The functional status of people with epilepsy in rural sub-Saharan Africa.
OBJECTIVE
Little data is available regarding the impact of epilepsy on the functional status of people with epilepsy (PWE) in developing countries. In sub-Saharan Africa, limited medical services and social stigmatization subject PWE to substantial physical, psychological and social deprivation. To better delineate the overall burden and distribution of epilepsy-associated disability in sub-Saharan Africa, we assessed the functional status of PWE in a rural, population-based sample and made comparisons to published reports from urban Zimbabwe.


METHODS
A population-based survey of PWE with epilepsy in rural Zambia utilizing WHO questionnaires.


RESULTS
Among 86 PWE in 3 rural Zambian communities, 67% participated in the interviews. Only 62% of PWE were receiving treatment. Five to seven percent of rural PWE reported problems with basic hygiene and 9-14% were unable to fulfill work demands, attend social events or enjoy leisure activities. In contrast, 95% of urban PWE denied any problems with social functioning, work performance or relationships. Compared to the urban population, rural PWE had a greater seizure burden (2.3/month vs. 1/month, p=0.007) and reported more difficulties with activities of daily living, including problem solving (70% vs. 54%, p=0.02), speed of thinking (70% vs. 59%, p=0.02) and relationships with co-workers (68% vs. 26%, p< or =0.005).


CONCLUSIONS
A significant proportion of PWE in rural sub-Saharan Africa report problems fulfilling both social and professional functions. These results also suggest that rural PWE may have poorer functional status than their urban counterparts.
Birbeck
Gretchen L
GL
Michigan State University, #138 Service Road, A217, East Lansing, MI 48824-1313, USA. birbeck@msu.edu
Kalichi
Ellie M N
EM
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D004827:Epilepsy / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires