The epilepsy treatment gap in rural Tanzania: a community-based study in adults

Authors

• Ewan Hunter, London School of Hygiene and Tropical Medicine, UK
• Jane Rogathi, Jane Rogathi, Kilimanjaro Christian Medical University College, Tanzania
• Simukai Chigudu, Oxford University Department of International Development,UK
• Ahmed Jusabani, Aga Khan University, Tanzania
• Roger G. Whittaker, Royal Victoria Infirmary, UK
• William Gray, Rake Lane, UK
• Richard J.Q Richard J.Q.McNally,, Newcastle University, UK
• Eric Aris, Muhimbili National Hospital, Tanzania
• Declare Mushi, Kilimanjaro Christian Medical University College, Tanzania
• Richard Walker, Newcastle University, UK

Document Type

Article

Department

Imaging and Diagnostic Radiology (East Africa)

Abstract

Purpose: Most people with epilepsy (PWE) in low-income countries are not treated. We identified risk factors for the epilepsy treatment gap in rural Tanzania.

Methods: We identified adult PWE in a community-based prevalence study. Factors associated with failure to access or default from medical care were identified using logistic regression modelling.

Results: A total of 291 PWE were included, of whom 253 (86.9%) had presented to medical services. Failure to present was positively associated with using alcohol (odds ratio (OR) 4.20; 95% confidence interval (CI) 1.63 to 10.82) or attending traditional healers (OR 2.62; CI 1.00 to 6.83) and inversely associated with having completed primary education (OR 0.33; CI 0.11 to 0.96). Default from treatment was associated with being male (OR 3.35; CI 1.39 to 8.09), having a seizure-related injury (OR 2.64; CI 1.12 to 6.19), believing in a supernatural cause for epilepsy (OR 5.44; CI 1.48 to 19.94) or having no expressed knowledge of cause (OR 5.29; CI 1.60 to 17.52). Cases less likely to default had a duration of epilepsy greater than 10 years (OR 0.28; CI 0.09 to 0.90) or had previously received a seizure-related diagnosis (OR 0.25; CI 0.09 to 0.65). Of all 291 PWE included, 118 denied taking AEDs; the epilepsy treatment gap in this population was therefore 40.5% (95% CI 34.9 to 46.2).

Conclusion: Interventions to improve access to education and to support formal diagnoses may promote access to, and retention under, medical care for PWE in rural Tanzania and in other low-income countries.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Seizure

DOI

https://doi.org/10.1016/j.seizure.2016.02.008

Recommended Citation

Hunter, E., Rogathi, J., Chigudu, S., Jusabani, A., Whittaker, R. G., Gray, W., J.Q.McNally,, R. J., Aris, E., Mushi, D., Walker, R. (2016). The epilepsy treatment gap in rural Tanzania: a community-based study in adults. Seizure, 36, 49-56.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_imaging_diagn_radiol/111

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.