title: Childhood epilepsy in a tropical child psychiatric unit: challenges of providing care in a resource-constrained environment.
abstract: BACKGROUND
  Epilepsy is an important cause of childhood morbidity and its care is fraught with challenges. Itinerant search for remedy and manifestation as or with psychiatric disorders could result in presentation in a psychiatric unit. Identification of these challenges is essential to providing optimal care. The objective was to identify caregiver challenges in the provision of care to children with epilepsy presenting in a psychiatric unit.
  
  
  METHODS
  Administration of a structured questionnaire to caregivers of children with epilepsy presenting, between September and December 2011, in the newly constituted Child and Adolescent Mental Health(CAMH) Unit of the Federal NeuroPsychiatric Hospital, Kaduna Nigeria.
  
  
  RESULTS
  A total of 84 caregivers were interviewed. The age range of the caregivers was 23 to 62 years (mean 38 ± 9.2 years) and a female preponderance (50, 59.5%). Most of the caregivers were in the upper social classes (I-III, 79.8%). A high number of challenges were indicated by majority 65, 77.4%) of the caregivers. The recurrence of seizures (84,100%) was the commonest challenge while the experience of discrimination (17, 20.2%) was the least. All caregivers had sought remedy from multiple health care options. Challenges were significantly (P < 0.05) associated with the female caregiver, age < 40 years, generalized type of epilepsy and residing outside Kaduna.
  
  
  CONCLUSIONS
  The study identified multi dimensional caregiver challenges and highlighted the need for provision of comprehensive health and social services to children with epilepsy and their families.
authors.affiliation: Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
authors.forename: Edwin Ehi
authors.initials: EE
authors.lastname: Eseigbe
authors.forename: Taiwo Lateef
authors.initials: TL
authors.lastname: Sheikh
authors.forename: Folorunsho Tajudeen
authors.initials: FT
authors.lastname: Nuhu
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004827:Epilepsy / Q000175:diagnosis; D005260:Female; D019538:Health Care Surveys; D006295:Health Resources; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006778:Hospitals, Psychiatric; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D057545:Social Stigma; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires