Healthcare Provider Education to Reduce Epilepsy Care Disparities in Uganda (2020-2021)

Epilepsy is one of the most common (and most treatable) neurological disorders in the world, yet three in four people in low- and middle income countries do not receive care that they need. In Uganda, this treatment gap is further exacerbated due to stigma, widespread beliefs in non-biomedical etiologies and treatments for the condition, and other barriers which prevent or dissuade individuals from seeking and receiving care. Furthermore, severely limited specialized personnel resources means that those who do seek biomedical care are often treated by non-specialty providers, who are often undertrained to care for and communicate effectively with epilepsy patients. 

Given these challenges, this team worked to bolster the mastery of epilepsy treatment for non-specialized providers by designing a culturally specific and sensitive epilepsy education course. The program drew from the WHO’s Mental Health Gap (mhGap) education modules with modifications made to reflect the specific setting based on interviews with Ugandan providers, availability of certain treatments, and consultation with the Ugandan National Health Guidelines.

The team worked with local Ugandan epilepsy experts and Duke epileptologists to tailor two specific content sections in the module: 1) patient-provider communications and 2) anti-epileptic drug (AED) prescribing rubrics. The content of these sections was informed by the WHO mhGAP 2.0 module, current Ugandan Clinical Guidelines and relevant research and practice related to AED medication efficacy and cultural influences. This material will be shared with the Ugandan Ministry of Health for implementation in a planned national epilepsy education program.

Timing

Fall 2020 – Summer 2021

Team Outputs

Epilepsy treatment curriculum for Uganda

Healthcare Provider Education to Reduce Epilepsy Care Disparities in Uganda (poster by Pratamesh Ramasubramanian, Olivia Ratliff, Tyler Johnson, Antoinette Charles, Colby Newson, Wyatt Gildea, Deborah Koltai and Neil Prose)

Bridging the Gap in Epilepsy Care in Uganda through International Partnerships (Team profile)

Reflections

Tyler Johnson

Selected team member reflections

Video

Epilepsy Care in Low Income Communities: Erasing Stigma, Saving Lives

This Team in the News

Understanding the Influence of Spiritual Beliefs on Epilepsy Care

Duke Innovates Together to Advance Health Care

Two Faculty Receive Inaugural Bass Connections Leadership Award

A Holistic Approach to Neurological Care in Uganda

Together Around the World

See related teams, Cultural and Practical Barriers to Epilepsy Care in Uganda (2021-2022) and Cultural and Practical Barriers to Epilepsy Care in Uganda (2018-2019).

 

Image: Christopher Komakech demonstrates how to place electrodes for an EEG exam, from Fighting Epilepsy in Uganda with Tools and Teamwork, Duke Global Health Institute website 

EEG exam demonstration.

Team Leaders

  • Deborah Koltai, School of Medicine-Psychiatry and Behavioral Sciences;Neurology
  • Neil Prose, School of Medicine-Dermatology

/graduate Team Members

  • Antoinette Charles, Medicine-MD

/undergraduate Team Members

  • Michael Gildea, Public Policy Studies (AB)
  • Tyler Johnson, Psychology (AB)
  • Pratamesh Ramasubramanian, Biology (BS)
  • Olivia Ratliff, Computer Science (BS)

/yfaculty/staff Team Members

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

/zcommunity Team Members

  • Mark Kaddumukasa, Department of Medicine, Makerere University
  • Martin Kaddumukasa, Department of Medicine, Makerere University
  • Angelina Kakooza, Department of Medicine, Makerere University
  • Colby Newson, Medical Student, University of Virginia