Qualitative evaluation of the outcomes of care and treatment for children and adolescents with nodding syndrome and other epilepsies in Uganda  

作　　者：Catherine Abbo Amos Deogratius Mwaka Bernard Toliva Opar Richard Idro 

机构地区：[1]Department of Psychiatry,School of Medicine College of Health Sciences,Makerere University,Kampala,Ugandd [2]不详

出　　处：《Infectious Diseases of Poverty》2019年第2期93-93,共1页贫困所致传染病（英文）

摘　　要：Background:In 2012,the Ugandan Government declared an epidemic of Nodding Syndrome(NS)in the Northern districts of Gulu,Kitgum,Lamwo and Pader.Treatment guidelines were developed and NS treatment centres were established to provide symptomatic control and rehabilitation.However,a wide gap remained between the predefined care standards and the quality of routine care provided to those affected.This study is to qualitatively assess adherence to accepted clinical care standards for NS;identify gaps in the care of affected children and offer Clinical Support Supervision(CSS)to Primary Health Care(PHC)staff at the treatment centres;and identify psychosocial challenges faced by affected children and their caregivers.Methods:This case study was carried out in the districts of Gulu,Kitgum,Lamwo and Pader in Uganda from September to December in 2015.Employing the 5-stage approach of Clinical Audit,data were collected through direct observations and interviews with PHC providers working in public and private-not-for-profit health facilities,as well as with caregivers and political leaders.The qualitative data was analysed using Seidel model of data processing.Results:Clinical Audit and CSS revealed poor adherence to treatment guidelines.Many affected children had suboptimal NS management resulting in poor seizure control and complications including severe burns.Root causes of these outcomes were frequent antiepileptic drugs stock outs,migration of health workers from their work stations and psychosocial issues.There was hardly any specialized multidisciplinary team(MDT)to provide for the complex rehabilitation needs of the patients and a task shifting model with inadequate support supervision was employed,leading to loss of skills learnt.Reported psychosocial and psychosexual issues associated with NS included early pregnancies,public display of sexual behaviours and child abuse.Conclusions:Despite involvement of relevant MDT members in the development of multidisciplinary NS guidelines,multidisciplinary care was not imple

关 键 词：Nodding syndrome EPILEPSY MULTI-DISCIPLINARY Clinical audit Clinical support supervision Uganda 

分 类 号：R73[医药卫生—肿瘤]