# Bridging the Childhood Epilepsy Treatment Gap in Africa (BRIDGE)

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2020 · $1,184,130

## Abstract

Abstract: About half of the world's children with epilepsy are not receiving treatment – known as the epilepsy
treatment gap, and largely due to the 67%-90% of children in low- and middle-income countries (LMICs) with
epilepsy who do not receive treatment. Task-shifting epilepsy care to community health extension workers
(CHEWs) working in primary healthcare centers (PHCs) has been recommended by the World Health
Organization, but evidence of efficacy for task-shifted epilepsy care is lacking, and large-scale task-shifted
epilepsy care has not been implemented. In preparation for a first cluster-randomized clinical trial (cRCT) of task-
shifted childhood epilepsy care, we developed and piloted in northern Nigeria (R21TW010899) (a) a scalable
epilepsy training program for CHEWs, (b) an epilepsy community education program in the local language
(Hausa), and (c) an epilepsy data collection and management system. We also (d) validated an epilepsy
screening tool in this population and (e) documented the feasibility of enrolling children into a study of task-
shifted epilepsy care. We now propose this project, “Bridging the Childhood Epilepsy Treatment Gap in Africa
(BRIDGE)”, as the first cRCT of task-shifted childhood epilepsy care in Africa. Sixty PHCs in three northern
Nigeria cities (Kano, Zaria, and Kaduna) with an estimated epilepsy treatment gap of 70% will be randomly
selected; 30 PHCs will provide task-shifted (to CHEWs) childhood epilepsy care, and 30 PHCs will provide
enhanced usual care (EUC) (referral to a physician for epilepsy management plus primary care by an epilepsy-
trained CHEW). CHEWs with additional training in epilepsy will screen ~270,000 children ages 1-17, of which
we estimate (based on preliminary data) 1700-2552 will have untreated epilepsy, 1530-2297 will enroll in the
cRCT, and 1377-2067 will complete the 24-month cRCT. Assuming an equal proportion of children who are
seizure-free for at least six months at 24 months follow-up in the two cRCT arms, we will achieve ≥ 80% power
to determine an efficacy difference of 10% or greater between the arms. Secondary outcomes of the cRCT will
include the percent seizure reduction from enrollment baseline, time to next seizure after a 3-month period of
seizure freedom, and accuracy of epilepsy diagnosis and seizure type classification, as determined by blinded
physician epilepsy specialists. Socio-behavioral and implementation outcomes will also be determined for the
two arms of the cRCT, including acceptability, appropriateness, and feasibility among the healthcare providers
and quality of life, epilepsy-associated stigma, and trust in healthcare providers among parents/guardians and
enrolled patients (if age 15-17 years). The cost-effectiveness of the task-shifted epilepsy care intervention will
be determined in US dollars and Nigerian Naira per additional quality adjusted life year (QALY). This cRCT will
inform the implementation of task-shifted care systems to address the childh...

## Key facts

- **NIH application ID:** 9985224
- **Project number:** 5R01NS113171-02
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** AMINU ABDULLAHI TAURA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1,184,130
- **Award type:** 5
- **Project period:** 2019-08-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9985224

## Citation

> US National Institutes of Health, RePORTER application 9985224, Bridging the Childhood Epilepsy Treatment Gap in Africa (BRIDGE) (5R01NS113171-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9985224. Licensed CC0.

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