Quality of life among patients living with epilepsy attending the neurology clinic at kenyatta national hospital, Nairobi, Kenya: a comparative study

Abstract

BackgroundMost of the studies on epilepsy in Kenya and indeed the sub-Saharan region of Africa mainly focus on prevalence, psychiatric profile, and factors associated with increased seizure burden. This being the first Kenyan and sub-Saharan African study assessing quality of life among people living with epilepsy, it will identify their ‘intangible’ needs and enable evidence-based intervention that would ultimately lead to a comprehensive management and better outcome.MethodsDesign: A cross-sectional comparative study, using the World Health Organization Quality of Life questionnaire, a socio-demographic questionnaire, seizure burden and characteristics, drug and treatment profile questionnaires and the Mini-Mental state examination, among PLWE and those accompanying them, herein referred to as the normal healthy controls, attending the neurology clinic at Kenyatta National Hospital, Nairobi.Setting and subjects: Study was carried out between October 2006 and February 2007 at the neurology clinic in the hospital where three hundred consecutive subjects who satisfied the inclusion criteria and gave consent were recruited.Statistical tests used: Descriptive statistics were used to compute means, standard deviations as well as frequencies. Significance of associations was tested using the Chi square test statistic (x2), an independent samples t-test, analysis of variance (ANOVA) and a step-wise (forward) regression analysis. A p < 0.05 was considered statistically significant.ResultsThe mean quality of life among people living with epilepsy (49.90%) was significantly (p < 0.01) lower than that of the normal controls (77.60%) accompanying them and significantly impaired as compared to the hypothesized mean of 75±2.5%. Factors significantly (p < 0.05) associated with impairment of quality of life in those living with epilepsy were a low level of education, higher seizure burden, low annual income, unemployment, unskilled employment, and living in a rural residence.ConclusionsThe mean quality of life of people living with epilepsy at Kenyatta National Hospital was significantly impaired and lower than that of the normal controls accompanying them. A comprehensive epilepsy management program is recommended to address this problem and its associated risk factors for the people living with epilepsy in Kenya.

Health-related quality of life and its determinants among ambulatory patients with epilepsy at Ambo General Hospital, Ethiopia: Using WHOQOL-BREF

“…The current study disclosed that being single or divorced, uncontrolled seizure & low level of education [14,17,26,27,43], and poly-pharmacy were independent predictors for low HRQOL scores of social health. This finding was congruent with previous studies [14,24]. Besides this, patients who had Poly-pharmacy might have adverse effects and un-affordability issue which can negatively affect the HRQOL score [27,44].…”

“…Hence, during convulsion peoples are unwilling to help or to touch the person who has fallen during a seizure (lack of support during an emergency from the community) [1,2]. Due to earlier mentioned reason and the need for regular medications, their side effects and also due to prejudices and social conventions that surround it, epilepsy can affect the Health-related Quality of Life (HRQOL) negatively [14]. Furthermore, the appearance of psychosocial and medical barriers that promote less opportunity for education, lower school performance, less employment, lower annual income, low self-esteem, feelings of shame and guilt, and less marriage which hinders the involvement of patients with epilepsy (PWE) in full social life compared with individuals without epilepsy [6,[15][16][17][18].…”

“…Some of the contributing factors for poor HRQOL in PWE were: un-controlled seizure, high prevalence of psychiatric disorder (depression and anxiety) [22,23], old age, different socio-demographic factors, Poly-pharmacy [14,17,[24][25][26][27] and being chronic disease [19]. In addition, a high rate of uncontrolled seizure in LMICs (up to 64.4%) [28][29][30] than high-income countries (up to 36.3%) [31] may be contributing factors for poor HRQOL in this population.…”

Quality of life of depressed and suicidal patients seeking services from traditional and faith healers in rural Kenya

“…Similarly, some countries such as Israel, Turkey and Romania have reported marginal Cronbach’s α in the environmental domain [56]. Changes in Cronbach’s α have not been reported in other studies [1, 22, 34, 48]. Furthermore, this tool is derived from the WHOQOL-100 which was developed as part of a large cross-cultural initiative, and hence is likely to provide a relatively robust measure of QoL in different settings [52].…”

Burden of epilepsy in rural Kenya measured in disability‐adjusted life years

“…Epilepsy is common in low and middle income countries (LMICs), and is associated with considerable mortality and morbidity and poor quality of life . The treatment gap (the proportion of people with epilepsy [PWE] who do not receive appropriate treatment) is large (31–100%), especially in LMICs …”