Primary care treatment of epilepsy in Rural Ethiopia

Background: Chronic non-communicable diseases, such as epilepsy, are increasingly recognised as important health care problems in developing countries. Despite cheap effective treatment, the majority of people with epilepsy remain untreated. In northern Gondar, Ethiopia, we have established a treatment program for epilepsy at a primary care level. Method: Nurse-led clinics were set up at five rural health centers. Nurses from each health center received training in the management of epilepsy at Gondar College of Medical Sciences (GCMS). Result: Over an 18 month period from April 1998, 813 patients, aged 1-75 years (median age 20) with active epilepsy were registered and started on Phenobarbitone. The duration of epilepsy ranged from 1 month to 50 years (median 4 years) and 87% had not previously been treated with antiepileptic drugs. In only 4% due to an inability to pay for the drugs and more than 90% were unaware that medical treatment existed. Conclusion: It is possible to provide effective epilepsy treatment using existing health care infrastructure in the country with few additional resources. [Ethiop.J.Health Dev. 2002;16(3):235-240]