ICNC Abstracts, ICNC 2018

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Closing the Epilepsy Treatment Gap: A Pediatric Epilepsy Education Initiative for Primary Care Providers in Zambia
Leah Wibecan, Ornella Ciccone, Owen Tembo, Prisca Kalyelye, Manoj Mathews, Archana A. Patel

Last modified: 2018-09-09

Abstract


Introduction: Epilepsy is a highly treatable disease. While in higher-income countries, children with epilepsy generally receive care from neurologists, few neurologists are available in low- and middle-income countries (LMIC), and primary health providers – who often have limited training on these conditions – are responsible for neurological care. Primary health workers are therefore essential to closing the epilepsy treatment gap; however, these providers require the tools and education to provide adequate care.

Methods: We implemented a pilot educational program for clinical officers (primary health providers with three years of post-secondary general medical education) in Zambia, focusing on the diagnosis and management of pediatric epilepsy. We conducted a pre- and post-intervention analysis, including a knowledge assessment and an evaluation of provider comfort in caring for children with epilepsy.

Results: Ten clinical officers from three primary level health clinics participated. Following the 3-week course, there was improved overall knowledge about epilepsy (69% vs. 81% correct, p<0.05), including knowledge regarding medication management and recognition of focal seizures (p<0.05), as well as comfort obtaining seizure history and adjusting antiepileptic medications (p<0.05). However, knowledge regarding acute seizures, appropriate use of diagnostic studies, and general etiologies of epilepsy remained limited.

Conclusion: Our pediatric epilepsy education course demonstrated that a short, directed training program for primary care providers may improve knowledge about the diagnosis and management of seizures in children. Through promoting health workers’ capacity to provide high-quality care for children with epilepsy, future educational interventions – including clinical preceptorship – may reduce the epilepsy treatment gap.


Keywords


Pediatric epilepsy; Epilepsy; Primary care providers; Treatment gap; Education

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