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Barriers to biomedical care for people with epilepsy in Uganda: A cross-sectional study.

Publication ,  Journal Article
Kaddumukasa, MN; Kaddumukasa, M; Kajumba, M; Smith, PJ; Bobholz, S; Kakooza-Mwesige, A; Sinha, DD; Almojuela, A; Chakraborty, P; Nakasujja, N ...
Published in: Epilepsy Behav
January 2021

OBJECTIVE: Epilepsy, a neurological disorder with effective biomedical treatment, remains largely untreated in Uganda. Potential reasons for this treatment gap (TG) include limited access to trained providers and clinics, social stigmata of seizures, cultural beliefs, or lack of public understanding of epilepsy as a treatable condition. The current study aimed to formally evaluate barriers faced by people with epilepsy (PWE) in Uganda when seeking biomedical care. METHODS: In a cross-sectional study, 435 participants drawn from a community prevalence study were enrolled. We included participants reporting a history of recurrent seizures suggestive of epilepsy, who completed a survey about barriers to obtaining care for their symptoms. Principal axis factor analysis (PFA) using a promax rotation was conducted for data reduction. Frequencies of barrier factors were compared across those who did not seek care for epilepsy (n = 228), those who sought care from biomedical facilities (n = 166), and those who sought care from a traditional or pastoral healer (n = 41). RESULTS: The PFA yielded a five-factor solution: 1) logistical and actual costs; 2) treatment effectiveness; 3) influence of the opinion of others; 4) doctors' care; and 5) contextual factors impacting decision-making. Variables related to logistical and actual costs were most endorsed. Comparison of groups by care sought did not reveal a difference in endorsement of factors, with the exception that those who sought biomedical care were more likely to endorse factors related to doctors' care compared with those that sought care from traditional or pastoral healers (P = .005). CONCLUSIONS: People with repetitive seizures in Uganda report several barriers to obtaining biomedical care in Uganda, with those related to practical and actual costs endorsed the most. It is imperative that interventions developed to reduce the TG in Uganda consider these practical issues to improve access to effective epilepsy care. 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

107349

Location

United States

Related Subject Headings

  • Uganda
  • Surveys and Questionnaires
  • Neurology & Neurosurgery
  • Humans
  • Epilepsy
  • Cross-Sectional Studies
  • 5203 Clinical and health psychology
  • 5202 Biological psychology
  • 3209 Neurosciences
  • 1103 Clinical Sciences
 

Citation

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Kaddumukasa, M. N., Kaddumukasa, M., Kajumba, M., Smith, P. J., Bobholz, S., Kakooza-Mwesige, A., … Koltai, D. C. (2021). Barriers to biomedical care for people with epilepsy in Uganda: A cross-sectional study. Epilepsy Behav, 114(Pt B), 107349. https://doi.org/10.1016/j.yebeh.2020.107349
Kaddumukasa, Martin N., Mark Kaddumukasa, Mayanja Kajumba, Patrick J. Smith, Samuel Bobholz, Angelina Kakooza-Mwesige, Drishti D. Sinha, et al. “Barriers to biomedical care for people with epilepsy in Uganda: A cross-sectional study.Epilepsy Behav 114, no. Pt B (January 2021): 107349. https://doi.org/10.1016/j.yebeh.2020.107349.
Kaddumukasa MN, Kaddumukasa M, Kajumba M, Smith PJ, Bobholz S, Kakooza-Mwesige A, et al. Barriers to biomedical care for people with epilepsy in Uganda: A cross-sectional study. Epilepsy Behav. 2021 Jan;114(Pt B):107349.
Kaddumukasa, Martin N., et al. “Barriers to biomedical care for people with epilepsy in Uganda: A cross-sectional study.Epilepsy Behav, vol. 114, no. Pt B, Jan. 2021, p. 107349. Pubmed, doi:10.1016/j.yebeh.2020.107349.
Kaddumukasa MN, Kaddumukasa M, Kajumba M, Smith PJ, Bobholz S, Kakooza-Mwesige A, Sinha DD, Almojuela A, Chakraborty P, Nakasujja N, Nakku J, Gualtieri A, Onuoha E, Kolls BJ, Muhumuza C, Smith CE, Sanchez N, Fuller AT, Haglund MM, Koltai DC. Barriers to biomedical care for people with epilepsy in Uganda: A cross-sectional study. Epilepsy Behav. 2021 Jan;114(Pt B):107349.
Journal cover image

Published In

Epilepsy Behav

DOI

EISSN

1525-5069

Publication Date

January 2021

Volume

114

Issue

Pt B

Start / End Page

107349

Location

United States

Related Subject Headings

  • Uganda
  • Surveys and Questionnaires
  • Neurology & Neurosurgery
  • Humans
  • Epilepsy
  • Cross-Sectional Studies
  • 5203 Clinical and health psychology
  • 5202 Biological psychology
  • 3209 Neurosciences
  • 1103 Clinical Sciences