Abstract Details

Title Beliefs Regarding Epilepsy in the Republic of Guinea Contribute to Lost Opportunities and Delay Presentation to Medical Care

Topic Global Health and Neuroepidemiology

Presentation(s) S7 - Global Health (3:41 PM-3:52 PM)

Poster/Presentation
Number 002

Objective To characterize explanatory models and use of traditional healers for epilepsy in Guinea.

Background Limited data have been published on epilepsy and its sequelae in Guinea. However, a prior study from our group found that 25% of people with epilepsy (PWE) in Guinea were not taking antiepileptic medications (AEDs) and that 72% met criteria for poorly controlled epilepsy. In this study, we seek to characterize possible barriers and alternatives to medical care utilized by PWE in Guinea.

Design/Methods PWE were prospectively recruited in 2018. Self-referrals were solicited through appearances on national television and radio. PWE and their caregivers completed structured questionnaires and semi-structured interviews based on the Explanatory Models for Illness framework.

Results 132 PWE (mean age of 20 years, 49% under the age of 18, 44% female, 92% Muslim) were included in the study. 67% reported that they were currently taking AEDs, with 58% taking AEDs regularly. 84% reported supernatural beliefs regarding epilepsy, most often that epilepsy is caused by djinné (invisible spirits) or by sorcellerie (witchcraft). 78% reported having seen a traditional healer for their epilepsy and 71% reported seeing a traditional healer before seeing a physician for their epilepsy, with a mean interval time of 39 months. 41% of participants reported the community belief that epilepsy is contagious, most often through contact with sweat, blood, or saliva produced during a seizure. Participants reported that others’ fear of contracting epilepsy from contact with PWE led to them leaving school, losing employment, being unable to form relationships, and sustaining physical injuries during seizures.

Conclusions Beliefs regarding epilepsy dictated where PWE initially sought care and led to lost educational, employment, and interpersonal opportunities. These findings suggest that traditional healers are providing frontline care for epilepsy. Engaging with these healers will be critical in providing care that reaches most PWE and addressing misperceptions regarding epilepsy.

Authors/Disclosures
Pria Anand, MD (Boston University School of Medicine) PRESENTER	Dr. Anand has nothing to disclose.
	No disclosure on file
	No disclosure on file
Guelngar Carlos Othon, Jr., MD (National Ignace Deen Hospital, University of Conakry)	Guelngar Carlos Othon has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Andre Vogel (Massachusetts General Hospital)	No disclosure on file
	No disclosure on file
Farrah J. Mateen, MD, PhD, FAAN (Massachusetts General Hospital)	Dr. Mateen has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon Therapeutics (Amgen). Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Mateen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology. The institution of Dr. Mateen has received research support from Genentech. The institution of Dr. Mateen has received research support from EMD Serono. The institution of Dr. Mateen has received research support from Novartis. The institution of Dr. Mateen has received research support from Horizon Therapeutics (Amgen). The institution of Dr. Mateen has received research support from TG Therapeutics. Dr. Mateen has received intellectual property interests from a discovery or technology relating to health care.

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