Decentralized, primary-care delivered epilepsy services in Burera District, Rwanda: Service use, feasibility, and treatment

Nyirandagijimana, Beatha; Nshimyiryo, Alphonse; Mukasakindi, Hildegarde; Odhiambo, Jackline; Uwimana, Eugenie; Mukamurenzi, Valerie; Bienvenu, Robert; Ndikubwimana, Jean Sauveur; Uwamaliya, Clemence; Kundu, Priya; Park, Paul H.; Mpunga, Tharcisse; Raviola, Giuseppe; Kateera, Fredrick; Rusangwa, Christian; Smith, Stephanie L.

doi:10.1016/j.ensci.2020.100296

Cited by 2 publications

(2 citation statements)

References 21 publications

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“… 11 A task shifting model with tasks shifted from psychiatrists and other mental health specialists (belonging to the Partners in Health network) to primary care nurses in Rwanda improved the basic care of PWE. 12 Continuous specialty neurology care is often not financially or practically feasible in many parts of the world. Thus, new and innovative models are required for task sharing, education, and continuous specialty care.…”

Section: Commentarymentioning

confidence: 99%

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

Marawar

2023

Epilepsy Curr

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Section: Commentarymentioning

confidence: 99%

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

Marawar

2023

Epilepsy Curr

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“…The Rwandan Organization against Epilepsy (ROAE) drove capacity building through training of mental health physicians, nurses and psychologists in primary HCs and district hospitals as epilepsy diagnosis and management relies on their expertise [3]. A community-based healthcare insurance was developed to cover up to 90% of medical costs, if a subscription fee is paid [9].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of community health workers on identification and mobilization of persons living with epilepsy in rural Rwanda using a validated screening tool

et al. 2022

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Introduction Engagement and training of community health workers (CHWs) have demonstrated their value in different conditions. Despite repeat epilepsy trainings of CHWs in Northern Rwanda, the treatment gap remained high. We hypothesized that effectiveness of CHWs on mobilization of patients living with epilepsy (PwE) could be improved using a validated tool for epilepsy screening. Methods CHWs associated with health centers (HCs) of Gataraga, Kimonyi and Karwasa attended a 1-day training on epilepsy and Limoges epilepsy screening questionnaire (Kinyarwanda version). Thereafter, CHWs screened households in their villages for persons with one or more positive answer. CHWs then accompanied positively screened persons to a consultation for clinical evaluation and diagnosis by neurologists, and demographic data were collected. CHW variables were collected retrospectively. Results A total of 1308 persons were screened positive by 281 CHWs. Clinical diagnosis of epilepsy was confirmed in 589 and in 93 additional unscreened PwE, presenting voluntarily at the consultation. Pre-intervention number of 48 PwE increased to 682 after, a 14.2-fold increase. The overall treatment gap amounted to 93.0%. The age distribution of male PwE preponderance at younger age inverted to females at older age. CHW characteristics showed non-significant differences within and across HCs. Logistic regression did not relate CHW age, gender, and experience to screening results. Discussion Equipping CHWs with a validated screening tool was effective in identifying and mobilizing PwE in a short time frame and offers opportunity for future scaling. Nonetheless, barriers to sustainability of care will need to be addressed before.

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Decentralized, primary-care delivered epilepsy services in Burera District, Rwanda: Service use, feasibility, and treatment

Cited by 2 publications

References 21 publications

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

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

Effectiveness of community health workers on identification and mobilization of persons living with epilepsy in rural Rwanda using a validated screening tool

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