Comprehensive evaluation of the psychosocial parameters of epilepsy: A representative population-based study in Prey Veng (Cambodia)

Authors

  • Devender Bhalla,

    1. INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
    2. School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
    3. Centre Hospitalier Universitaire, Limoges, France
    4. Cambodian Society of Neurology, Phnom Penh, Cambodia
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  • Kimly Chea,

    1. University of Health Sciences, Phnom Penh, Cambodia
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  • Hun Chamroeun,

    1. Cambodian Society of Neurology, Phnom Penh, Cambodia
    2. University of Health Sciences, Phnom Penh, Cambodia
    3. Department of Neurology, Calmette Hospital, Phnom Penh, Cambodia
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  • Chan Vichea,

    1. Department of Neurology, Calmette Hospital, Phnom Penh, Cambodia
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  • Pierre Huc,

    1. INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
    2. School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
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  • Chan Samleng,

    1. Cambodian Society of Neurology, Phnom Penh, Cambodia
    2. University of Health Sciences, Phnom Penh, Cambodia
    3. Department of Neurology, Calmette Hospital, Phnom Penh, Cambodia
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  • Robert Sebbag,

    1. Department of Access to Medicines, Sanofi, Gentilly, France
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  • Daniel Gérard,

    1. Department of Access to Medicines, Sanofi, Gentilly, France
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  • Michel Dumas,

    1. INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
    2. School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
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  • Sophal Oum,

    1. University of Health Sciences, Phnom Penh, Cambodia
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  • Michel Druet-Cabanac,

    1. INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
    2. School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
    3. Centre Hospitalier Universitaire, Limoges, France
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  • Pierre-Marie Preux

    Corresponding author
    1. INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
    2. School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, Limoges, France
    3. Centre Hospitalier Universitaire, Limoges, France
    • Address correspondence to Prof. Pierre-Marie Preux, Institut de Neuroépidémiologie et Neurologie Tropicale (EA3174), Faculté de Médecine, 2, rue du Dr Marcland, 87025 Limoges Cedex, France. E-mail: preux@unilim.fr

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Abstract

Purpose

We conducted a population-based study of epilepsy in Prey Veng (Cambodia) to explore self-esteem, fear, discrimination, knowledge–attitude–practice (KAP), social-support, stigma, coping strategies, seizure-provoking factors, and patient-derived factors associated with quality of life (QOL).

Methods

The results are based on a cohort of 96 cases and matched controls (n = 192), randomly selected from the same source population. Various questionnaires were developed and validated for internal consistency (by split-half, Spearman-Brown prophecy, Kuder-Richardson 20), content clarity and soundness. Summary, descriptive statistics, classical tests of hypothesis were conducted. Uncorrected chi-square was used. Group comparison was done to determine statistically significant factors, for each domain, by conducting logistic regression; 95% confidence interval (CI) with 5% (two-sided) statistical significance was used.

Key Findings

All questionnaires had high internal consistency. Stress was relevant in 14.0% cases, concealment in 6.2%, denial in 8.3%, negative feelings in public in 3.0%. Mean self-esteem was 7.5, range 0–8, related to seizure frequency. Mean discrimination was least during social interactions. Coping strategies were positive (e.g. look for treatment). Postictal headache, anger, no nearby health facility, etc. were associated with QOL.

Significance

The reliability of our questionnaires was high. A positive social environment was noted with many infrequent social and personal prejudices. Not all populations should (by default) be considered as stigmatized or equipped with poor KAP. We addressed themes that have been incompletely evaluated, and our approach could therefore become a model for other projects.

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