Epilepsy Prevalence, Treatment Gap, and Stigma in Western Kenya (P1.272)

Objective: To determine the prevalence of epilepsy and neurocysticercosis, epilepsy treatment gap, and stigma Background: Epilepsy-associated stigma leads to poor health outcomes, higher treatment gaps and reduced quality-of-life for people with epilepsy (PWE), particularly in resource-limited settings. Methods: We conducted a community-based door-to-door epilepsy and cysticercosis prevalence study in a village with suspected high prevalence of porcine cysticercosis. Epilepsy cases were identified with screening questionnaire and neurologist evaluation. Neurocysticercosis was determined with blood apDia ELISA and contrast-enhanced brain CT. Results: Most village households [94[percnt](145/154)] and residents [80[percnt](648/810)] participated; 57[percnt](368/648) were female and 60[percnt](392/648) were children. Among adults, 72[percnt](185/256) had a primary school education or less, and 75[percnt](193/256) were farmers. Crude prevalence of lifetime epilepsy was 2.6[percnt](17/648)[95[percnt]CI:1.5-4.2] and age-sex-adjusted prevalence was 3.5[percnt] [95[percnt]CI:1.3-5.9]. None had neurocysticercosis. The treatment gap was 53[percnt](9/17). Nearly 53[percnt](136/256) of adults did not know the cause of epilepsy though 23[percnt] (59/256) thought epilepsy was caused by a curse from god, spirit possession, or witchcraft and 46[percnt](116/256) thought that epilepsy was contagious. Most adults knew that daily anti-epilepsy drugs could treat epilepsy 63[percnt](160/256), though 18[percnt](45/256) would recommend church healing sessions. Most adults felt that PWE should have equal rights 83[percnt] (209/256), employment opportunities 54[percnt](137/256) and education 79[percnt](200/256). Most adults would feel comfortable working with PWE 68[percnt](172/256), being seen in the company of PWE 69[percnt](175/256) and having a friend with epilepsy 65[percnt](165/256). However, most adults would not date or marry a PWE 54[percnt](162/256), would advise family members not to marry PWE 60[percnt](152/256), and felt that PWE should study in a special schools 63[percnt] (158/256) or classrooms 43[percnt](108/256). Conclusions: Epilepsy prevalence and treatment gaps were high in this region of Western Kenya. Knowledge of causes of epilepsy was poor. While most adults supported equal rights and opportunities for PWE, significant stigma exists around marriage and integration of PWE into communities