepsy in sub-Saharan Africa

Medication adherence in epilepsy and potential risk factors associated with non adherence in tertiary care teaching hospital in southwest Ethiopia

Epilepsy in Papua New Guinea: a longitudinal cohort study

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