Epilepsy Research 128 (2016) 21–26 Contents lists available at www.sciencedirect.com Epilepsy Research journal homepage: www.elsevier.com/locate/epilepsyres Community integration of people living with epilepsy in a Nigerian population Emmanuel Chiebuka Okoye a,∗ , Grace Chinyere Obi a , Christopher Olusanjo Akosile a , Joseph Onuwa Umunnah a , Maduabuchi Joseph Nwankwo a , Loveth Oluchi Obiora b a Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria b Department of Nursing Sciences, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria a r t i c l e i n f o Article history: Received 5 July 2016 Received in revised form 26 September 2016 Accepted 17 October 2016 Available online 21 October 2016 Keywords: Epilepsy Community integration Associated factors Nigeria a b s t r a c t Background: Epilepsy is a chronic seizure disorder that affects numerous people worldwide. Community integration (CI) is the ultimate goal of rehabilitation of any chronic condition. There seems to be a dearth of research on CI among people living with epilepsy (PLWE). Aim: The present study was designed to investigate on the level of satisfaction with CI and its associated factors in a Nigerian PLWE. Methodology: This was a cross-sectional survey of 70 adult PLWE (28.6% females; mean age = 34.91 ± 16.21 years) consecutively recruited from three purposively selected specialized clinics in Anambra State of South-eastern Nigeria. The Reintegration to Normal Living Index was used to assess the level of satisfaction with CI among the participants. Data was analysed using Spearman Rank Order Correlation, Mann-Whitney U and Kruskal-Wallis tests at 0.05 level of significance. Results: The total level of satisfaction with CI among PLWE was poor (59.76 ± 23.24). PLWE were severely restricted in nine out of the fourteen CI scores but were mildly or moderately restricted in the remaining five CI scores. The participants’ total level of satisfaction with CI significantly correlated with their annual (r = −0.319; p = 0.007), six-month (r = −0.275; p = 0.021) and one-month (r = −0.221; p = 0.025) episodes of seizures, and was significantly influenced by their occupational status (k = 12.15; p = 0.009) and highest educational attainment (k = 12.39; p = 0.006). Conclusion: Generally, the total level of satisfaction with CI among PLWE was poor. There is need for inter- ventional programmes aimed at integrating PLWE into their various communities with special emphasis laid on unemployed and less educated ones having high seizure frequency. © 2016 Elsevier B.V. All rights reserved. 1. Introduction Epilepsy is a chronic seizure disorder that affects almost 70 mil- lion people worldwide. Eighty five percent of people living with epilepsy (PLWE) live in the developing world, with 10 millions liv- ing in Africa (World Health Organization, 2003). Epilepsy is the most common non-infectious neurological disease in developing countries, and has a Nigerian prevalence of 5.3–37 per one thou- sand (Akinsolure and Adewuya, 2009). There is more to epilepsy than having recurrent seizures (Kabir et al., 2005). Epilepsy imposes ∗ Corresponding author. E-mail addresses: bukanuel2004@yahoo.com, emc.okoye@unizik.edu.ng (E.C. Okoye), chinyeremgrace@gmail.com (G.C. Obi), coakosile@yahoo.com (C.O. Akosile), dynamojoe2000ng@yahoo.com (J.O. Umunnah), drizu2002@yahoo.co.uk (M.J. Nwankwo), lovethegboka@yahoo.com (L.O. Obiora). enormous physical, psychological, social and economic burdens on individuals, families and countries (World Health Organization, 2003). Across the world and throughout history, epilepsy has been a culturally devalued condition (de Boer et al., 2008). People living with epilepsy (PLWE) are exposed to discrimination in education, employment and promotion at work (de Boer et al., 2008; Kabir et al., 2005); violence, abuse, and health insurance and marriage restrictions (Petersilia, 2000); social ostracism (de Boer et al., 2008) among others. These may negatively influence the level at which PLWE are integrated into their community. Community integration/reintegration (CI), defined as the oppor- tunity to live in the community and be valued for one’s uniqueness and abilities like everyone else, has attracted considerable atten- tion in rehabilitation of sufferers of chronic conditions (Marco et al., 2007; McColl et al., 2001; Salzer, 2006). The goal of rehabilitation has shifted from only mere survival and improvement in physi- cal, psychological and social health to include how well a sufferer http://dx.doi.org/10.1016/j.eplepsyres.2016.10.001 0920-1211/© 2016 Elsevier B.V. All rights reserved.