Abstracts

Rationale: Epilepsy Week in Antigua and Barbuda (A&B) is often aimed at advocacy for epilepsy management awareness. It highlights challenges faced by low- and middle-income regions with the paucity of epilepsy care and the urgency to address basic needs. A collaboration among visiting epilepsy providers, the local physician thought leaders, with direct governmental involvement, led to success in providing improved clinical care for patients with epilepsy, available antiepileptic medications (6 government-sponsored AED’s), advocacy and education, with intent to build and maintain a sustained multi-layered level of care.The A&B approach to Epilepsy Week, provides clinical care, internal auditing, addressing clinical and investigative needs and topic directed education. To emphasize a sense of urgency, the team focused on a single Patient X, then direct all efforts back to the entire community. Methods: The Ministry of Health, Wellness and the Environment of Antigua and Barbuda formed a strategic partnership with international clinicians, local stakeholders, and private donors to bridge the gaps in the care of persons with epilepsy. This was congruent with their national goals for health and empower of individuals and families to manage their own health, strengthen health systems and community support mechanisms and expand strategic partnerships. Targeted Health Professionals came from Barbados and Jamaica and the USA. Activities planned were inclusive of addressing needs identified, clarifying misunderstandings, reducing stigma, empowering patients with epilepsy and their families and having a surgical epilepsy conference involving all stakeholders. Results: Patient X was a teenager with a mesial left temporal lesion and an initial history of fever-related seizures. She had pharmacoresistant Epilepsy with difficulty acquiring investigative studies and acute management, faced bullying, had teacher-related challenges in school, and had neurocognitive difficulties. Concerns addressed during Epilepsy week related to all facets of her care. - Education (school children, school principals, parents, nurses, physicians and society at large via media); Advocacy (addressing questions and concerns via media, TV and Radio, a town hall meeting, and involvement of the Chief Medical Officer of the country, the head of the Central Hospital, and the Minister of Health). - Investigative Studies (Supporting the trained EEG Technologist with ongoing training and establishing International 48-hour EEG interpretations) - Dietary support (Establishing training for 4 local Dietitians trained by a Ketogenic Dietician) - Neuropsychological support (A regional psychologist established training of a local psychometrist with ‘hub and spoke’ online support). - Surgical Epilepsy Conference (inclusive of case discussions with local physicians and a presentation of imaging by the local Radiologist); Planning (epilepsy week critique, establishing timelines and 11 suggestions).Clinical Care: 48 Patients identified (Pediatric- 26; Adults-22) by Primary Care Physicians, that require subspecialist care. Conclusions: Epilepsy Week in Antigua has transcended a week of overarching discussions and education. It has evolved into a national targeted working week of yearly reflection, critique, directed educational needs, and addressing future needs with timelines. Focusing on one child with epilepsy, established a sense of national urgency. This unique use of the week expedites the building of a more sustainable Epilepsy Program and may be replicated in other poorly resourced regions/countries. Funding: No funding