Research Question
Is there a difference in the management of epilepsy in the UK versus Kenya and in what ways can the management of epilepsy in the UK, which is a developed country inform the management of epilepsy in Kenya, which is a developing country?
Aims
a) To establish how health practitioners manage epilepsy in the UK
b) To establish how health practitioners manage epilepsy in Kenya
c) To establish how management of epilepsy in the UK can inform the management of epilepsy in Kenya.
Case Study
Considering the availability of firsthand information on the management of epilepsy in the UK, which is a developed country it is justified to conduct a study that looks at the management of the same disability in a developing country (Reynolds and Trimble 2009). Kenya has been selected since it is one of the anchoring nations of Sub-Saharan Africa, as well as the East African region and the studies by Mbuba et al. (2012), indicate that in Kenya, Epilepsy is perceived to be a taboo that is associated with evil spirits. With such as perception, it is interesting to see how health practitioners manage epilepsy in Kenya, the challenges they come by as well as the lessons they can derive from UK’s management of epilepsy (Sharma et al. 2013). On the other hand, researchers such as Booth and Thompson (2010) point out that the UK perceives epilepsy as medical, neurological medical condition. As such, the UK has over the
recent years purposed to initiate strategic actions towards providing support in its healthcare system, with the help of the medical practitioners, to care for the affected patients and thus, ensure that they enjoy the best quality-of-life. It is significant to note that epilepsy is manageable in a more easy way, especially if the patient is in a position to access anti-epileptic drugs. Crombie et al. (2017) further note that with easy access to the drugs, they can make the patient lead a better life whilst suffering from the disease. For example, there are prominent personalities, who suffered from epilepsy, yet they led successful lives. Tatum et al. (2009) point out that they include Alfred Nobel, Alexander the Great and even Theodore Roosevelt. This clearly shows that with the introduction of more advanced medicine; an epileptic person can live a normal and successful life, meaning epilepsy needs not to be a major health concern. However, studies conducted by Mbubi and Newton (2009) notes that Kenya considers epilepsy to be a critical health issue and as such, the affected individuals undergo stigmatization to the extent that they do not have the privilege to live normal lives, especially, with the limited provision of healthcare (Ibinda et al. 2014).
The difference in the level of perception for the disease by the both countries has created the urge for this review to answer how epilepsy management in the UK can significantly inform Kenya about the management of the same disease (Epilepsy Action 2017). With reference to the writings of Guerrini (2006), he states that this could be effective in the following ways: first, through changing of the wrong Kenyan perception about the disease, to consider it as a medical condition rather than a taboo. Secondly, Hollaway (2006) states that by influencing the Kenyan government to provide medical support, owing to the fact that Kenya has many epileptic patients. This is significant if the Kenyan government purposes to ensure the supply of affordable
anti-epileptic drugs to all parts of the country. Thirdly, the UK management of epilepsy can inform the Kenyan management to initiate a collaborative effort among the healthcare providers, the patient’s immediate family members, and the government, in a bid to strategize a care plan for epileptic patients (Mbuba et al. 2017).
Methodology
The methodology will be limited to secondary research, which entails collection of data from sources that already exist. Some of the sources that I will explore in the collection of data include the school library, Google Books, databases such as ProQuest and EBSCO.
In a bid to establish the research question and aims, only the secondary data is used, and as such, it is not necessary to incorporate primary data to have an informative and valid research study. Significantly, the undertaken literature ascertains that the research area is valid and as such, provides an extensive knowledge gap. The initial preliminary study presented information, which was accurate enough to prove that the management of the affected epileptic patients in Kenya is not at a standard level and that the patients fall subjects to stigmatization, thereby, denying them the freedom to enjoy efficient healthcare that purposes to aid them in managing their epileptic condition. Owing to the fact that the research for the previous study employed the utilization of the research studies that focused on answering the aims and objectives of the review and in addition the research question, this review has been motivated to incorporate the inclusive and exclusive criteria. In which case, it targets at remodeling the study in a bid to provide an extensive knowledge regarding the understanding of the different management concepts of
epilepsy, as portrayed in the UK, beinga developed country, and Kenya, a developing country (Munyoki et al. 2010).
This review study has conducted extensive research on various websites that have relevant information relating to the UK and Kenya’s ways of epilepsy management. The incorporated websites include NICE (2016), Epilepsy Action and NHS for the UK and the Kenya Association for the Welfare of People with Epilepsy for Kenya. On the selection of the relevant sources for the research, these websites proved to be worthwhile enough since they had an extensive knowledge regarding the epilepsy management. Moreover, in an attempt to get to these websites, the used key words were “UK management of Epilepsy” and “Kenya Management of Epilepsy.” It is evident that these sites provided essential information, as pertaining to the perception, management, as well as prevalence of epilepsy in both the UK and Kenya.
Following the internet search, I embarked on searching for scholarly books, published in not more than 10 years ago. The school library was my first option as it has a variety of essential reading materials and I equally searched for three google books, which focused on epilepsy. These books provided the medical background, which underpinned epilepsy, as the focus of the research. The last research sources came from credible databases, which included ProQuest and EBSCO. These databases had multiple journals, such as that of Kendall-Taylor et al. (2008), which discussed how the Kenyan communities such as those in the coastal region used traditional methods to treat epilepsy, whereas, in the UK, uses only the advanced anti-epileptic drugs. The used terminologies for searching for the journals include “Kenya and epilepsy” and “The UK and epilepsy.”
I excluded research studies, published more than ten years ago, regardless of whether they had the essential information that I needed for the study. I also excluded research studies, which never had relevant information, as pertaining to the subject of the research. Overall, I had the modification made in the previous methodology because I needed this review to have a much more extensive knowledge, which can qualify as a reference material for future use.
As an ethical requirement, I purposed to ensure that the sources that I used as reference in the write up were as such, acknowledged in the dissertation through the incorporation of in-text citation, which also appeared in the list of references.
Completion Plan
This project required a systematical timing of the tasks involved towards its completion. The duration for completing the work took 4 months, starting from 25th January 2017 to the submission date, which was on Friday 7th April 2017. In this regard, the first step involved in the project was the refining and implementation of the searches meant for the relevant pieces of research for the study. This task commenced on 25th of January and ended on 31st January when I got my final selection of the peer-reviewed journal articles and websites, which proved to be essential for the study. This was purposeful, in a bid to get various research studies that had extensive knowledge of epilepsy management in both the UK and Kenya. Following that task, I engaged in the critical analysis of the selected sources, which commenced on 1st February 2017 and ended on 15th February 2017. I visited various websites and used the inclusion and exclusion method, to select sources that had wide knowledge regarding epilepsy management in the UK and Kenya. I included sources, published less than 10 years ago, and excluded those published older than 10years ago. Moreover, I also excluded sources that were not relevant to the topic in
particular and included those that were focusing on the research objections and question. The write up for my review commenced on 16th February 2017 and ended on 25th March 2017, whereby, I broke down the review into 8 sections. The first section, which dealt with the statement of findings ended on 18th February. The second section, the strength, and limitation of the study ended on 21st February. The third section, the question context ended on 25th February. The fourth section, the methodology ended on 2nd March, the fifth section, the results ended on 26th March February, the sixth section, thematic discussion ended on 1st April, the seventh and eight section, which is the conclusion and recommendations respectively ended on 2nd April. I took the write up to the supervisor on 3rd April 2017, whereby various corrections were made on my written work, and I commenced the proof reading process on 4th April 2017, which ended on 6th April 2017 and finally submitted the final work on 7th April 2017.
References
Booth, L. and Thompson, G. (2010). Epilepsy Statistics. House of Commons: Library.
Crombie, I. Irvine, L. Elliott, L. and Wallace, H. Closing Health Inequalities Gap: An International Perspective. World Health Organisation. Accessed on 13th June 2017 Retrieved from https://www.euro.who.int/__data/assets/pdf_file/0005/124529/E87934.pdf
Epilepsy Action (n.d) Treatment With Epilespy Medicine. [online] retrieved from https://www.epilepsy.org.uk/info/treatment/anti-epileptic-drug-treatment [accessed 13th June 2017]
Guerrini, R. (2006) Epilepsy in Children, Lancet, 367, pp. 499–524
Hollaway, K. J. (2006). New research on epilepsy and behavior. New York: Nova Science Publishers.
Ibinda, F., Wagner, R., Bertram, M., Ngugi, A., Bauni, E., Vos, T., Sander, J., & Newton, C. (2014) Burden of epilepsy in rural Kenya measured in disability-adjusted life years, Epilepsia (Series 4), 55(10), p1626-1633
Kendall-Taylor, N., Kathomi, C., Rimba, K., & Newton, C. (2008) Traditional healers and epilepsy treatment on the Kenyan coast, Epilepsia (Series 4), 49, 9, pp. 1638-1639
Mbuba, C., and Newton, C., (2009) Packages of care for epilepsy in low- and middle-income countries, Plos Medicine, 6, 10
Mbuba, C., Ngugi, A. Fegan, G. Ibinda, F. Muchochi, S. Nyundo, C. Odhiambo, R. Edwards, T, Odermatt, P. Carter, J. and Newton, C. (2012) Risk factors associated with the epilepsy treatment gap in Kilifi, Kenya: a cross-sectional study. Lancet Neurology, 11(8): 688–696.
Mbuba, C., Ngugi, A. Fegan, G. Ibinda, F. Muchochi, S. Nyundo, C. Odhiambo, R. Edwards, T, Odermatt, P. Carter, J. and Newton, C. (2012) Risk factors associated with the epilepsy treatment gap in Kilifi, Kenya: a cross-sectional study. Lancet Neurology, 11(8): 688–696.
Munyoki, G., Edwards, T., White, S., Kwasa, T., Chengo, E., Kokwaro, G., Odera, V., Sander, J., Neville, B., & Newton, C. (2010), Clinical and neurophysiologic features of active convulsive epilepsy in rural Kenya: a population-based study, Epilepsia, 51(12), p2370-2376
NICE (2016) Epilepsies: Diagnosis and Management. National Institute of Health and Care Excellence. [Online] available from: https://www.nice.org.uk/guidance/cg137/chapter/1-Guidance#pharmacological-treatment [accessed on 13th June 2017].
Reynolds, E. and Trimble, M. (2009) Epilepsy, Psychiatry, and in Neurology. Epilepsia, 50(3), p50–55
Sharma, S. and Dixit, V. (2013) Epilepsy – A Comprehensive Review. International Journal of Pharma Research & Review, vol 2(12): 61-80.
Tatum, W. Kaplan, P. & Jallon, P. (2009) Epilepsy A to Z: A Concise Encyclopaedia. New York: Demos Medical.