Paediatric electroencephalography in sub-Saharan Africa: access to effective services, training capacity and applicability of teaching modules

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dc.contributor.advisorWilmshurst, Jo
dc.contributor.advisorHardman, Joanne
dc.contributor.authorKander, Veena
dc.date.accessioned2025-11-25T12:28:20Z
dc.date.available2025-11-25T12:28:20Z
dc.date.issued2025
dc.date.updated2025-11-25T12:25:40Z
dc.description.abstractMisinterpretation and misuse of an electroencephalogram (EEG) leads to misdiagnosis and unnecessary use of anti-seizure medication (ASM). This is prevalent in countries that lack qualified trained personnel to perform and interpret EEGs. Interpretation of paediatric EEGs is complicated, owing to brain maturation and many epilepsy syndromes manifesting from infancy to adolescence. This can be compounded if the EEG is not performed correctly, with technical artefacts mimicking abnormalities. Paediatric neurologists and neurologists are scarce in sub-Saharan Africa (SSA), as are trained paediatric technologists and technicians. This lack of specialised professionals exacerbates the difficulty of providing quality neurodiagnostic services and accessing essential care for paediatric patients, especially in SSA and other low income (LIC) and low middle income countries (LMIC). This thesis explored the question of who performs paediatric EEGs in SSA and whether they have the experience to report on these studies. The overall aim of this work was to establish a pedagogy in basic paediatric interpretation that could be used internationally to decrease existing gaps in paediatric EEG training. The study was divided into four chapters, with two additional chapters for the introduction and conclusion of the work. Chapter 1 presents the background and aim of the study, namely, to understand paediatric electroencephalography practice with the intent to develop tools to improve the ability to perform and deliver this service, especially in Africa. Chapter 2 presents a published systematic review analysing published reports critiquing EEG training programs accessible to non-specialist clinicians worldwide, over a 30-year period. Chapter 3 provides information from a web-based survey exploring who performs and interprets EEG studies in SSA. Chapter 4 provides information based on the use of an EEG training handbook, from a web-based survey of 50 participants who registered for the online course. Chapter 5 presents qualitative data from 15 experts on training non-epilepsy specialists in paediatric EEG interpretation. In chapter 6, I conclude the correlation of data provided from the four articles. There is a need for critiqued training resources to enable non-epilepsy specialists to utilise EEG. This healthcare cadre is considered to be appropriate with adequate support to perform this role, and the EEG training handbook was found to be a useful tool to teach non-epilepsy specialists in paediatric EEG interpretation, thus further bridging the knowledge gap in SSA.
dc.identifier.apacitationKander, V. (2025). <i>Paediatric electroencephalography in sub-Saharan Africa: access to effective services, training capacity and applicability of teaching modules</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/42336en_ZA
dc.identifier.chicagocitationKander, Veena. <i>"Paediatric electroencephalography in sub-Saharan Africa: access to effective services, training capacity and applicability of teaching modules."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2025. http://hdl.handle.net/11427/42336en_ZA
dc.identifier.citationKander, V. 2025. Paediatric electroencephalography in sub-Saharan Africa: access to effective services, training capacity and applicability of teaching modules. . University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. http://hdl.handle.net/11427/42336en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Kander, Veena AB - Misinterpretation and misuse of an electroencephalogram (EEG) leads to misdiagnosis and unnecessary use of anti-seizure medication (ASM). This is prevalent in countries that lack qualified trained personnel to perform and interpret EEGs. Interpretation of paediatric EEGs is complicated, owing to brain maturation and many epilepsy syndromes manifesting from infancy to adolescence. This can be compounded if the EEG is not performed correctly, with technical artefacts mimicking abnormalities. Paediatric neurologists and neurologists are scarce in sub-Saharan Africa (SSA), as are trained paediatric technologists and technicians. This lack of specialised professionals exacerbates the difficulty of providing quality neurodiagnostic services and accessing essential care for paediatric patients, especially in SSA and other low income (LIC) and low middle income countries (LMIC). This thesis explored the question of who performs paediatric EEGs in SSA and whether they have the experience to report on these studies. The overall aim of this work was to establish a pedagogy in basic paediatric interpretation that could be used internationally to decrease existing gaps in paediatric EEG training. The study was divided into four chapters, with two additional chapters for the introduction and conclusion of the work. Chapter 1 presents the background and aim of the study, namely, to understand paediatric electroencephalography practice with the intent to develop tools to improve the ability to perform and deliver this service, especially in Africa. Chapter 2 presents a published systematic review analysing published reports critiquing EEG training programs accessible to non-specialist clinicians worldwide, over a 30-year period. Chapter 3 provides information from a web-based survey exploring who performs and interprets EEG studies in SSA. Chapter 4 provides information based on the use of an EEG training handbook, from a web-based survey of 50 participants who registered for the online course. Chapter 5 presents qualitative data from 15 experts on training non-epilepsy specialists in paediatric EEG interpretation. In chapter 6, I conclude the correlation of data provided from the four articles. There is a need for critiqued training resources to enable non-epilepsy specialists to utilise EEG. This healthcare cadre is considered to be appropriate with adequate support to perform this role, and the EEG training handbook was found to be a useful tool to teach non-epilepsy specialists in paediatric EEG interpretation, thus further bridging the knowledge gap in SSA. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Paediatric electroencephalography KW - Sub-Saharan Africa LK - https://open.uct.ac.za PB - University of Cape Town PY - 2025 T1 - Paediatric electroencephalography in sub-Saharan Africa: access to effective services, training capacity and applicability of teaching modules TI - Paediatric electroencephalography in sub-Saharan Africa: access to effective services, training capacity and applicability of teaching modules UR - http://hdl.handle.net/11427/42336 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/42336
dc.identifier.vancouvercitationKander V. Paediatric electroencephalography in sub-Saharan Africa: access to effective services, training capacity and applicability of teaching modules. []. University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/42336en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectPaediatric electroencephalography
dc.subjectSub-Saharan Africa
dc.titlePaediatric electroencephalography in sub-Saharan Africa: access to effective services, training capacity and applicability of teaching modules
dc.typeThesis / Dissertation
dc.type.qualificationlevelDoctoral
dc.type.qualificationlevelPhD
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