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Behavioral And Physiological Analysis In A Zebrafish Model Of Epilepsy
Published on: October 19, 2021
Development and Evaluation of a Pediatric Epilepsy Training Program for First Level Providers in Zambia
Archana A Patel1,2, Ornella Ciccone3, Kafula Lisa Nkole3
1Boston Children's Hospital, Department of Neurology, Harvard Medical School, Boston, MA, USA.
Insights
A structured education intervention significantly improved pediatric epilepsy knowledge and clinical practice among first-level providers in Zambia. This training addressed the treatment gap for children with epilepsy, enhancing care delivery.
Area of Science:
- Global Health
- Pediatric Neurology
- Medical Education
Background:
- Developing nations face significant challenges in epilepsy treatment due to high disease burden and limited expert providers.
- Children with epilepsy are at increased risk for developmental impairments and refractory disease without timely, appropriate management.
- A substantial treatment gap exists for epilepsy, particularly in pediatric populations, necessitating improved provider capacity.
Purpose of the Study:
- To assess the impact of a structured education intervention on pediatric epilepsy knowledge and clinical practice among first-level healthcare providers in Zambia.
- To evaluate changes in the management and documentation of pediatric epilepsy cases following the educational program.
Main Methods:
- A structured education intervention on pediatric epilepsy was delivered to first-level providers across three facilities in Zambia.
- Pre- and post-intervention assessments measured changes in knowledge and confidence levels.
- Chart reviews before and four months after the intervention assessed improvements in clinical practice and documentation.
Main Results:
- Seven out of fifteen knowledge assessment concepts showed statistically significant improvement (P < .05) post-intervention.
- Significant improvements were observed in the documentation of seizure description (P = .008), seizure frequency (P = .00), and possible causes of epilepsy (P = .034).
- The training was completed by 23 participants, including clinical officers and nurses, indicating good engagement.
Conclusions:
- Structured, hands-on, and case-based education, developed with provider input, effectively enhances pediatric epilepsy knowledge and clinical practice.
- This intervention shows promise in improving the management of pediatric epilepsy in resource-limited settings.
- Further research is needed to evaluate the long-term health outcomes for children with epilepsy.
Abstract:
Introduction. The developing world continues to face challenges in closing the large treatment gap for epilepsy, due to a high burden of disease and few experienced providers to manage the condition. Children with epilepsy are susceptible to higher rates of developmental impairments and refractory disease due to delays or absence of appropriate management as a result. We demonstrated that a structured education intervention on pediatric epilepsy can improve knowledge, confidence, and impact clinical practice of first level providers in Zambia. Methods. Three first-level facilities across Zambia were included. After initial pilot versions and revisions, the final course was implemented at each site. Pre- and post-intervention knowledge and confidence assessments were performed. Additionally, chart reviews were conducted prior to intervention and 4 months after completion of training at each site to assess change on management. Results. Twenty-three of the original 24 participants from all 3 sites completed the training; 48% clinical officers, 43% nurses, 9% other expertise. Of the 15 concepts tested by knowledge assessment, 12 showed trends in improvement, 7 of which were significant (P < .05). Chart reviews demonstrated significant improvement in documentation of seizure description (P = .008), seizure frequency (P = .00), and possible causes of seizures/epilepsy (P = .034). Discussion. Key elements of success to this program included hands on clinical skills building and case-based teaching, development of a program with direct and ongoing input from the target audience, and inclusion of assessments to monitor impact on clinical practice. Future studies looking at health outcomes are necessary to determine sustained impact.
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