Hospital-based epilepsy care in Uganda: A prospective study of three major public referral hospitals.
Journal: Epilepsy & behavior : E&B
Volume: 114
Issue: Pt B
Year of Publication: 2021
Affiliated Institutions:
Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box Duke University Medical Center, Durham, NC , USA; Duke Global Health Institute, Trent Dr, Durham, NC , USA; Duke University, School of Medicine, Durham, NC, USA.
Section of Neurosurgery, Rady Faculty of Health Sciences, University of Manitoba, GB- Sherbrook Street, Health Sciences Centre, Winnipeg, MB RA R, Canada.
Department of Medicine, Mulago National Referral Hospital, Neurology Unit, Kampala, Uganda; School of Medicine, College of Health Sciences, Makerere University, P.O. Box , Kampala, Uganda.
Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box Duke University Medical Center, Durham, NC , USA; Duke Global Health Institute, Trent Dr, Durham, NC , USA.
Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, DUMC Box , Trent Drive, Durham, NC, USA.
Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box Duke University Medical Center, Durham, NC , USA; Duke University School of Medicine, Department of Neurology, Durham, NC, USA; Duke Clinical Research Institute, Neuroscience Medicine, W Morgan St, Durham, NC , USA.
Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box Duke University Medical Center, Durham, NC , USA; Department of Medicine, Group Biomedical Sciences, KU Leuven, Belgium.
Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box Duke University Medical Center, Durham, NC , USA; Makerere University School of Public Health, Department of Epidemiology and Biostatistics, Mulago Complex, P.O. Box , Kampala, Uganda.
Butabika National Referral Mental Hospital, P.O. Box , Kampala, Uganda.
School of Medicine, College of Health Sciences, Makerere University, P.O. Box , Kampala, Uganda.
Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences, P.O. Box , Kampala, Uganda.
Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Mulago Hill Road, P.O. Box , Kampala, Uganda; Department of Paediatrics and Child Health, Mulago National Referral Hospital, Pediatric Neurology Unit, Kampala, Uganda.
Duke Division of Global Neurosurgery and Neurology, Department of Neurosurgery, Box Duke University Medical Center, Durham, NC , USA; Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, DUMC Box , Trent Drive, Durham, NC, USA; Duke University School of Medicine, Department of Neurology, Durham, NC, USA. Electronic address: koltai@duke.edu.
Abstract summary
This study sets out to describe the current demographics of people with epilepsy (PWE) attending hospital-based care in Uganda and the epilepsy treatment practices within three of the largest Ugandan public referral hospitals.In a six-month prospective cohort study, 626 children and adults attending epilepsy clinics at Mulago National Referral Hospital, Butabika National Referral Mental Hospital and Mbarara Regional Referral Hospital were enrolled. Using a study questionnaire, data were collected at baseline and at 3 weeks, 3 months, and 6 months following enrollment. Specific data surrounding individual patient demographics, clinical characteristics and severity of epilepsy, and treatment of epilepsy with antiepileptic drugs (AEDs) were collected.Female patients totaled to 50.8%, with a nearly equal gender distribution at each hospital. There was no statistical difference in gender or age between sites. The majority of PWE had completed primary school, with less than 15% of patients completing more than a secondary education. Seizure severity was high, with most patients having multiple seizures per week at the initial onset of epilepsy, and greater than 90% of patients reporting a loss of consciousness with seizures. The majority of patients (54.95%) also reported a developmental or learning delay. Most patients were on 1 AED (46.01%) or 2 AEDs (36.90%), with carbamazepine being the most frequently prescribed AED. There was a trend towards improved seizure severity over the follow-up period, as assessed by the corresponding Personal Impact of Epilepsy Scale (PIES) subscale.People with epilepsy attending hospital-based care in Uganda tend to have severe forms of epilepsy requiring management with AEDs. Current hospital-based practices show a positive trend for seizure burden and quality of life of PWE in Uganda. Further interventions to improve overall access to biomedical care are required to continue to advance the management of PWE across all communities. This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda".
Authors & Co-authors:
Fuller Anthony T AT
Almojuela Alysa A
Kaddumukasa Martin N MN
Chakraborty Payal P
Smith Patrick J PJ
Kolls Brad J BJ
Van Belleghem Florence F
Muhumuza Christine C
Nshemerirwe Sylvia S
Kaddumukasa Mark M
Nakasujja Noeline N
Nakku Juliet J
Kakooza-Mwesige Angelina A
Haglund Michael M MM
Koltai Deborah C DC
Study Outcome
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