The Burden of Epilepsy in Low Income Countries reviewed

In an article published in the Lancet on September 27, Professor Newton and Professor Hector Garcia, both Wellcome Trust Senior Research Fellows describes the burden of epilepsy in in poor areas of the world.

They conducted a comprehensive review of academic articles about epilepsy in developing countries in order to piece together a picture of the burden of the disease in poorer parts of the world.

The burden of epilepsy in low-income countries is more than twice that found in high-income countries, probably because the incidence of risk factors for eg head trauma, complications during childbirth, and parasite infections such as pork tapeworm (neurocysticercosis), and river blindness (onchocerciasis) is higher.

The researchers call for greater recognition from international and national health agencies to address the management of epilepsy in the developing world.

Epilepsy is associated with substantial stigma in low-income countries, which acts as a barrier to patients accessing biomedical treatment and becoming integrated within society. Seizures can be controlled by inexpensive antiepileptic drugs, but the supply and quality of these drugs can be erratic in poor areas.Prof. Charles Newton

The treatment gap for epilepsy is high (>60%) in deprived areas, but this could be reduced with low-cost interventions. Despite being one of the most cost-effective disorders to treat, there are twice as many people living with epilepsy in low- and lower-middle-income countries than higher income nations and more than 60% of those affected in these regions are not accessing any appropriate treatment.

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- Professor Charles Newton

"Sadly, adequate facilities for diagnosis, treatment and on-going 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," added Professor Newton. who works in the Wellcome Trust programmes in Tanzania and Kenya

The authors call for greater recognition from international and national health agencies to address the management of epilepsy in the developing world.

Journal article: 

Charles R Newton, Hector H Garcia, Epilepsy in poor regions of the world, The Lancet, Volume 380, Issue 9848, 29 September–5 October 2012, Pages 1193-1201, ISSN 0140-6736, 10.1016/S0140-6736(12)61381-6.
(http://www.sciencedirect.com/science/article/pii/S0140673612613816)