Objective: This study investigates the prevalent issues of healthcare access and the impact of antiseizure treatments among people with epilepsy (PWE) in rural Limpopo and Mpumalanga, South Africa, where healthcare facilities and affordable treatments are often inadequate.Methods: Using a cross‐sectional survey, 162 PWE were selected using multistage sampling across the provinces. Data were collected via a structured questionnaire and analyzed descriptively using SPSS v27.Results: Most of the participants experienced seizures intermittently, with 70.6% in Limpopo and 53.3% in Mpumalanga reporting occasional episodes, whereas a significant minority in both regions—20.6% and 40%, respectively—suffered from frequent seizures. A notable portion of PWE also reported recurring side effects from antiseizure drugs, which led to consequential life disruptions, including educational dropout and unemployment.Significance: The findings underscore an urgent need for enhanced educational programs and increased awareness to improve the understanding and management of epilepsy in these underserved areas. Optimizing care for PWE requires a multifaceted approach, including evaluating healthcare accessibility, affordability, and societal beliefs influencing treatment adherence. The study advocates for government and policy interventions to mitigate the quality of life deterioration caused by epilepsy and its treatment in rural communities.Plain Language Summary: In Limpopo and Mpumalanga, many individuals with epilepsy experience seizures occasionally, while a significant minority have them frequently. Numerous people also suffer recurring side effects from antiseizure medications, impacting their lives severely by causing school dropouts and job losses. This underscores the urgent need for improved education and awareness programs to manage epilepsy in these provinces effectively. The study urges government action and policy reforms to enhance care and support for people with epilepsy in rural areas, aiming to improve their quality of life.
1 April 2023 in Neuropsychiatric Disease and Treatment
Introduction: Epilepsy is a neurological disorder which causes seizures and may be accompanied by loss of unconsciousness and control of bowel or bladder function. However, other types of epilepsy are only characterised by rapid blinking or a few seconds of staring into space. Many people living with epilepsy in rural communities consult traditional healers as their first line of treatment for epilepsy. Second preference is given to medical practitioners which causes unnecessary delay in the early diagnosis and treatment of epilepsy. This study aimed to explore how traditional healers diagnose epilepsy and its implications on management in the selected rural communities of Limpopo and Mpumalanga Provinces. Methods: A qualitative approach using explorative, descriptive and contextual designs was adopted. Purposive sampling was used to sample six villages in Limpopo and Mpumalanga Provinces. Snowball sampling was used to sample twenty traditional healers. Data were collected through in-depth individual interviews at the participant’s homes. Data were analysed using Tesch’s eight steps of open coding data analysis. Results: This study found that traditional healers have varied beliefs and misconceptions regarding the causes and diagnosis of epilepsy, hence this greatly influencing the management. The misconceptions on the causes include a calling by ancestors, urine contents, snake in the stomach, contaminated digestive system and witchcraft. The management included using herbal plants, insects, foam excreted during seizures and urine of the person living with epilepsy. Recommendation: It is recommended that for effective management of epilepsy, there should be coordination between traditional healing and western medicine. Future research should look at the integration of traditional medicine and western medicine.
25 September 2023 in Epilepsy and paroxysmal conditions
Views of traditional healers on collaboration with health professionals when managing epilepsy in rural areas of Limpopo and Mpumalanga Provinces (South Africa)
3 August 2024 in Seizure: European Journal of Epilepsy
Epilepsy is a neurological disorder affecting approximately 50 million individuals globally, contributing significantly to the global disease burden. Professional nurses play a crucial role in the care and treatment of people living with epilepsy, ensuring their safety and well-being. Professional nurses frequently encounter challenges, such as restricted access to drugs, specialised equipment, and epilepsy treatment training. Despite these obstacles, professional nurses are essential to providing high-quality care to patients with epilepsy in remote locations. A qualitative design using explorative, descriptive, and contextual design was employed to achieve the objectives of the study. The sample comprised 20 professional nurses working in selected rural communities in Limpopo and Mpumalanga. Data was collected through in-depth individual interviews and analysed using Tesch's eight steps of data analysis. Four themes emerged from the data: experiences of professional nurses during management of epilepsy; inadequate training in management of epilepsy; insufficient supply of antiepileptic drugs and late presentation to local clinics. The study found that professional nurses experienced several challenges hindering the effective management of epilepsy. Cultural beliefs in supernatural causes of epilepsy significantly influence treatment preferences, consequently delaying diagnosis and treatment. Despite limited resources and cultural barriers experienced by professional nurses, they strive to provide appropriate care to minimise seizures. Ongoing education and training on epilepsy management is vital to enable professional nurses to keep up-to-date with current methods and new developments.
Background: Intrauterine foetal death (IUFD) is a traumatic event leading to substantial grief reactions with a variety of experiences in an expectant woman. After delivery, these experiences have shown to impact the mother’s psychological well-being, where she experiences post-traumatic stress, sadness, anxiety and depression. The psychosomatic experiences before labour commenced are not known.Objectives: This study explored the psychosomatic (mind–body connection) experiences of women who had an IUFD before labour commenced in rural areas of Limpopo province, South Africa.Method: A qualitative approach with an explorative descriptive design was carried out among all 10 consented participants who were selected using a purposive sampling technique. The sample consisted of women who delivered an IUFD as reflected by the hospital register from the selected hospitals. Data were collected at the participants’ homes through in-depth individual interviews guided by one open-ended central question as follows, ‘Please share with me your experiences of IUFD before you went into labour’, and analysed using Tesch’s open coding method.Results: Two themes reflecting the psychosomatic (mind–body connection) experiences of women who had an IUFD emerged from the analysis. The themes are danger alerts and emotional responses.Conclusion: This qualitative study revealed that women could relate a lack of or decreased foetal movement as the danger alert or warning sign that the baby was in danger before labour commenced. Upon noticing that something was wrong with the baby, a message was sent to the women’s minds, which equally affected and activated their emotional dimensions. An investigation regarding the kind of support needed by women after being informed of an IUFD is recommended.
Background: Epilepsy is a neurological disorder affecting millions of people in Africa. Among other reported findings, many people living with epilepsy (PLWE) believe that the condition is caused by spiritual factors. Previous studies have revealed that majority of PLWE are not receiving adequate care and treatment because of diverse cultural beliefs associated with epilepsy. Consequently, they consult either faith-based healers or traditional healers. Others, however, acknowledge the medical causes of epilepsy and seek developed medical treatment. Aim: To develop a culturally congruent care conceptual framework to provide comprehensive and holistic epilepsy care. Setting: This study was conducted in the selected rural communities of Limpopo and Mpumalanga provinces. Methods: A qualitative multi-method research approach was employed and sub-divided into three phases. Phase 1: All 15 articles were reviewed and appraised using the Critical Appraisal Skills Programme (CASP) rating tool. Phase 2 involved two stages of empirical study in which an exploratory-descriptive study design was used. The study population comprised of 20 traditional healers, 15 faith-based healers, 20 professional nurses and 22 PLWE. Data were collected using in-depth individual interviews and analysed through eight Tesch’s steps of data analysis. Following data analysis, Phase 3 entailed synthesising the systematic and empirical findings into a conceptual framework. Results: Three themes that emerged from the findings were cultural epilepsy interventions, faith-based epilepsy intervention and medically developed epilepsy interventions. Conclusion: Incorporation of cultural beliefs, values and practices into the medically developed management of epilepsy is crucial for providing culturally congruent care that is preferred by majority of PLWE. Contribution: Healthcare providers may tailor care interventions that are culturally appropriate and acceptable hence promoting early diagnosis and treatment adherence leading to improved quality of life.