Cultural and Practical Barriers to Epilepsy Care in Uganda (2018-2019)

While epilepsy affects over 50 million people globally, three of four people in low-resource countries do not get care for this treatable condition. In Uganda, stigma is pervasive: one in five people believes epilepsy is contagious, and there are strong beliefs in supernatural or witchcraft-based causes, treatments and even inoculation. The objective for the 2018-19 Bass Connections project team was to address the question, Given that we now know potent predictors of care-seeking behavior, how will we systematically address the barriers to epilepsy care in Uganda through well designed, culturally relevant and sensitive interventions? 

This project team designed an intervention program with the goal of impacting the epilepsy treatment gap in Uganda. This work occurred as Duke Global Neurosurgery and Neurology (DGNN) continued to build the biomedical care training and access infrastructure.

The team utilized numerous sources of data and models, including Bass Connections Phase I barriers data (qualitative and modeled barriers), models of epilepsy awareness programs utilized in East Africa, community education programs for infectious disease and maternal-fetal medicine, models of traditional healer and biomedical care partnerships (e.g., for HIV) and previous research pilots in Kilifi, Kenya.

The intervention included three components: stakeholder education; access to treatment; and traditional and biomedical care partnerships. It was implemented during a field visit in Uganda, with impact data collected pre- and post-implementation.


Summer 2018 – Summer 2019  

Team Outputs

Deborah Koltai et al. The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda. 2021. Epilepsy & Behavior 114B (special issue).

Caleigh E. Smith, Mayanja Kajumba, Samuel Bobholz, Patrick J. Smith, Mark Kaddumukasa, Angelina Kakooza-Mwesige, Payal Chakraborty, Drishti D. Sinha, Martin N. Kaddumukasa, Alex Gualtieri, Noeline Nakasujja, Erica Onuoha, Juliet Nakku, Christine Muhumuza, Nadine Sanchez, Anthony T. Fuller, Michael M. Haglund, Deborah C. Koltai. "Pluralistic and singular causal attributions for epilepsy in Uganda." 2020. Epilepsy & Behavior.

Identifying Health Care Provider Needs for Epilepsy Care in Uganda (poster by Deborah Koltai Attix, Anthony Fuller, Sarah Snouse, Caleigh Smith, Olivia Ratliff, Grace Cai, presented at Bass Connections Showcase, Duke University, April 17, 2019; runner up, Bass Connections Poster Competition, Judges’ Selection)

This Team in the News

These Seniors Took Their Bass Connections Research Further and Graduated with Distinction

See related teams, Healthcare Provider Education to Reduce Epilepsy Care Disparities in Uganda (2020-2021) and Cultural and Practical Barriers to Epilepsy Care in Uganda (2017-2018).

Bass Connections team members with their team's poster

Team Leaders

  • Anthony Fuller, School of Medicine-Neurosurgery
  • Deborah Koltai, School of Medicine-Psychiatry and Behavioral Sciences;Neurology

/graduate Team Members

  • Sarah Snouse, Global Health - MSc

/undergraduate Team Members

  • Grace Cai, Psychology (AB)
  • Olivia Ratliff, Computer Science (BS)
  • Caleigh Smith, Biology (BS)

/yfaculty/staff Team Members

  • Michael Haglund, Duke Global Health Institute|School of Medicine-Neurosurgery

/zcommunity Team Members

  • Martin Kaddumukasa, Department of Medicine, Makerere University
  • Mark Kaddumukasa, Department of Medicine, Makerere University
  • Angelina Kakooza, Department of Medicine, Makerere University