ArticleSeizure2020
Epilepsy care cascade, treatment gap and its determinants in rural South Africa.
Article in Seizure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Prevalence, characteristics, and treatment outcomes of epilepsy in Nigeria: a systematic review and meta-analysis.European journal of medical research · 2025Pooled it
- Psychological Burden Among Family Caregivers of People with Epilepsy in Limpopo and Mpumalanga Provinces, South Africa: A Qualitative Study.Behavioral sciences (Basel, Switzerland) · 2026Article
- Lived experiences and acceptability challenges among caregivers of people with epilepsy in Limpopo and Mpumalanga, South Africa.Frontiers in psychology · 2026Article
- Prevalence and determinants of uncontrolled seizures in adult people with epilepsy attending comprehensive specialized hospitals in Northwest Amhara, Ethiopia: a multicenter study.BMC public health · 2025Article
- The association of polytherapy and psychiatric comorbidity in epilepsy.Epilepsy & behavior : E&B · 2025Article
- Neurological conditions among pediatric patients seeking care at a tertiary level hospital in western Kenya.PloS one · 2025Observational
- Epileptic Patients with More Clinic Visits Are More Likely to Be Diagnosed with Dementia-A Population-Based Retrospective Cohort Study.Diagnostics (Basel, Switzerland) · 2024Article
- Epilepsy in rural South Africa: Patient experiences and healthcare challenges.Epilepsia open · 2024Article
- Hypertension treatment cascade among men and women of reproductive age group in India: analysis of National Family Health Survey-5 (2019-2021).The Lancet regional health. Southeast Asia · 2024Article
- E = mcEpilepsia open · 2024Article
- Mental health services in Gauteng, South Africa: A proxy evaluation using pharmaceutical data.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2024Article
- Conceptual framework to provide culturally congruent care to epilepsy patients in selected rural communities in South Africa.Health SA = SA Gesondheid · 2024Article
- Exploration of health care providers' knowledge-based care and support given to family members and caregivers of people living with epilepsy.Frontiers in psychology · 2024Article
- Experience of the new seizure diary in the Free State and Northern Cape.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2023Article
- Diagnosis of Epilepsy by Traditional Healers and Its Implications on Management in the Selected Rural Communities of Limpopo and Mpumalanga Provinces: A Qualitative Study.Neuropsychiatric disease and treatment · 2023Article
- Epilepsy-Related Direct Medical and Direct Non-Medical Cost in Adult Patients Living with Epilepsy at a Tertiary Neurology Center in Rwanda.ClinicoEconomics and outcomes research : CEOR · 2023Article
- A framework for health equity in people living with epilepsy.Epilepsy research · 2022Review
- An aqueous extract of Syzygium cumini protects against kainate-induced status epilepticus and amnesia: evidence for antioxidant and anti-inflammatory intervention.Metabolic brain disease · 2022Article
- Characteristics of people with epilepsy in three Eastern African countries - a pooled analysis.BMC neurology · 2022Article
- Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe percentage of people who are diagnosed with epilepsy (diagnostic gap), access, receive and adhere (treatment gap) to anti-seizure medication (ASM) in low- and middle- income countries remains low. We explored the epilepsy care cascade, measured the diagnostic and treatment gaps, and examined socio-demographic factors associated with adherence to ASMs in rural South Africa.
methodsUtilizing a population-based cohort of 311 people with active convulsive epilepsy (ACE) residing in rural northeastern South Africa, a questionnaire was administered to examine associations between demographic and socioeconomic factors and the epilepsy treatment gap. Blood was taken to measure levels of ASMs.
resultsOf the 311 individuals diagnosed, 93 % of individuals reported being previously told they had epilepsy and 94 % reported previously attending a health facility for their epilepsy. ASMs were detected in 138 individuals (76 %) and optimal levels were detected in 67 individuals, resulting in a treatment gap of 63 % (95 % confidence interval [95 %CI]: 56 %-70 %). Self-reported specificity of ASM use was 23 % (95 %CI: 12-39 %) and individuals ≥18 years were significantly more likely to report taking ASM than children and were significantly (p = 0.011) more likely to be adherent.
conclusionMost people with epilepsy in rural South Africa had been previously diagnosed with epilepsy and had accessed care for epilepsy, yet the level of ASM adherence remained low, significantly lower amongst children. Understanding ways of improving knowledge of and adherence to ASM in rural South Africa is necessary, especially amongst children. The epilepsy care cascade can be useful in identifying gaps in care and targeting interventions to reduce these gaps.
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Registered trials
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