OBJECTIVE Epilepsy, a neurological disorder with effective biomedical treatment, remains largely untreated in Uganda. Potential reasons for this treatment gap (TG) include limited access to trained providers and clinics, social stigmata of seizures, cultural beliefs, or lack of public understanding of epilepsy as a treatable condition. The current study aimed to formally evaluate barriers faced by people with epilepsy (PWE) in Uganda when seeking biomedical care. METHODS In a cross-sectional study, 435 participants drawn from a community prevalence study were enrolled. We included participants reporting a history of recurrent seizures suggestive of epilepsy, who completed a survey about barriers to obtaining care for their symptoms. Principal axis factor analysis (PFA) using a promax rotation was conducted for data reduction. Frequencies of barrier factors were compared across those who did not seek care for epilepsy (n = 228), those who sought care from biomedical facilities (n = 166), and those who sought care from a traditional or pastoral healer (n = 41). RESULTS The PFA yielded a five-factor solution: 1) logistical and actual costs; 2) treatment effectiveness; 3) influence of the opinion of others; 4) doctors' care; and 5) contextual factors impacting decision-making. Variables related to logistical and actual costs were most endorsed. Comparison of groups by care sought did not reveal a difference in endorsement of factors, with the exception that those who sought biomedical care were more likely to endorse factors related to doctors' care compared with those that sought care from traditional or pastoral healers (P = .005). CONCLUSIONS People with repetitive seizures in Uganda report several barriers to obtaining biomedical care in Uganda, with those related to practical and actual costs endorsed the most. It is imperative that interventions developed to reduce the TG in Uganda consider these practical issues to improve access to effective epilepsy care. This article is part of the Special Issue "The Intersection of Culture, Resources, and Disease: Epilepsy Care in Uganda.

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乌干达癫痫患者生物医学护理的障碍：一项横断面研究

目的 癫痫是一种具有有效生物医学治疗的神经系统疾病，但在乌干达基本上仍未得到治疗。这种治疗差距 (TG) 的潜在原因包括获得训练有素的提供者和诊所的机会有限、癫痫发作的社会污名、文化信仰或公众对癫痫作为可治疗病症缺乏了解。目前的研究旨在正式评估乌干达癫痫患者 (PWE) 在寻求生物医学护理时面临的障碍。方法 在一项横断面研究中，从社区流行率研究中抽取了 435 名参与者。我们纳入了报告有癫痫反复发作史的参与者，他们完成了一项关于获得症状护理障碍的调查。使用 promax 旋转进行主轴因子分析 (PFA) 以减少数据。比较了不寻求癫痫治疗的患者 (n = 228)、寻求生物医学机构护理的患者 (n = 166) 以及寻求传统或牧师治疗师护理的患者 (n = 41) 的障碍因素频率. 结果 PFA 产生了五个因素的解决方案：1) 后勤和实际成本；2) 治疗效果；3) 他人意见的影响；4) 医生的护理；5) 影响决策的背景因素。与后勤和实际成本相关的变量得到了最多的认可。按寻求的护理进行的组比较并未显示出对因素认可的差异，除了寻求生物医学护理的人比寻求传统或牧师治疗的人更可能认可与医生护理相关的因素（P = .005）。结论 乌干达反复癫痫发作的人报告说，在乌干达获得生物医学护理存在若干障碍，其中与实际和实际成本相关的障碍最多。在乌干达，为减少 TG 制定的干预措施必须考虑这些实际问题，以改善获得有效癫痫护理的机会。本文是特刊“文化、资源和疾病的交叉点：乌干达的癫痫护理”的一部分。