Decentralized, primary-care delivered epilepsy services in Burera District, Rwanda: Service use, feasibility, and treatment.

Journal: eNeurologicalSci

Volume: 22

Issue: 

Year of Publication: 

Affiliated Institutions:  Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda. Ministry of Health, Kigali, Rwanda. Partners In Health, Boston, USA.

Abstract summary 

Integrating epilepsy care into primary care settings could reduce the global burden of illness attributable to epilepsy. Since 2012, the Rwandan Ministry of Health and the international nonprofit Partners In Health have collaboratively used a multi-faceted implementation program- MESH MH-to integrate and scale-up care for epilepsy and mental disorders within rural primary care settings in Burera district, Rwanda. We here describe demographics, service use and treatment patterns for patients with epilepsy seeking care at MESH-MH supported primary care health centers.This was a retrospective cohort study using routinely collected data from fifteen health centers in Burera district, from January 2015 to December 2016. 286 patients with epilepsy completed 3307 visits at MESH-MH participating health centers over a two year period (Jan 1st 2015 to Dec 31st 2016). Men were over twice as likely to be diagnosed with epilepsy than women (OR 2.38, CI [1.77-3.19]), and children under 10 were thirteen times as likely to be diagnosed with epilepsy as those 10 and older (OR 13.27, CI [7.18-24.51]). Carbamazepine monotherapy was prescribed most frequently (34% of patients).Task-sharing of epilepsy care to primary care via implementation programs such as MESH-MH has the potential to reduce the global burden of illness attributable to epilepsy.

Authors & Co-authors:  Nyirandagijimana Beatha B Nshimyiryo Alphonse A Mukasakindi Hildegarde H Odhiambo Jackline J Uwimana Eugenie E Mukamurenzi Valerie V Bienvenu Robert R Ndikubwimana Jean Sauveur JS Uwamaliya Clemence C Kundu Priya P Park Paul H PH Mpunga Tharcisse T Raviola Giuseppe J GJ Kateera Fredrick F Rusangwa Christian C Smith Stephanie L SL

Study Outcome 

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Statistics
Citations :  Ba-Diop A., Marin B., Druet-Cabanac M., Ngoungou E.B., Newton C.R., Preux P.-M. Epidemiology, causes, and treatment of epilepsy in sub-Saharan Africa. Lancet Neurol. 2014 Oct;13(10):1029–1044.
Authors :  16
Identifiers
Doi : 100296
SSN : 2405-6502
Study Population
Men,Women
Mesh Terms
Other Terms
Epilepsy;Health systems research;Mental health;Neurology;Operational research;Primary care integration
Study Design
Cohort Study
Study Approach
Country of Study
Rwanda
Publication Country
Netherlands