Published in PLOS One on 2026-08-11, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Emmanuel Kwame Darkwa, Patrick Adjei, Sabina Asiamah, Elizabeth Awini, Cynthia Sottie, Anthony Godi, John E Williams, Frank Atuguba, Fuseini Sataru, Alexander Adjei, Arjune Sen, Charles R Newton, Anthony Danso-Appiah, J Helen Cross, Josemir W Sander, Albert Akpalu, on behalf of the EPInA investigators, Hiroki Annaka
Source: PLOS One • DOI 10.1371/journal.pone.0355854
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Epilepsy is an easily treatable condition, but a substantial treatment gap persists, particularly in low- and middle-income countries. We quantified the epilepsy treatment gap in Ghana.
We conducted a three-stage population-based study in the Shai Osudoku and Ningo-Prampram districts, embedded within the Dodowa Health and Demographic Surveillance System to estimate prevalence and assess treatment barriers from April 2023 to December 2023.
We found an epilepsy prevalence of 8.84 per 1,000 people (95% CI: 8.00–9.68). A 70% treatment gap was identified, with only 30% of those with a confirmed diagnosis using antiseizure medication. Among untreated people, the most common reason was a lack of diagnostic awareness (37.8%). Barriers to treatment included sociocultural beliefs and misconceptions, stigma, preference for alternative medicine, cost, and antiseizure medication shortages. Significant knowledge gaps were evident, with 36.8% of respondents attributing epilepsy to witchcraft or supernatural causes.
Most people with epilepsy in the area were not receiving adequate biomedical care. The observed treatment gap was associated with multiple factors, including gaps in awareness, sociocultural misconceptions, and economic barriers, suggesting the need for targeted public health interventions to improve epilepsy care and management.
Background
Epilepsy is a manageable condition [1], imposing a significant multidimensional burden worldwide [2–4]. In low- and middle-income countries (LMIC), where 80% of the over 50 million affected people live, the substantial burden is underpinned by a wide treatment gap [2–5]. Most people with epilepsy can achieve seizure freedom and experience improved quality of life with access to first-line antiseizure medications (ASM) costing less than US$10 annually [1,6].
Disparities in epilepsy treatment rates across and within countries mainly result from unequal access to healthcare [7–9]. In resource-limited settings, systemic barriers weaken diagnostic capacity and access to care, increasing the risk of untreated epilepsy. These barriers include disparities in geographic access, fewer specialists, and a lack of advanced diagnostic technology [10–12]. In sub-Saharan Africa (SSA), particularly, these systemic weaknesses are amplified by entrenched cultural misconceptions, as well as the cost and availability of ASM [13–17].
Similar to other LMICs, Ghana has a large epilepsy treatment gap, with most people with epilepsy lacking access to biomedical care [1,6]. Critical knowledge gaps exist regarding the extent and contributing factors nationwide, complicating a nationwide understanding of the issue, enabling targeted interventions, and achieving better outcomes. Quantifying these gaps is crucial to improving treatment rates and outcomes and to developing targeted interventions. We aim to identify barriers and quantify the local epilepsy treatment gap in two districts of Ghana using a comprehensive, three-stage prevalence survey. This study is part of a broader project generating current epidemiological data on epilepsy in southeastern Ghana.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider technology & industry desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Emmanuel Kwame Darkwa, Patrick Adjei, Sabina Asiamah, Elizabeth Awini, Cynthia Sottie, Anthony Godi, John E Williams, Frank Atuguba, Fuseini Sataru, Alexander Adjei, Arjune Sen, Charles R Newton, Anthony Danso-Appiah, J Helen Cross, Josemir W Sander, Albert Akpalu, on behalf of the EPInA investigators, Hiroki Annaka. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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