Unlocking the hidden burden of epilepsy in Africa: Understanding the challenges and harnessing opportunities for improved care

Abstract

Background: Epilepsy is a common neurological disorder that affects many people in Africa, yet the burden of the disease is often hidden. The management of epilepsy in Africa is often inadequate due to a lack of awareness and education, limited access to diagnostic tools and treatments, inadequate coordination of care, and the stigma associated with the condition.Method: A comprehensive literature review was conducted to gather information on the epidemiology, diagnosis, management, and outcomes of epilepsy in Africa. The review included studies from peer-reviewed journals, government reports, and gray literature. Results:The review revealed a high burden of epilepsy in Africa. The studies also showed a significant gap in the availability and accessibility of diagnostic tools, antiepileptic drugs, and specialized therapies such as physical, occupational, and speech therapy. Additionally, the review found that cultural beliefs and practices, socioeconomic factors such as poverty and lack of access to healthcare, and the stigma associated with the condition, also pose significant challenges to managing epilepsy in Africa. Conclusion:The study highlights the urgent need for improved epilepsy management in Africa. Additionally, the study calls for further research on epilepsy in Africa and collaboration between all stakeholders to improve the management of epilepsy in Africa.

An Overview of The Harmful Cultural Practices on Epilepsy in Sub-Saharan Africa and Their Impact on Its Clinical Management

“…In Nigeria, the estimated prevalence of epilepsy was reported to be approximately 8 per 1000 people (9) , similar to findings in Uganda, with a slightly higher prevalence of 10.3 per 1000 (10). Tanzania has a relatively higher prevalence rate of 10% than Ghana, with an estimated prevalence of 7.9% (8).…”

“…The burden of epilepsy in Africa has also been found to have a bimodal distribution, higher among children and elderly individuals. A higher prevalence and incidence rate have also been found in rural areas compared to urban areas of low-and middle-income countries, due to a lack of access to needed healthcare services as well as a lack of awareness of the disease conditions (8). The epidemiology of epilepsy in Africa varies widely across countries and populations studied.…”

“…In terms of incidence, studies have reported rates ranging from 20 to 50 per 100,000 people per year in different African countries. For example, Ghana has an estimated incidence of 40 per 100,000 people per year, whereas Ethiopia has an estimated incidence of 30 per 100,000 people per year (8). Nigeria and South Africa have close-range estimated incidence rates of 27 and 25 cases per 100,000 people per year, respectively (8).…”

Epilepsy in Africa: a multifaceted perspective on diagnosis, treatment, and community support

“…Epilepsy has significant cultural and social impacts in Africa. Due to superstitions and cultural beliefs, epilepsy is often stigmatized and misunderstood in many African communities 24 . People with epilepsy are seen as possessed by evil spirits or witches, which can lead to discrimination and exclusion from society 25 .…”

Interventions connecting young people living in Africa to healthcare; a systematic review using the RE-AIM framework

“…Barriers to linking to care in Africa are multilayered and encompass a range of factors that hinder individuals from accessing and utilizing healthcare services. These barriers include fear of judgmental attitudes of healthcare workers ( 23 ), lack of time to access a clinic ( 24 ), lack of standardization and consistency in defining “linkage to care” ( 25 ), stigma associated with Health facilities ( 26 , 27 ), service efficiency, poor provider-patient interactions, and lack of patient incentives ( 28 ), lack of accessible transportation ( 28 ), limited health insurance coverage ( 29 ), and socioeconomic factors such as poverty and lack of access to healthcare ( 30 ). Barriers also include the disparities between rural and urban healthcare, insufficient infrastructure, and the absence of programs for rural practice exposure, contributing to the obstacles ( 31 ).…”