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Epilepsy in developing countries "often left untreated"

13 May, 2003

A new study shows that the number of people with epilepsy in rural areas of China and the number who are not adequately treated are even higher than previously estimated.

Questionnaires were given door-to-door to over 58,000 people in five rural communities. Of those, 869 people were identified as possible cases and were screened by a neurologist. A diagnosis of epilepsy was determined for 387 people.

A total of 7 out of every 1,000 people had experienced epilepsy at some point in their lifetime, and 41 per cent of all cases had never received appropriate treatment. The study found that 4.6 out of every 1,000 people had active epilepsy, and 63 per cent of those had not received treatment in the week prior to the survey. Active epilepsy was defined as having two or more unprovoked seizures in the past 12 months.

Study author and neurologist Dr Wenzhi Wang of the Beijing Neurosurgical Institute said that the lifetime prevalence of epilepsy was nearly 50 per cent higher than previously estimated and the "treatment gap," or the difference between the number of people with epilepsy and the number receiving adequate therapy, was more than 30 per cent higher than estimated.

Dr Wang added:

"The total number of people with epilepsy in the People's Republic of China is now estimated at almost 9 million. The worldwide prevalence of epilepsy and the treatment gap may also be underestimated. This data shows the need for epilepsy to become a high priority in China and around the world. In China, successful treatment of even 60 to 70 per cent of cases could provide a productive boost to the nation's economy.

"Perceptions about epilepsy may lead to the treatment gap. People may not view epilepsy as a treatable condition. The disorder is stigmatised and people are unlikely to admit they have epilepsy or to know that treatment exists."

The study, published in the journal Neurology, was conducted by the World Health Organization, the International League Against Epilepsy and the International Bureau for Epilepsy.

The Chinese study was the first step in a pilot project; other pilot projects are underway in Senegal, Zimbabwe and Argentina. Other goals for the pilot projects include evaluating the effectiveness of training programs for health professionals, promoting new attitudes about epilepsy in the community and eliminating preventable causes of the condition.