Prevalence Of Epilepsy And General Knowledge About Neurocysticercosis At Ngangelizwe Location, South Africa

Abstract

Fifteen medical students from the University of Transkei divided into 5 groups were sent to make a community diagnosis of the Ngangelizwe community. The main goal was to evaluate the socio-economic status of the community, to identify major risk factors in the community, to find out the prevalence of epilepsy, and investigate the level of knowledge about neurocysticercosis and HIV/AIDS in the community. Setting: The Ngangelizwe community, is located at 6 km away from Mthatha (Capital of the former Transkei) being the closer to others locations investigated previously such as: Sidwadweni, Nkalukeni, Ngqwala, Kwandugwane and Makaula locations Design: A two-stage design study was used. The first stage involved screening of the general population on door-to-door basis by interviewing peoples living in 100 households selected by block-randomisation procedure, and using an internationally validated questionnaire for detecting epilepsy and knowledge about other associated diseases. The second stage consisted of a neurological assessment of the peoples who screened positive. The questionnaire covered four main areas: Demographics and Socio-economics; Main Risk Factors; Health Services, Traditional Medicine; and Knowledge about neurocysticercosis and epilepsy. Results: A total of 2341 adults were screened. The prevalence of active epilepsy in these adults was 13.8/1000. Only 14.7% of epileptic patients were under regular anti-epileptic treatment, 100% of the total population had not idea about NCC, and 28% did not know the cause of AIDS. Our findings revealed that Ngangeliswe village was a low socio-economic area. Level of unemployment was high, incomes were low, education level was mostly to high school, and housing was mostly of poor quality and crowded. There was a problem with the supply of water in the area. Few people actually boiled their water. There was much indoor pollution from cooking. Toilets were unhygienic and there were no flush toilets. Food storage was a risk for diseases as there was no electricity. Many people still prefer traditional healers rather than medical doctors and one of the reasons that we found surveying this community was language barrier because all doctor working at the clinic are not from the former Transkei therefore they do not speak the native language (isiXhosa) and many patients do not speak English, although good support for translation is getting from the native nurses the necessary privacy for affording some health problems like epilepsy is absent. Conclusions: The prevalence of epilepsy is high compared with a similar location but a poor utilization of anti-epileptic treatment is cause for concern. Poor communication and the stigma of epilepsy make it a more difficult problem to treat. NCC and HIV/AIDS awareness campaign at the rural locations in the former Transkei should be made as soon as possible while permanent solutions are implemented.