Impact of Epilepsy, Stigma and Depression on Quality of life in People with epilepsy in rural Communities in Cameroon and Implications for Rural Epilepsy Care

Background Depression and stigma are common in epilepsy and may significantly impact quality of life but are often rarely addressed. This study aimed to assess the impact of epilepsy, stigma, and depression on the quality of life of people with epilepsy in rural communities in Cameroon. Methods We conducted a community-based cross-sectional study in 8 rural communities in the Central region of Cameroon. Quality of life was assessed using the quality of life in epilepsy (QOLIE) questionnaires for adults (QOLIE-31-P version 2) and adolescents (QOLIE-AD-48 version 1). The Kilifi Stigma Scale for Epilepsy and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) were used to screen for stigma and depression respectively. Results Two hundred and one persons (201) were included in the study. The age range varied from 11 to 72 years, with a slight female predominance of 51.2% vs 48.8% for males. Most participants had a poor quality of life (mean scores for adolescents and adults were 40.46 ± 10.254 and 44.50 ± 9.331 respectively). Stigma and depression were significantly associated with poor quality of life. Conclusion The substantial and negative impact of epilepsy, stigma and depression on the quality of life of people with epilepsy in our study could have several implications for rural public health such as decreased life expectancy and higher disease burden. Public health interventions to improve quality of life must be multifaceted and not only focused on seizure control. Interventions such as community-based education and awareness campaigns, improving access to antiseizure medications, provision of mental health services and the development of robust policies for epilepsy care could address the negative impact of epilepsy, stigma and depression on the quality of life of people with epilepsy in rural communities.