TABLE OF CONTENTS
DECLARATION ............................................................................................................................... i
ACKNOWLEDGEMENT ................................................................................................................ ii
DEDICATION ................................................................................................................................. iii
TABLE OF CONTENTS ................................................................................................................ iv
ABBREVIATIONS ........................................................................................................................ vii
CHAPTER ONE .............................................................................................................................. 1
1.0 INTRODUCTION ............................................................................................................... 1
1.1.0 Background ............................................................................................................................. 1
1.2.0Problem statement. .................................................................................................................. 2
1.3.0Research questions ................................................................................................................... 3
1.4.00bjectives ................................................................................................................................ 3
1.4.1 General objectives ................................................................................................................... 3
1.4.2 Specific objectives. ................................................................................................................. 4
1.5.0Justification of the study .......................................................................................................... 4
1.6.0Significance of the study ......................................................................................................... 5
CHAPTER TWO ......................................................................................................................... 6
2.0 LITERATURE REVIEW ...................................................................................................... 6
2.1.0 Causes and symptoms of seizures ....................................................................................... 6
2.2.0 Epilepsy and genes ............................................................................................................. 7
2.3.0 Epilepsy and anti-epileptic drugs ........................................................................................ 7
2.4.0Epilepsy in Africa ................................................................................................................ 9
2.5.0 Adherence to epileptic therapy ........................................................................................... 9
CHAPTER THREE ............................................................................................................... 11
3.0 METHODOLOGY AND MATERIALS ......................................................................... ll
3.1.0 Study design .................................................................................................................. 11
3.2.0 Study area ..................................................................................................................... 11
3.3.0 Study population ........................................................................................................... 11
3.4.0 Selection criteria ........................................................................................................... 11
3.~.0 Population and sampling ............................................................................................... 12
3.6.0 Sampling procedure ...................................................................................................... 12
3.7.0 Tools and data collection methods ................................................................................ 12
3.8.0 Data collection .............................................................................................................. 12
3.9.0 Data analysis ................................................................................................................. 12
3.10.0 Ethical considerations ................................................................................................. 13
iv
3.10.1 Limitation of the study ................................................................................................ 13
CHAPTER FOUR ................................................................................................................. 14
4.0 RESULTS ........................................................................................................................ 14
4.1.0 DEMORGRAPHIC DATA .......................................................................................... 14
TABLE !.Showing the demographic distribution and social economic filctors of the
participants ............................................................................................................................. 15
4.2.0 ASSESSMENT OF THE PATIENT/PHYSICIAN RELATIONSHIP AND
PATJENT/DISPENSER OR PHARMACIST RELATIONSHIP ......................................... 16
TABLE 2. Showing patient/physician relationship and patient/dispenser questions and advice
offered to patients .................................................................................................................. 16
4.3.0 THE PERCENTAGE PROPORTION OF ADHERENT PATIENTS TO
THEIR ANTI-EPILEPTIC MEDICATION .......................................................................... 16
TABLE 3, showing the percentage proportion of adherent patients ...................................... 17
4.4.0 THE DETAILED ACCOUNT OF THE NON-ADHERENT PATIENTS (TIME
FACTOR AND THE REASONS FOR NON-ADHERENCE) ............................................. 17
TABLE 4; showing the detailed account of non-adherent patients ....................................... 17
GRAPH 1 ............................................................................................................................... 18
4.6.0 FACTORS AFFECTING ADHERENCE (N=38) ....................................................... 19
4.7.0 PATIENT'S ATTITUDE TOWARDS HIS/HER ABILITY TO COMPLY AND
WHETHER HE/SHE BELIEVES THERAPY IS BENEFICIAL. ........................................ 19
TABLES, showing the demographic and social economic factors among the non-adherent
patients ................................................................................................................................... 20
Table 6, showing physician factors and dispenser questions and advise to patients who did not
adhere ..................................................................................................................................... 21
CHAPTER FIVE ................................................................................................................... 22
5.1.0 DISCUSSION, CONCLUSIONS AND RECOMMENDATIONS................................. 22
5.1.1 DISCUSSION ............................................................................................................. 22
5.1.2CONCLUSION .............................................................................................................. 23
5.1.3 RECOMMENDATIONS .............................................................................................. 23
REFERENCES . ..................................................................................................................... 24
Appendix 1: ............................................................................................................................ 25
QUESTIONNAIRE ............................................................................................................... 25
Appe~dix l 1 ............................................................................................................................ 28
RESEARCH BUDGET ......................................................................................................... 28
Appendix II! ......................................................................................................................... 28
TIME FRAME ....................................................................................................................... 28
Appendix IV .......................................................................................................................... 29
CHAPTER ONE 1.0 INTRODUCTION. Epilepsy is a chronic condition characterized by recurrent unprovoked seizures caused by abnormal discharges in the brain. (UCG, 20 16). It is one of the most common neurologic disorders affecting over 50million people worldwide with no boundary to age, race, social class and geographical locality. Among patients who have epilepsy, 85% of them found in developing countries (an estimate of 40million) do not receive appropriate treatment. (WHO, 2014) Globally epilepsy is the third most common neurologic disorder after cerebral vascular and Alzheimer's disease. Epilepsy is an assortment of different seizure types originating from several mechanisms that have a sudden discharge of cerebral neurons. The abnormal electrical activity may result in loss of consciousness, abnormal movements, atypical or odd behavior and distorted perceptions of limited duration but recur if untreated. In most cases, epilepsy has no identifiable cause however focal areas that are functionally abnormal may be triggered by alteration in blood gases, PH, electrolytes, blood glucose levels and changes in environmental factors such as sleep deprivation, alcohol intake and stress. Therefore in most cases epilepsy is referred to as idiopathic since the cause is not always known.
