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Hospital-based epilepsy care in Uganda: A prospective study of three major public referral hospitals.

Publication ,  Journal Article
Fuller, AT; Almojuela, A; Kaddumukasa, MN; Chakraborty, P; Smith, PJ; Kolls, BJ; Van Belleghem, F; Muhumuza, C; Nshemerirwe, S; Kaddumukasa, M ...
Published in: Epilepsy Behav
January 2021

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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".

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Published In

Epilepsy Behav

DOI

EISSN

1525-5069

Publication Date

January 2021

Volume

114

Issue

Pt B

Start / End Page

107301

Location

United States

Related Subject Headings

  • Uganda
  • Referral and Consultation
  • Quality of Life
  • Prospective Studies
  • Neurology & Neurosurgery
  • Humans
  • Hospitals
  • Female
  • Epilepsy
  • Child
 

Citation

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Fuller, A. T., Almojuela, A., Kaddumukasa, M. N., Chakraborty, P., Smith, P. J., Kolls, B. J., … Koltai, D. C. (2021). Hospital-based epilepsy care in Uganda: A prospective study of three major public referral hospitals. Epilepsy Behav, 114(Pt B), 107301. https://doi.org/10.1016/j.yebeh.2020.107301
Fuller, Anthony T., Alysa Almojuela, Martin N. Kaddumukasa, Payal Chakraborty, Patrick J. Smith, Brad J. Kolls, Florence Van Belleghem, et al. “Hospital-based epilepsy care in Uganda: A prospective study of three major public referral hospitals.Epilepsy Behav 114, no. Pt B (January 2021): 107301. https://doi.org/10.1016/j.yebeh.2020.107301.
Fuller AT, Almojuela A, Kaddumukasa MN, Chakraborty P, Smith PJ, Kolls BJ, et al. Hospital-based epilepsy care in Uganda: A prospective study of three major public referral hospitals. Epilepsy Behav. 2021 Jan;114(Pt B):107301.
Fuller, Anthony T., et al. “Hospital-based epilepsy care in Uganda: A prospective study of three major public referral hospitals.Epilepsy Behav, vol. 114, no. Pt B, Jan. 2021, p. 107301. Pubmed, doi:10.1016/j.yebeh.2020.107301.
Fuller AT, Almojuela A, Kaddumukasa MN, Chakraborty P, Smith PJ, Kolls BJ, Van Belleghem F, Muhumuza C, Nshemerirwe S, Kaddumukasa M, Nakasujja N, Nakku J, Kakooza-Mwesige A, Haglund MM, Koltai DC. Hospital-based epilepsy care in Uganda: A prospective study of three major public referral hospitals. Epilepsy Behav. 2021 Jan;114(Pt B):107301.
Journal cover image

Published In

Epilepsy Behav

DOI

EISSN

1525-5069

Publication Date

January 2021

Volume

114

Issue

Pt B

Start / End Page

107301

Location

United States

Related Subject Headings

  • Uganda
  • Referral and Consultation
  • Quality of Life
  • Prospective Studies
  • Neurology & Neurosurgery
  • Humans
  • Hospitals
  • Female
  • Epilepsy
  • Child