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Magili PF, Kakoko DC, Bhwana D, Akyoo WO, Amaral LJ, Massawe IS, Colebunders R, Mmbando BP. Accessibility to formal education among persons with epilepsy in Mahenge, Tanzania. Epilepsy Behav 2023; 148:109445. [PMID: 37778222 DOI: 10.1016/j.yebeh.2023.109445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Epilepsy is estimated to affect 50 million people globally, with 80% living in sub-Saharan Africa (SSA). Children with epilepsy (CWE) in SSA are often socially isolated, and many do not get access to school. This study aimed to explore the barriers hindering accessibility to formal education among CWE in Mahenge, Tanzania. METHODS The study was conducted in June 2022 in four villages (Mdindo, Msogezi, Mzelezi and Sali) using quantitative and qualitative methods. The quantitative included 203 persons with epilepsy (PWE), while the qualitative involved six focus group discussions and 17 in-depth interviews. Quantitative and qualitative data were analyzed using Stata and Nvivo software, respectively. RESULTS Of the 203 PWE, 62 (30.5%) had never enrolled in school, while 77 (54.6%) of those enrolled dropped-out before completing it. The perceived barriers to accessing education were categorized as individual barriers (such as frequent seizures, learning difficulties, anti-seizure medication side effects and perceived stigma), Community barriers (such as stigma and discrimination, negative beliefs and misconceptions, relocation to farms and poor socio-economic status), and Institutional barriers (including lack of knowledge about epilepsy among stake-holders, topography and distance to schools). CONCLUSION There is a high rate of dropouts and non-enrolment of CWE in schools within the Mahenge area. Negative beliefs and low awareness of the community about epilepsy and formal education contribute to this issue. This calls for more advocacy to raise community awareness on epilepsy. The government should enforce an inclusive education policy and provide free and uninterrupted anti-seizure medication for seizure control.
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Affiliation(s)
- Pendo F Magili
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania.
| | - Deodatus C Kakoko
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Dan Bhwana
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania.
| | - Winfrida O Akyoo
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | | | - Isolide S Massawe
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania.
| | | | - Bruno P Mmbando
- National Institute for Medical Research, Tanga Research Centre, Tanga, Tanzania.
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Yoon S, Goh H, Foo CP, Kao MIM, Hie SL, Chan SL, Krishnappa J, Ngoh ASF, Ling SR, Yeo TH, Chan DWS. Parents' priorities for decision-making of pediatric epilepsy treatments and perceived needs for decision support in multi-ethnic Asian clinical setting: A qualitative analysis. Epilepsy Behav 2022; 135:108880. [PMID: 35986955 DOI: 10.1016/j.yebeh.2022.108880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To identify parents' priorities when making a decision on genetic testing and antiseizure drug (ASD) options for pediatric epilepsy and their support needs for informed decision-making in multi-ethnic Asian clinical settings. METHODS Qualitative in-depth interviews, using a semi-structured interview guide, were conducted with purposively selected parents of pediatric patients with newly diagnosed epilepsy or known diagnosis of epilepsy (n = 26). Interviews were audio recorded and transcribed verbatim. Thematic analysis was undertaken to generate themes. RESULTS Parents' narratives showed difficulty assimilating information, while knowledge deficit and emotional vulnerability led parents' desire to defer a decision for testing and ASDs to mitigate decisional burden. Priorities for decisions were primarily based on intuitive ideas of the treatment's risks and benefits, yet very few could elaborate on tradeoffs between risks and efficacy. Priorities outside the purview of the healthcare team, such as children's emotional wellbeing and family burden of ASD administration, were also considered important. Authority-of-medical-professional heuristic facilitated the ASD decision for parents who preferred shared rather than sole responsibility for a decision. Importantly, parents' support needs for informed decision-making were very much related to the availability of support mechanisms in post-treatment decisions owing to perceived uncertainty of the chosen ASD. CONCLUSIONS Findings suggest that multiple priorities influenced ASD decision process. To address support needs of parents for informed decision-making, more consideration should be given to post-treatment decision support through the provision of educational opportunities, building peer support networks, and developing a novel communication channel between healthcare providers and parents.
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Affiliation(s)
- Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore.
| | - Hendra Goh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore; Faculty of Dentistry, National University of Singapore, Singapore
| | - Chuan Ping Foo
- KK Research Centre, KK Women's and Children's Hospital, Singapore
| | - Martha I M Kao
- Department of Pediatrics, Neurology Service, KK Women's and Children's Hospital, Singapore
| | | | - Sze Ling Chan
- Health Services and Systems Research, Duke-NUS Medical School, Singapore; Health Services Research Centre, Singapore Health Services, Singapore
| | - Janardhan Krishnappa
- Department of Pediatrics, Neurology Service, KK Women's and Children's Hospital, Singapore
| | - Adeline Seow Fen Ngoh
- Department of Pediatrics, Neurology Service, KK Women's and Children's Hospital, Singapore
| | - Simon Robert Ling
- Department of Pediatrics, Neurology Service, KK Women's and Children's Hospital, Singapore
| | - Tong Hong Yeo
- Department of Pediatrics, Neurology Service, KK Women's and Children's Hospital, Singapore
| | - Derrick W S Chan
- KK Research Centre, KK Women's and Children's Hospital, Singapore; Department of Pediatrics, Neurology Service, KK Women's and Children's Hospital, Singapore
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Kharbat FF, Alshawabkeh A, Woolsey ML. Identifying gaps in using artificial intelligence to support students with intellectual disabilities from education and health perspectives. ASLIB J INFORM MANAG 2020. [DOI: 10.1108/ajim-02-2020-0054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeStudents with developmental/intellectual disabilities (ID/DD) often have serious health issues that require additional medical care and supervision. Serious health issues also mean increased absence and additional lags in academic achievement and development of adaptive and social skills. The incorporation of artificial intelligence in the education of a child with ID/DD could ameliorate the educational, adaptive and social skill gaps that occur as a direct result of persistent health problems.Design/methodology/approachThe literature regarding the use of artificial intelligence in education for students with ID/DD was collected systematically from international online databases based on specific inclusion and exclusion criteria. The collected articles were analyzed deductively, looking for the different gaps in the domain. Based on the literature, an artificial intelligence–based architecture is proposed and sketched.FindingsThe findings show that there are many gaps in supporting students with ID/DD through the utilization of artificial intelligence. Given that the majority of students with ID/DD often have serious and chronic and comorbid health conditions, the potential use of health information in artificial intelligence is even more critical. Therefore, there is a clear need to develop a system that facilitates communication and access to health information for students with ID/DD, one that provides information to caregivers and education providers, limits errors, and, therefore, improves these individuals' education and quality of life.Practical implicationsThis review highlights the gap in the current literature regarding using artificial intelligence in supporting the education of students with ID/DD. There is an urgent need for an intelligent system in collaboration with the updated health information to improve the quality of services submitted for people with intellectual disabilities and as a result improving their quality of life.Originality/valueThis study contributes to the literature by highlighting the gaps in incorporating artificial intelligence and its service to individuals with ID/DD. The research additionally proposes a solution based on the confounding variables of students’ health and individual characteristics. This solution will provide an automated information flow as a functional diagnostic and intervention tool for teachers, caregivers and parents. It could potentially improve the educational and practical outcomes for individuals with ID/DD and, ultimately, their quality of life.
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Karayağmurlu A, Aytaç İ. Pre- and postoperative quality of life and emotional/behavioural problems in children with PFAPA. Int J Pediatr Otorhinolaryngol 2020; 137:110239. [PMID: 32896352 DOI: 10.1016/j.ijporl.2020.110239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 06/26/2020] [Accepted: 06/27/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study aimed to evaluate the effects of surgical intervention on quality of life, emotional/behavioural problems and school absenteeism in children with periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA.) METHOD: A total of 56 children aged between 4 and 12 years, diagnosed with PFAPA and undergoing tonsillectomy with/without adenoidectomy at a tertiary hospital were included in the study. The Questionnaire for Quality of Life Assessment for Children and Adolescents Parent Form (Kid-KINDL) and the Strengths and Difficulties Questionnaires (SDQ) were used to evaluate quality of life and emotional/behavioural problems, respectively. The cases were assessed before and three months after surgery. RESULTS The mean (SD) age of the children was 6.64 (3.03) years, and 58.9% (n = 33) were boys. The numbers of pre- and post-operative periodic fever episodes were 3.0 (1.7) and 0.6 (0.9) (p < 0.001), those for school absenteeism were 10.28 (5.53) and 2.85 (2.95) days (p < 0.001) and those for hospital presentations were 3.8 (2.5) and 1.1 (1.1) (p < 0.001), respectively, all of which were significantly lower in children with PFAPA at three months after the operation. The surgical procedures were effective in improving quality of life and emotional/behavioural problems, as evidenced by the significant differences between the pre- and post-treatment scores in outcome measures, including SDQ and Kid-KINDL (p < 0.001). CONCLUSIONS This study demonstrated that the surgical approach exhibited positive effects in terms of improving quality of life and reducing emotional/behavioural problems and school absenteeism in children with PFAPA.
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Affiliation(s)
- Ali Karayağmurlu
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Istanbul University, İstanbul, Turkey.
| | - İsmail Aytaç
- Department of Otorhinolaryngology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
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Kampra M, Tzerakis NG, Losidis S, Katsarou E, Voudris K, Mastroyianni S, Mouskou S, Siatouni A, Gatzonis S. Teachers' knowledge about epilepsy in Greece: Information sources and attitudes towards children with epilepsy during school time. Epilepsy Behav 2016; 60:218-224. [PMID: 27240308 DOI: 10.1016/j.yebeh.2016.04.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/18/2016] [Accepted: 04/03/2016] [Indexed: 12/20/2022]
Abstract
AIM The aim of this study was to explore the sources of information for the educators in Greek primary and secondary schools with regard to epilepsy, first aid to seizures, and pupils' health conditions. METHOD A semistructured anonymous 52-item questionnaire was sent to 100 public primary and secondary Greek schools from all districts. Two thousand thirty-seven teachers were approached; 446 questionnaires returned. The data were analyzed with SPSS20. Also, 70 head teachers were phone-interviewed with an open-ended unstructured questionnaire. The derived data were analyzed using mixed methodology. RESULTS Twenty-two percent of the addressed educational community responded to the questionnaire, mostly women (66.6%). More responses came from urban areas (71.5%). The main source for the teachers to obtain information about epilepsy was found to be personal experience (37.75%) and internet (34.93%). Only a small percentage was referred to courses (6.2%). Eighty point three percent of the educators knew what epilepsy is, and 88.1% had the right view about the nature of the illness. However, 92% of the educators replied that they have not had adequate first aid training. Although 80.3% of the teachers believed that the school personnel are aware of the pupils' medical history, 85.48% of the teachers considered that they are informed about the pupils' condition from the parents/carers, and only 5.53% believed that the information came from the family doctor. Ninety-five point seventy percent of the educators declared a wish for further information and training about epilepsy. CONCLUSION Knowledge and attitudes of the educators towards epilepsy are improved compared with those reported in previous studies conducted in Greece. However, there are still areas of uncertainty which need improvement. The necessity for more information about epilepsy and pupils' medical history along with appropriate training about seizure incidents seems crucial for the Greek educational community. Educational campaigns about epilepsy could improve teachers' knowledge of epilepsy to develop a well-informed and tolerant community. Further research in the field is necessary to provide teachers with accurate information about the illness and the ways to cope with it.
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Affiliation(s)
- Matina Kampra
- Ministry of Health, Aristotelous 17, P.C. 10433, Greece.
| | - Nikolaos G Tzerakis
- Department of Neurosurgery, University Hospital of North Midlands NHS Trust, UK.
| | - Sotiris Losidis
- University of Piraeus, Karaoli Dimitriou 80, P.C. 18534 Piraeus, Greece.
| | - Efstathia Katsarou
- Department of Neurology, Children's Hospital of Athens "P. and A. Kyriakou", Thivon and Levadias str, Athens P.C. 115 27, Greece.
| | - Konstantinos Voudris
- Department of Neurology, Children's Hospital of Athens "P. and A. Kyriakou", Thivon and Levadias str, Athens P.C. 115 27, Greece.
| | - Sotiria Mastroyianni
- Department of Neurology, Children's Hospital of Athens "P. and A. Kyriakou", Thivon and Levadias str, Athens P.C. 115 27, Greece.
| | - Stella Mouskou
- Children's Hospital "P & A Kyriakou", Athens 115 27, Greece.
| | - Anna Siatouni
- Department of Neurosurgery, "Evangelismos" Hospital, National and Kapodistrian University, Greece.
| | - Stylianos Gatzonis
- Department of Neurosurgery, "Evangelismos" Hospital, National and Kapodistrian University, Greece.
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Determinants of Noncompliance to Clinic Appointments and Medications among Nigerian Children with Epilepsy: Experience in a Tertiary Health Facility in Enugu, Nigeria. Behav Neurol 2016; 2016:6580416. [PMID: 26997756 PMCID: PMC4779509 DOI: 10.1155/2016/6580416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 01/12/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. To determine the frequency and determinants of noncompliance to clinic appointment and medication among Nigerian children with epilepsy. Method. This is a cross-sectional survey of noncompliance to clinic appointments and medication among 113 consecutive children with epilepsy attending the Paediatric Neurology Clinic of University of Nigeria Teaching Hospital, Enugu, southeastern Nigeria. Results. Noncompliance to clinic appointment and medication was 23% and 15.3%, respectively. The major reasons given were lack of finance, clashing with school time, and forgetting to take the drugs. Children whose mothers were less educated and unemployed were more likely to miss clinic appointments. Noncompliance to medication was associated with poor seizure control. Children that were on phenobarbitone were more likely to be noncompliant with medication than those on sodium valproate and/or carbamazepine. Conclusion. Missed clinic appointment and medication noncompliance are common among Nigerian children with epilepsy and financial constraint is the most common reason.
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Ezenwosu OU, Emodi IJ, Ikefuna AN, Chukwu BF, Osuorah CD. Determinants of academic performance in children with sickle cell anaemia. BMC Pediatr 2013; 13:189. [PMID: 24246094 PMCID: PMC3835142 DOI: 10.1186/1471-2431-13-189] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 11/12/2013] [Indexed: 11/24/2022] Open
Abstract
Background Some factors are known to influence the academic performance of children with Sickle Cell Anaemia (SCA). Information on their effects in these children is limited in Nigeria. The factors which influence academic performance of children with SCA in Enugu, Nigeria are determined in this study. Methods Consecutive children with SCA aged 5–11 years were recruited at the weekly sickle cell clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age- and sex- matched normal classmates were recruited as controls. The total number of days of school absence for 2009/2010 academic session was obtained for each pair of pupils from the class attendance register. Academic performance was assessed using the average of the overall scores in the three term examinations of same session. Intelligence ability was determined with Draw-A-Person Quotient (DAPQ) using the Draw-A-Person Test while socio-economic status was determined using the occupational status and educational attainment of each parent. Results Academic performance of children with SCA showed statistically significant association with their socio-economic status (χ2 = 9.626, p = 0.047), and significant correlation with DAPQ (r = 0.394, p = 0.000) and age (r = -0.412, p = 0.000). However, no significant relationship existed between academic performance and school absence in children with SCA (r = -0.080, p = 0.453). Conclusions Academic performance of children with SCA is influenced by their intelligence ability, age and socio-economic status but not negatively affected by their increased school absenteeism.
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Affiliation(s)
- Osita U Ezenwosu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu, Nigeria.
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Mushi D, Burton K, Mtuya C, Gona JK, Walker R, Newton CRJC. Perceptions, social life, treatment and education gap of Tanzanian children with epilepsy: a community-based study. Epilepsy Behav 2012; 23:224-9. [PMID: 22341180 PMCID: PMC3597140 DOI: 10.1016/j.yebeh.2011.12.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Revised: 11/30/2011] [Accepted: 12/01/2011] [Indexed: 10/28/2022]
Abstract
The effects of epilepsy on children and their families, factors influencing the treatment and education gap and socio-cultural beliefs about epilepsy in children in rural sub-Saharan Africa are not clearly defined. We conducted a qualitative study, with 38 in-depth interviews and 2 focus group discussions with carers of children with epilepsy (CWE) in Tanzania. Discrimination, isolation and lack of hope were identified as major issues. Poor school attendance was attributed to learning difficulties, behavior problems, ongoing seizures and restricted school access. The treatment gap was related to misdiagnosis, preferential use of traditional treatment and cost of biomedical treatment. The hopes expressed for the future centered on access to treatment and education. Improved access to diagnosis, cost-effective treatment, sensitization of the community on epilepsy, collaborative care provision with traditional and faith healers and improved access to specialist schooling could improve the quality of life and future of CWE in this region.
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Affiliation(s)
- D Mushi
- Community Health Department, Tumaini University, Kilimanjaro Christian Medical College, Moshi, Tanzania
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