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Objectives: To close the epilepsy treatment gap and reduce related stigma, eradication of misconceptions is importantIn 2014, Community Health Workers (CHWs) from Musanze (Northern Rwanda) were trained on different aspects of epilepsy. This study compared knowledge, attitude and practices (KAPs) towards epilepsy of trained CHWs 3 years after training, to untrained CHWs from Rwamagana (Eastern Rwanda).Methods: An epilepsy KAP questionnaire was administered to 96 trained and 103 untrained CHWs. Demographic and intergroup KAP differences were analysed by response frequencies. A multivariate analyses was performed based on desired and undesired response categories.Results: Epilepsy awareness was high in both groups, with better knowledge levels in trained CHWs. Negative attitudes were lowest in trained CHWs, yet 17% still reported misconceptions. Multivariate analysis demonstrated the impact of the training, irrespective of age, gender and educational level. Knowing someone with epilepsy significantly induced more desired attitudes.Conclusion: Despite demographic differences between trained and untrained CHWs, a single epilepsy training resulted in significant improvement of desired KAPs after 3 years. Nation-wide CHW training programs with focus on training-resistant items, e.g., attitudes, are recommended.

Background Depression is more prevalent in medically ill patients than in the general population. More is not known about depression rates in internal medicine outpatients consulting the teaching hospitals in Rwanda. Adults with medical diseases are more likely to develop depression, it is an often-unrecognized co-morbidity in this group, and it has a major impact on their function and disability. In the absence of studies in our region, we did this research in our country with interest in what factors might be associated with depressive symptoms. Methods The descriptive cross-sectional study was used to determine the prevalence of depression and associated factors among internal medicine outpatients of Kigali university teaching hospital (CHUK). The 9 items Patient Health Questionnaire (PHQ-9) instrument was used to screen depression symptoms among outpatients. The validated cut-off score of 10 for diagnosing depression was applied in this study. Patients’ clinical and socio-demographic characteristics were collected and analyzed for their relationship with depression. All patients who scored PHQ-9 above 10 were referred to CHUK mental health department for appropriate management. Results Three hundred patients were recruited, of whom 65.3%) were females and 51% had an age between 45 and 96 years. The overall prevalence of depression among outpatients in the internal medicine department of CHUK was 45.7%. Outpatients had 20.7%, 17%, and 10% for moderate, moderately severe, and severe depression, respectively. Age, educational status, and follow-up visits as current physical complaints were independently associated with depression (P < 0.05). As much as 22.7% of patients were presenting with Suicidal ideas. The study showed that low income was strongly associated with suicide ideation (P < 0.001). Regardless of age and gender, the prevalence of depression was higher among outpatients of internal medicine than the general population. Conclusions A holistic approach in the management of internal medicine outpatients should be implemented to facilitate the early detection and treatment of depression in general tertiary hospitals. Furthermore, intervention programs that address depression and suicide in adults are needed.

IntroductionThe World Health Organization reported that one third of global population was tobacco smoker. In countries with a high tuberculosis burden, a big proportion was attributed to tobacco smoking. In the general population of Rwanda, the prevalence of tobacco smoking was higher among males (14%) compared to females (3%). We conducted a second analysis to assess factor associated with tobacco smoking among patient with TB attending Health Facilities.MethodologyA retrospective case-control study in Centres of Diagnosis and Treatment of tuberculosis (CDT). Cases were patients with bacteriological TB confirmation; controls were persons with signs and symptoms without TB confirmation. Proportions and logistic regression were used in data analysis.ResultsThe total number of tobacco smokers was 680. Among tobacco smokers, 88.1% tobacco smokers were males, 94.3% tobacco smokers had at least 25 years old and 64.6% were living in union. By education, 84.9% tobacco smokers were illiterate or attained primary school. Almost all tobacco smokers (97.0%) ever drunk alcohol while 67.9% used illicit drugs and 25.3% had low BMI (≤ 18.5) with increased proportion among cases (29.1%). A proportion of 38.3% in tobacco smokers had history of imprisonment. In multivariable logistic regression data analysis, males compared to females (aOR = 3.49[95%CI:1.76–6.94]), ever drunk alcohol compared to never drank alcohol (aOR = 6.39[95%CI:2.67–15.31]) and ever used illicit drugs compared to never used illicit drugs (aOR = 9.89[95%CI:3.87–25.25]) were associated with high odds of tobacco smoking. In addition, illiterate people or people who attained only primary school education level compared to people having primary education level and above (aOR = 0.39[95%CI:0.23–0.69]) were associated with low odds of tobacco smoking.ConclusionTobacco smoking is common in pulmonary TB patients. Males were more likely using tobacco smoking compared to females. Alcohol drinkers and illicit drug users were associated to tobacco smoking. A campaign on tobacco cessation, focusing on males, should be conducted in the general population starting by people on TB treatment.