Abstracts

Rationale: Epilepsy is a common cause of morbidity and mortality in developing countries. Epidemiological studies have shown a higher prevalence and incidence of epilepsy in the general population of Latin America compared to northern hemisphere countries (1). Although epilepsy is common, it can be associated with stigmatization, misconceptions, and poor public awareness (2). During our short-term medical trip to the Dominican Republic we had the opportunity to interact with members in the community, observe and participate in patient care, and lead lectures at various institutions in this developing country. One main goal was to build lasting relationships with local pediatricians, neurologists, and physical medicine physicians, thus allowing for collaborative learning and a cross-cultural experience. We sought to provide education to deepen the community’s knowledge and address myths and misconceptions about epilepsy. Methods: A comprehensive lecture on epilepsy was given in Spanish. Pre-lecture and post-lecture questionnaires with closed ended questions were completed by the audience. The audience included family members of patients with epilepsy, physicians, and other medical staff (nurses, therapists, and nutritionists). The lecture was given at various institutions in Santo Domingo, Dominican Republic (Robert Reid Cabral Children’s Hospital, Pediatric Center for Integrated Attention for Patients with Disabilities, and the Dominican Rehabilitation Association). Results: A total of 326 (166 pre-lecture;160 post-lecture) questionnaires were obtained. The majority of respondents knew or cared for someone with epilepsy (n=144, 86.8% pre-lecture; n=145, 90.6% post-lecture). After the lecture, the ability to accurately define epilepsy increased from 89.7% (n=149) to 97.5% (n=156). The biggest effect was noted regarding seizure first aid and treatment. Prior to the lecture only 56.6% (n=94) of respondents knew to avoid putting objects in an actively seizing person’s mouth; afterwards this increased to 98.1% (n=157). Before education only 67.5% (n=112) knew that surgery was available to treat some types of epilepsy; after education 98.1% (n=157) recognized this. The lecture had almost no effect on changing the perspective of whether women with epilepsy should get pregnant—pre-lecture 85.5% (n=142) felt they should get pregnant compared to 88.1% (n=141) post-lecture. Unexpectedly, fewer people thought that epilepsy could result in death after the lecture (n=102, 61.5%) than before the lecture (n=76, 47.5%). Conclusions: We were able to gather understanding of the existing outlook and baseline knowledge of epilepsy in our study population. Our educational intervention clarified the diagnosis of epilepsy, introduced new treatment options, and dispelled myths regarding seizure safety. However, by discussing advanced therapy options (ketogenic diet, epilepsy surgery, VNS, etc.), many of which were novel to our audience, we may have unknowingly caused some to inadvertently minimize the risk of epilepsy’s morbidity and mortality. Future directions include sub-group analysis, revising the lecture and surveys to address the deficits this study elucidated, and administering a follow-up survey to assess retention of information. Funding: No funding