A model for managing epilepsy in a rural community in Africa

As most Malawians with epilepsy consider treatment of seizures to be the domain of traditional healers and attend hospital only when they require treatment for burns which they suffer during fits, steps were taken to encourage people with epilepsy to attend hospital for regular treatment with antico...

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Bibliographic Details
Published in:BMJ 1989-03, Vol.298 (6676), p.805-807
Main Author: Watts, A. E.
Format: Article
Language:English
Subjects:
Anticonvulsants
Bathing
Burns
Child health services
Dosage
Epilepsy
Epilepsy - therapy
Fires
Healers
Health Education
Health Services Administration
Hospital admissions
Humans
Malawi
Middles
Mobile Health Units
Outpatient Clinics, Hospital
Patient Acceptance of Health Care
Phenobarbital - therapeutic use
Phenytoin - therapeutic use
Rural Health
Seizures
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Summary:As most Malawians with epilepsy consider treatment of seizures to be the domain of traditional healers and attend hospital only when they require treatment for burns which they suffer during fits, steps were taken to encourage people with epilepsy to attend hospital for regular treatment with anticonvulsant drugs. At first only a few patients attended, but within two years 461 had registered at the hospital and two mobile clinics. Publicity was spread through the area action committee, which was organised by the area chief. The main drug used was phenobarbitone. After treatment was given for six months seizures were fully controlled in 40 (56%) out of 71 patients. A further 20 (28%) had greatly improved. As news of the clinics spread other health units adopted the model, and eventually over 3000 patients with epilepsy were receiving regular treatment at 45 units throughout Malawi.
ISSN:0959-8138
1468-5833
1756-1833
DOI:10.1136/bmj.298.6676.805