Epilepsy treatment gap: prevalence and associated factors in Southeast Nigeria

Nwani, Paul; Nwosu, MC; Enwereji, Kelechi O.; Asomugha, A. L.; Arinzechi, E. O.; Ogunniyi, Adesola

doi:10.1111/ane.12096

Cited by 28 publications

(43 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The treatment gap of 68% in our survey while high is relatively similar to those reported from recent studies across Sub-Saharan Africa, notably 70% in Kenya [14] and 76% in Southeast Nigeria [20]. In a study from Tanzania, the treatment gap was 76%, rising to 86% among patients with active epilepsy [21].…”

Section: Discussionsupporting

confidence: 87%

Addressing the treatment gap and societal impact of epilepsy in Rwanda — Results of a survey conducted in 2005 and subsequent actions

Sebera

Munyandamutsa

Teuwen

et al. 2015

Epilepsy & Behavior

View full text Add to dashboard Cite

This study, supported by the Rwandan Ministry of Health and the World Health Organization, was conducted in 2005 to determine the prevalence of epilepsy and its sociocultural perception in Rwanda, as well as epilepsy-related knowledge and practices of health-care professionals (HCPs). A cross-sectional, nationally representative survey was conducted throughout Rwanda by trained investigators. Participants were recruited by random cluster sampling based on the organization of administrative units in the country. Overall, 1137 individuals (62% from rural areas) were interviewed. The prevalence of epilepsy was estimated to be 49 per 1000 people or 41 per 1000 for active epilepsy. Onset of epilepsy before the age of 2 years was reported in 32% of the cases. Family history of epilepsy, head trauma, and premature delivery were reported in 53%, 50%, and 68% of the cases, respectively. Most (68%) patients did not receive any medical treatment for epilepsy; 21.5% had received some form of traditional treatment. According to responses from the general population, people with epilepsy should not be entitled to schooling (according to 66%), to work (according to 72%), to the use of public places (according to 69%), or to marriage (according to 66%). Furthermore, 50% believed that epilepsy was untreatable, and 40% thought that it was transmissible. Of the 29 HCPs interviewed, the majority knew the definition of epilepsy and status epilepticus, as well as basic treatment options and side effects. However, 90% believed that treatment was only necessary in the first week after a seizure. Living with epilepsy was associated heavily with stigma, and a significant treatment gap (68%) was identified. Following this study, numerous actions have been taken by the Rwandan government, the Rwandan League Against Epilepsy, and several nongovernmental organizations to increase awareness about epilepsy and to close the treatment gap. An overview of these activities is provided.

show abstract

Section: Discussionsupporting

confidence: 87%

Addressing the treatment gap and societal impact of epilepsy in Rwanda — Results of a survey conducted in 2005 and subsequent actions

Sebera

Munyandamutsa

Teuwen

et al. 2015

Epilepsy & Behavior

View full text Add to dashboard Cite

show abstract

“…The overall epilepsy treatment gap in Southeast Nigeria was found to be 76%, and the major contributors to the overall treatment gap were people who were never diagnosed, accounting for a diagnostic gap of 38%, and those who were diagnosed but who discontinued antiepileptic drug treatment of their own volition, accounting for a therapeutic gap of 38%. The epilepsy treatment gap in Southeast Nigeria is comparable to that in many other developing countries (Nwani et al, 2013).…”

Section: Global Disparities In the Epilepsy Treatment Gapmentioning

confidence: 83%

Treatment gaps of epilepsy and retention rates of sodium valproate in rural Guangxi, China

et al. 2014

View full text Add to dashboard Cite

ABSTRACT. This study aimed to investigate the prevalence and treatment gaps of epilepsy, as well as the clinical effects, drug safety, and retention rates of sodium valproate (VPA) for treating epilepsy. Physicians received supervised training to use the survey form recommended by the Chinese Association Against Epilepsy while screening for suspected or confirmed epilepsy cases. These cases were ultimately enrolled in the study by neurologists. Enrolled patients were given a year of free VPA treatment so that its efficacy and adverse effects during the follow-up period could be evaluated. In total, 302 patients were enrolled in this study, which included 189 males and 113 females. Among these cases, 179 (59.27%) were confirmed to have generalized seizures, 162 (53.6%) had tonic-clonic seizures, 10 (3.3%) had absence seizures, and 123 (40.72%) had partial seizures. Only 63 patients had received regular treatments 1 week before enrollment, with a treatment gap of 79.1%. The retention rates during the 6th, 12th, 18th, and 24th months were 100, 93.56, 89.05, and 77.06%, respectively. During the 1-year follow-up period, 30 cases encountered mild adverse effects, but no severe adverse reactions were reported. A large treatment gap for epilepsy still existed in the rural areas of southern China, with few adverse effects and high

show abstract

“…In a rural African community, the mean duration of epilepsy before receiving evidence-based biomedical treatment was six and half years [18]. The simultaneous use of biomedical and traditional treatments for epilepsy has been found to be commonplace [19, 20]. A reliance upon traditional healing approaches has also been observed in Ethiopia [21].…”

Section: Introductionmentioning

confidence: 99%

Help seeking and suicidality among people with epilepsy in a rural low income country setting: cross-sectional survey

Tsigebrhan

Hanlon

Medhin

et al. 2017

Int J Ment Health Syst

View full text Add to dashboard Cite

BackgroundsEpilepsy is a serious neurological disorder associated with a high level of psychiatric comorbidity. Suicidality is a recognised complication of epilepsy. As part of developing an integrated service for people with epilepsy (PWE) and priority psychiatric disorders within primary care, a cross-sectional study was conducted in a rural district in Ethiopia to investigate patterns of help-seeking, suicidality and the association with duration of untreated epilepsy (DUE) among PWE.MethodsCases were identified through community key informants and diagnosis was confirmed by trained primary care clinicians. Severity of epilepsy, depression and suicidality were assessed using standardised methods. Multivariable regression analysis was used to test the hypothesis that suicidality was associated with DUE.ResultsThe majority of PWE sought help from both religious and biomedical healing centres. The lifetime treatment gap for biomedical care was 26.9%, with a 12 month treatment gap of 56.7%. Close to one-third (29.9%) of participants reported using traditional and cultural healing practices. Nearly one-third (30.2%) of participants reported suicidality (suicidal ideation, plan or attempt) in the previous 1 year. The median (IQR) DUE was 24 months (4–72). There was no association between DUE and suicidality. In the multivariable model, being married [odds ratio (OR) 2.81, 95% CI 1.22, 6.46], increased depressive symptoms (OR 1.17, 95% CI 1.10, 1.26) and perceived poorer wealth relative to others (OR 2.67, 95% CI 1.07, 6.68) were associated independently with suicidality.ConclusionIn this study, PWE sought help from both biomedical and religious healing centres. Suicidality and depression have a high prevalence in PWE in this setting. Integrated mental and neurological health care within primary care is needed for improved holistic management of epilepsy.

show abstract

Epilepsy treatment gap: prevalence and associated factors in Southeast Nigeria

Cited by 28 publications

References 19 publications

Addressing the treatment gap and societal impact of epilepsy in Rwanda — Results of a survey conducted in 2005 and subsequent actions

Addressing the treatment gap and societal impact of epilepsy in Rwanda — Results of a survey conducted in 2005 and subsequent actions

Treatment gaps of epilepsy and retention rates of sodium valproate in rural Guangxi, China

Help seeking and suicidality among people with epilepsy in a rural low income country setting: cross-sectional survey

Contact Info

Product

Resources

About