Socioeconomic associations of poorly controlled epilepsy in the Republic of Guinea: cross-sectional study

Dylan R. Rice, Foksouna Sakadi, Nana Rahma Tassiou, Andre C. Vogel, Abdoul Bachir Djibo Hamani, Aissatou Kenda Bah, Alex Garcia, Bryan N. Patenaude, Abass Fode Cisse, Farrah J. Mateen

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To explore the socioeconomic factors associated with epilepsy in the Republic of Guinea. Methods: People living with epilepsy (PLWE) were prospectively recruited at Ignace Deen Hospital, Conakry, in 2018. An instrument exploring household assets as a measure of wealth was designed and administered. Multivariate logistic regression models with fixed effects were fitted to assess the associations of sociodemographic and microeconomic factors with self-reported frequency of seizures in the prior month and regular intake of antiseizure medications (ASMs). Participants were stratified by age group: children (<13 years), adolescents (13–21) and adults (>21). Results: A total of 285 participants (mean age 19.5 years; 129 females; 106 children, 72 adolescents, 107 adults, median household size 8) had an average of 4.2 seizures in the prior month. 64% were regularly taking ASMs. Direct costs of epilepsy were similar across income strata, averaging 60 USD/month in the lowest and 75 USD/month in the highest wealth quintiles (P = 0.42). The poorest PLWE were more likely to spend their money on traditional treatments (average 35USD/month) than on medical consultations (average 11 USD/month) (P = 0.01), whereas the wealthiest participants were not. Higher seizure frequency was associated with a lower household education level in adolescents and children (P = 0.028; P = 0.026) and with being male (P = 0.009) in children. Adolescents in higher-educated households were more likely to take ASMs (P = 0.004). Boys were more likely to regularly take ASMs than girls (P = 0.047). Conclusions: Targeted programming for children and adolescents in the households with the lowest education and for girls would help improve epilepsy care in Guinea.

Original languageEnglish (US)
Pages (from-to)813-823
Number of pages11
JournalTropical Medicine and International Health
Volume25
Issue number7
DOIs
StatePublished - Jul 1 2020

Keywords

  • epilepsy
  • global health
  • health services
  • health status disparities
  • poverty
  • risk factors

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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