Abstract
BackgroundEpilepsy is a common disorder in South Africa and the literature indicates that many patients do not access treatment. The reasons are complex and include a poor knowledge about causes, symptoms, diagnosis and treatment (medical knowledge). This study aimed to assess the medical knowledge of isiZulu-speaking people with epilepsy (PWE) who attend a combination regional and district hospital in the eThekwini district in KwaZulu-Natal Province.MethodThis was a prospective, cross-sectional, descriptive study. Data were collected using a validated data collection tool for assessing the medical knowledge of PWE and analysed descriptively.ResultsThe questionnaires were completed by 199 PWE, with the general level of schooling being low and half being unemployed. Knowledge around causes, symptoms, diagnosis and treatments was good, but there were significant gaps in knowledge that may affect morbidity and mortality.DiscussionThe findings will serve as a useful guide to develop both preventive and educational interventions to enhance knowledge around the causes and treatment of epilepsy in this population. It is important that such interventions also consider family and healthcare providers.ConclusionThere were considerable gaps in the medical knowledge of isiZulu-speaking PWE's, indicating the need for an educational intervention to improve their understanding of epilepsy. Further research is needed-using a range of tools to ensure that the data is reliable and valid–if the results are to be generalisable to the rest of the province and South Africa.
Highlights
Epilepsy is a common, chronic neurological disorder that affects approximately 69 million people worldwide.[1]
Chronic neurological disorder that affects approximately 69 million people worldwide.[1]. It affects individuals of all ages, ethnicities, socio-economic class and geographic location.2The prevalence is estimated as 1% of the total global population, and there are over 13 million people with epilepsy (PWE)residing in Africa.1Epilepsy is common in low-income countries, where the prevalence is more than twice that of high-income countries, possibly due to the higher incidence of risk factors.[3]
A lack of ‘medical’ knowledge was demonstrated in a large door-to-door survey in Senegal amongst 4500 people, where half reported that epilepsy is caused by evil spirits, a third said that it is contagious, and a quarter reported that traditional therapy was better than western treatment.5A lack of knowledge, including medical knowledge, underpinned by poor literacy, has been shown to contribute directly to problems associated with poor medicine regimen compliance.5As a consequence, PWE often have a lower quality of life than people with other chronic illnesses.6A systematic literature review in 2000 reported the mortality rate of PWE in Africa to be 6.2 times greater than that of the general population, with treatmentavoidance behaviour being found to be a significant contributory factor.[6]
Summary
Chronic neurological disorder that affects approximately 69 million people worldwide.[1]. The World Health Organization (WHO) estimates that, in Africa, 80% of PWE do not receive treatment, those who are disadvantaged and marginalised, despite effective treatment options being available.[4] Reasons why African patients, in particular, do not access or receive care and treatment are complex and interrelated and include: limited financial resources, poor patient-provider communication, a lack of social support for those with the condition, as well as patient, societal and healthcare provider factors.5In addition, patients and their families may lack basic ‘medical’ knowledge about causes of the disorder, as well as its symptoms, diagnosis and treatment. This study aimed to assess the medical knowledge of isiZulu-speaking people with epilepsy (PWE) who attend a combination regional and district hospital in the eThekwini district in KwaZulu-Natal Province
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