More Than 60% Of People In Low- And Lower-Middle Income Regions Are Not Accessing Any Appropriate Epilepsy Treatment
The number of people with epilepsy in low- and lower-middle-income countries (LLMICs) is more than double that in higher-income nations, and more than 60% of people in these regions are not accessing any appropriate epilepsy treatment, according to a paper published as part of The Lancet Series on epilepsy. The paper highlights the fact that the burden of epilepsy in LLMICs is under-acknowledged by health agencies, despite the fact that treatments for this disorder are highly cost-effective.
According to lead author Professor Charles Newton, of the Department of Psychiatry, University of Oxford, UK, “Deriving accurate figures on the epidemiology of epilepsy in low- and lower-middle income countries is very difficult – there have been very few surveys to gather the sort of data we need, and such studies tend to be expensive, especially for countries whose health research funding is likely to be very limited.”
“However, the research we do have shows that the burden of epilepsy in these regions is at least double that found in high-income countries, and sadly, adequate facilities for diagnosis, treatment and ongoing management of epilepsy are virtually non-existent in many of the world’s poorest regions. Many people with epilepsy or their families do not even know that they have a disorder that can be controlled with biomedical treatment, so it is vitally important that awareness is raised and medical care improved in these regions.”*
Despite the lack of reliable data on the incidence and prevalence of epilepsy in these regions, the authors suggest that the higher incidence of risk factors for epilepsy – such as head trauma, poor neonatal care, and infections such as neurocysticercosis (pork tapeworm) and onchocerciasis (river blindness) – are probably responsible for the high numbers of people with epilepsy in these regions.
They go on to suggest that the epilepsy burden could be easily and inexpensively reduced by addressing some of these risk factors. They highlight several ways in which epilepsy care could be improved at low cost, including potentially by engaging traditional healers – who for many people are the only point of care for epilepsy. Given the lack of expertise in management of epilepsy in the poorer areas, neurologists and psychiatrists need to combine to set up services for the management of epilepsy in these regions. However, the authors caution that, ultimately, international and national agencies need to recognise the high burden of epilepsy in these regions before any of the recommended strategies can have a real impact.
“Epilepsy needs to be brought into the agenda of non-communicable diseases. It was not mentioned in the UN General Assembly Meeting in New York to address the global burden of non-communicable diseases, and yet it represents a substantial burden of ill health,” concludes Professor Newton.
The Lancet journals