Abstract
Objectives: To close the epilepsy treatment gap and reduce related stigma, eradication of misconceptions is importantIn 2014, Community Health Workers (CHWs) from Musanze (Northern Rwanda) were trained on different aspects of epilepsy. This study compared knowledge, attitude and practices (KAPs) towards epilepsy of trained CHWs 3 years after training, to untrained CHWs from Rwamagana (Eastern Rwanda). Methods: An epilepsy KAP questionnaire was administered to 96 trained and 103 untrained CHWs. Demographic and intergroup KAP differences were analysed by response frequencies. A multivariate analyses was performed based on desired and undesired response categories. Results: Epilepsy awareness was high in both groups, with better knowledge levels in trained CHWs. Negative attitudes were lowest in trained CHWs, yet 17% still reported misconceptions. Multivariate analysis demonstrated the impact of the training, irrespective of age, gender and educational level. Knowing someone with epilepsy significantly induced more desired attitudes. Conclusion: Despite demographic differences between trained and untrained CHWs, a single epilepsy training resulted in significant improvement of desired KAPs after 3 years. Nation-wide CHW training programs with focus on training-resistant items, e.g., attitudes, are recommended.
Highlights
Epilepsy is a common chronic neurological disorder affecting people of all ages
Most participants had heard of epilepsy, yet significantly different favouring the trained group, with only one Community Health Workers (CHW) in the trained group A not able to recall epilepsy as a disease, 3 years after training (Table 3)
Of interest is that over 85% of untrained CHWs had witnessed a seizure indicating good familiarity with seizures or patients living with epilepsy (PwE)
Summary
Epilepsy is a common chronic neurological disorder affecting people of all ages. Up to 80% of the 70 million people living with epilepsy (PwE) in the world live in low- and middle-income countries [1].In sub-Saharan Africa (SSA), epilepsy is associated with a high “triple” burden of disease. Epilepsy is a common chronic neurological disorder affecting people of all ages. Up to 80% of the 70 million people living with epilepsy (PwE) in the world live in low- and middle-income countries [1]. In sub-Saharan Africa (SSA), epilepsy is associated with a high “triple” burden of disease. High prevalence is the first burden, often secondary to treatable or avoidable causes such as infectious. Community Health Worker Training Impact diseases, limited perinatal care, and traumatic brain injury [2,3,4,5,6]. In a meta-analysis of SSA community-based door-to-door surveys the prevalence of active epilepsy is estimated at 9.0‰ and lifetime epilepsy at 16‰, which is much higher compared to High Income Countries or Latin America and Asia [7]. In Rwanda, prevalence of 49‰ reported in 2005 greatly exceeds the SSA prevalence and was recently re-confirmed by a door-todoor survey in three villages of Musanze district in the Northern province in 2017 [5]
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