Epilepsy care In Kenya: gaps and opportunities from targeted survey of health workers

Abstract

Introduction: Epilepsy affects 1 to 2% of the world’s population with low- and middleincome countries bearing the greatest burden of the disease. Kenya has reported 4% prevalence in rural areas. The epilepsy treatment gap in Sub-Saharan Africa is estimated between 75 to 90%, compared to less than 10% in high-income countries1. The Addis Clinic, a nonprofit organization, uses telemedicine technology to address this gap by connecting frontline health workers (FHWs) in rural Kenya with specialist physicians located globally. We leveraged The Addis Clinic’s platform and network of FHWs in Kenya to identify factors contributing to epilepsy treatment gaps, assess resources, and design interventions to address any reported gaps and challenges. Objective: Investigate resources, current practices, training, challenges, and utilization of national guidelines by health care workers in the daily management of seizures and epilepsy amongst patients presenting to health care facilities in Kenya. Methods: We developed a targeted survey aimed to assess epilepsy care observed by FHWs of The Addis Clinic network and Moi Teaching and Referral Hospital. The survey examined six domains: (1) demographics and practice type, (2) current understanding of epilepsy, (3) epilepsy training and level of confidence, (4) utilization of Kenya National Guidelines for the Management of Epilepsy (KNGME 2016)3, , (5) resources and barriers for epilepsy care, and (6) use of telemedicine. Survey responses were collated using an online survey. Descriptive statistics and generalized linear models were used for survey analysis.