INTRODUCTION

1. BURDEN OF EPILEPSY IN KENYA INTRODUCTION KENYA PHARMACEUTICAL ASSOCIATION ANNUAL SCIENTIFIC CONFFERENCE. SATURDAY 21ST MAY 2011 ‘’PHARMACY IN 21ST CENTURY’’ JANE ROIMEN KAWE MEDICAL MANAGER

2. INTRODUCTION • Epilepsy is the most common chronic neurological disorder characterized by recurrent seizures. • Not all seizures are epilepsy. • Active epilepsy is where there has been two or more seizures with a year. • Seizures are a sign and symptom of brain disturbance. • has no age, racial, social, gender or geographical boundaries.

3. Global Perspectives. • 10% of total world population experiences at least one seizure in normal life. • Approx.50 million people worldwide have recurrent seizures , of whom 40 million (80%)are estimated to live in resource poor countries . • Although 70% of all these can be treated to have seizure free lives, up to 80-90% of people with epilepsy do not receive appropriate treatment for their condition in low income countries. • Only 10 million of these receive treatment.

4. PrevalencePrevalence • Rates of epilepsy range from 2.2 to 58 per 1000 in the African region • From many studies around the world it has been estimated approximately 8.2 per 1,000 of the general population. • Lowest is in South Africa • Higher in poor states due to poor health conditions

5. Kenya’s situation • Epilepsy is a chronic and serious medical condition. • In Kenya today, an estimated 800,000 people suffer from Epilepsy. • Majority of these (over 80%) are in the rural and urban slum areas. • This translates to 2 out of every 100 Kenyan suffers from Epilepsy today. • 20 per 1,000 Kenyans have Epilepsy

6. In Kenyan a study done by Kaamugusha and Feksi in 1988 in a semi-urban area in Nakuru found a prevalence of 18.2 per 1,000 population, Kibwezi 10.2 children per 1,000 and Kilifi and 30 per 1000 respectively.

7. Why High Rate? • Most of it is unknown- idiopathic • Predisposing factors include • Cerebral disorders • Communicable diseases • Peri -natal insults • Brain stressing factors • Road injuries

8. Challenges in Epilepsy control. • High level of social stigma and negative prejudices. • Poor attitude and traditional beliefs . • Ignorance. • Discrimination in employment and education. • Traditional healers. Most patients tend to consult them first. • Lack of resources. High poverty level. • Lack of Policy within Government. Low priority • Inadequate supply of AEDs. • Poor drug compliance. Cost of drugs. • Inadequate training of Medical Personnel. • High rate of refractory seizures (30%) in children because of frequent brain damage, complex types of seizures and Syndromes.

9. KAWE RESPONSE.(Kenya Ass. for the Welfare of People with Epilepsy). 1. TRAINING • Training all cadres of health personnel in epilepsy management 2.EDUCATION AND AWARENESS CREATION • To educate and empower various groups within the communities and their families. Ways of creating awareness. • Mass media campaigns. • Oral presentations at public gatherings, churches, schools, institutions etc. • Distribution of Educational and Information Material. 3.MEDICAL AND SOCIAL SUPPORT. Three clinics in Nairobi. Karen, Riruta and Mathare –Huruma.

10. Way forward • Integrating epilepsy into the primary health care system. • Collaboration with other government sectors e.g. education, culture and social services • Commitment of resources to epilepsy activities. • Training of health workers to improve epilepsy management skills • Health facility support – drugs

11. Conclusion • Epilepsy is one of the most common neurological disorder and has no age, racial, social, gender or geographical boundaries. • Epilepsy can have profound social, physical and psychological consequences. • In up to 70% of people, epilepsy responds to treatment, but in developing countries, 75% of people with epilepsy may not receive the treatment they need. • People with epilepsy continually face social stigma and exclusion. A fundamental part of ridding the world of this stigma is to raise public and professional awareness.