The scarcity of treatment for epilepsy in low-income countries
Epilepsy is one of the most common neurological diseases, affecting nearly 50 million people of all ages around the world. It is a brain disease characterised by abnormal electrical activity causing seizures or unusual behaviour, sensations and sometimes loss of awareness. Epilepsy affects people of all ages, with peaks among children and the over-60s. It has neurological, cognitive, psychological and social consequences.
Three quarters of people living with epilepsy in low-income countries do not get the treatment they need, increasing their risk of dying prematurely and condemning many to a life of stigma.
The findings are published in "Epilepsy, a public health imperative" released by the World Health Organisation (WHO) and leading nongovernmental organisations for epilepsy, the International League Against Epilepsy and the International Bureau for Epilepsy.
Premature death is three times higher in people with epilepsy
The risk of premature death in people with epilepsy is up to three times higher than for the general population. In low- and middle-income countries, early death among people with epilepsy is significantly higher than in high-income countries. Reasons for this premature mortality in low- and middle-income countries are likely associated with lack of access to health facilities when seizures are long-lasting or occur close together without recovery in between, and preventable causes such as drowning, head injuries and burns.
Roughly half of adults with epilepsy have at least one other health condition. The most common are depression and anxiety: 23% of adults with epilepsy will experience clinical depression during their lifetime and 20% will have anxiety. Mental health conditions such as these can make seizures worse and reduce quality of life. Development and learning difficulties are experienced by 30-40% of children with epilepsy.
Stigma is widespread
Stigma about the condition is also widespread. Public information campaigns in schools, workplaces, and the broader community to help reduce stigma and the introduction of legislation to prevent discrimination and violations of human rights are also important elements of the public health response.
Treatment for epilepsy can be integrated into primary health services
The report also shows that when the political will exists, the diagnosis of and treatment for epilepsy can be successfully integrated into primary health services.
25% epilepsy cases can be prevented
Causes of epilepsy include injury around the time of birth, traumatic brain injury, infections of the brain (such as meningitis or encephalitis) and stroke. It is estimated that 25% of cases can be prevented.
Effective interventions for prevention of epilepsy can be delivered as part of broader public health responses in maternal and newborn health care, communicable disease control, injury prevention and cardiovascular health.
Screening for pregnancy complications and the presence of trained birth attendants can help prevent injury around the time of birth; immunisation against pneumonia and meningitis; malaria control programmes in endemic areas; initiatives to reduce road traffic injuries, violence and falls; and health and community interventions to prevent high blood pressure, diabetes, obesity and tobacco use can all help reduce epilepsy rates.
Source: World Health Organisation
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