Primary care treatment of epilepsy in rural Ethiopia: causes of default from follow-up.
Seizure
; 18(2): 100-3, 2009 Mar.
Article
en En
| MEDLINE
| ID: mdl-18701322
ABSTRACT
BACKGROUND:
In 1998, we set up nurse-led epilepsy clinics in five rural health centres around Gondar in northern Ethiopia. Despite good treatment outcomes, two years after registration only 40% of patients were still under follow-up.AIM:
The purpose of this study was to examine the causes of default and factors that might improve adherence to follow-up.METHOD:
The study was carried out at one of the five health centres. Patients who had defaulted from follow-up were identified from the clinic register. Trained enumerators visited the patients' villages and administered a questionnaire to the patients, or relatives if the patient was not available.RESULTS:
113 patients were traced. 28 (25%) had died and 21 (19%) had moved from the area. Of the remaining 64 patients, seven were accessing treatment from another source and 13 were in remission off treatment. 44 patients were still experiencing seizures and were on no treatment or had reverted to traditional remedies. The main reason given for default, in 44% of the patients, was difficulty in travelling to the health centre. 12% claimed that they preferred traditional remedies and 9% felt that they had not been improved by medical treatment.CONCLUSION:
Despite decentralisation of care to rural health centres, the most common reason for default was the distance to travel to the health centre. Further decentralisation of care to a community level coupled with improved education may reduce default from follow-up.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Servicio Ambulatorio en Hospital
/
Atención Primaria de Salud
/
Servicios de Salud Rural
/
Epilepsia
/
Accesibilidad a los Servicios de Salud
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Adolescent
/
Adult
/
Aged
/
Child
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Africa
Idioma:
En
Revista:
Seizure
Asunto de la revista:
NEUROLOGIA
Año:
2009
Tipo del documento:
Article
País de afiliación:
Etiopia
Pais de publicación:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM