RESUMEN
BACKGROUND: Epilepsy prevalence in sub-Saharan Africa is high with a significant treatment gap. In this context, epilepsy presents substantial challenges to effective and safe reproductive and maternal healthcare. To improve this, it is important to understand the views and perceptions of healthcare professionals delivering epilepsy care to this population. METHODS: This study uses an online questionnaire which asked healthcare professionals (both from nursing and medical backgrounds) who work in sub-Saharan African countries to rate a set of pre-established options designed with the feedback of a local focus group of epilepsy experts from countries targeted. The questionnaire consisted of 21 questions and was a mix of multiple choice and Likert scale questions on managing reproductive health in women in local settings. RESULTS: Of 203 healthcare professionals respondents from over 10 countries majority were doctors (48%) or nurses (36%). The Gambia (28.6%), Nigeria (22.2%), Cameroon (13.3%) and Zambia (9.4%) accounted for nearly three-quarters of respondents. Over half (54%) felt that they have the necessary training to counsel women with epilepsy on reproductive health and pregnancy. Only 40% reported they regularly discuss family planning. Carbamazepine was reported to be the most used anti-seizure medication (ASM) for childbearing age women. Key challenges outlined were epilepsy awareness among patients and their families, information deficit on ASMs and pregnancy and access to a sufficient range of ASMs. CONCLUSION: Understanding the challenges faced by health professionals in sub-Sharan Africa, provides better comprehension of the specific "treatment-education gap" in counselling women with epilepsy on ASM risks and benefits.
RESUMEN
BACKGROUND: Mental illness is commonly comorbid with epilepsy. In sub-Saharan Africa there exists limited access to neurological and psychiatric services predisposing to a "treatment gap" in epilepsy and mental healthcare. AIMS: To understand healthcare providers' knowledge, attitudes, and management practices toward epilepsy and comorbid mental illness in sub-Saharan Africa. METHODS: A cross-sectional online survey following the STROBE guidance was conducted among healthcare providers in sub-Saharan Africa. Eleven questions looking to ascertain clinician demographics, knowledge of epilepsy, and comorbid mental illness as well as management practices were developed. FINDINGS: Of 203 responses most (92%) respondents recognized a bi-directional relationship between mental health and epilepsy. However, mental illness screening in people newly diagnosed with epilepsy was infrequently performed (14%). Only 1 in 7 (16%) respondents had high confidence in their clinical competence at managing psychiatric comorbidities. Most would value further training (74%) and improvements to be made in current management practices within their local healthcare settings (94%). CONCLUSIONS: This pilot study highlights the need to improve the awareness of management of mental disorders in populations with epilepsy within sub-Saharan Africa in health providers there.