Global Health Institute (GHI), Faculty of Medicine and Health Sciences, University of Antwerp, Doornstraat 331, B-2610 Wilrijk, Belgium.
Provincial Health Division Ituri, Ministry of Health, Bunia, Democratic Republic of Congo.
Epilepsy Behav. 2021 Mar;116:107773. doi: 10.1016/j.yebeh.2021.107773. Epub 2021 Jan 27.
In October 2017, a community-based epilepsy treatment program (CBETP) was initiated in the Logo health zone (Ituri province, Democratic Republic of Congo), consisting mainly of community epilepsy education, provision of free antiepileptic drugs (AEDs), and monthly follow-up of persons with epilepsy (PWE). Prior to the implementation of the CBETP, qualitative research had revealed several misconceptions about the cause of epilepsy, major epilepsy-related stigma, and high economic cost for families of PWE mainly because of costly treatment by traditional healers. One year after the implementation of the CBETP, we assessed the perceived effect of this program on the community's perceptions and attitudes regarding epilepsy and on disease costs.
Focus group discussions (FGD) and semi-structured in-depth interviews (SSI) were conducted with different target groups. Additionally, the cost associated with epilepsy was evaluated using questionnaires administered to 74 PWE and/or their families.
Nine FGDs and 16 SSIs were conducted. There was a notable shift in perceptions and attitudes, as most community members no longer believed that epilepsy is contagious, while acknowledging that this condition can be treated in local health centers. Persons with epilepsy and their family experienced less epilepsy-related stigma and consulted less frequently traditional healers; the latter showed a growing willingness to collaborate with health professionals in the management of PWE. The direct and indirect costs for families caring for a PWE decreased by 95.2% and 95.7%, respectively.
The main perceived benefits of the CBETP were the decrease in misconceptions about epilepsy and epilepsy-related stigma. Families with PWE understood the benefit of seeking health care from trained health professionals rather than with traditional healers. The direct and indirect costs for families to take care of a PWE reduced considerably after the program. However, the cost-effectiveness and long-term sustainability of this approach remain to be assessed.
2017 年 10 月，在（刚果民主共和国伊图里省）Logo 卫生区启动了一项基于社区的癫痫治疗项目（CBETP），该项目主要包括社区癫痫教育、提供免费抗癫痫药物（AED）以及对癫痫患者（PWE）进行每月随访。在实施 CBETP 之前，定性研究揭示了人们对癫痫病因的一些误解、与癫痫相关的主要耻辱问题，以及 PWE 家庭因传统治疗师昂贵的治疗费用而面临的高昂经济负担。在实施 CBETP 一年后，我们评估了该项目对社区对癫痫的认知和态度以及疾病成本的感知效果。
对不同目标群体进行了焦点小组讨论（FGD）和半结构化深入访谈（SSI）。此外，通过向 74 名 PWE 和/或其家属发放问卷评估了与癫痫相关的成本。
共进行了 9 次 FGD 和 16 次 SSI。认知和态度发生了显著转变，因为大多数社区成员不再认为癫痫具有传染性，同时承认这种疾病可以在当地卫生中心得到治疗。癫痫患者及其家属经历的癫痫相关耻辱感减少，就诊传统治疗师的频率降低；后者表现出越来越愿意与卫生专业人员合作管理 PWE。照顾 PWE 的家庭的直接和间接成本分别降低了 95.2%和 95.7%。
CBETP 的主要感知益处是减少了对癫痫的误解和癫痫相关耻辱感。有 PWE 的家庭明白，寻求经过培训的卫生专业人员的医疗保健而不是传统治疗师的医疗保健更有益处。该项目实施后，家庭照顾 PWE 的直接和间接成本大大降低。然而，这种方法的成本效益和长期可持续性仍有待评估。
