Global Health Asia-Pacific Issue 2 | 2023 - Page 78


Treatment gaps in epilepsy could lead to more premature deaths

WHO recommends cross-sector collaboration to resolve health crisis
The cause of epilepsy varies , but some factors include genetics , environmental triggers , brain injury , infections , and developmental disorders .

People diagnosed with epilepsy are seven times more likely than young healthy individuals to die due to severe gaps in epilepsy care , according to the latest technical brief by the World Health Organization ( WHO ).

Entitled “ Improving the Lives of People with Epilepsy ,” the brief states that more than 50 million people worldwide have epilepsy , with 7.6 people per every 1,000 displaying active epilepsy at some point in their life . Approximately 125,000 epilepsy-related deaths have been recorded annually , with 80 percent of them in low- and middle-income countries ( LMIC ).
Epilepsy is a neurological disorder characterised by persistent seizures and convulsions due to the disruption of the brain ’ s electrical activity . Seizures are caused by an abrupt surge in this electrical activity , which can cause various symptoms depending on the affected brain area . Symptoms range from uncontrollable jerking movement of arms and legs to low muscle tone , low awareness , dizziness , speech impediment , and mood swings . Epilepsy can develop in people of all ages , but it is commonly diagnosed in children and adults over 60 .
The cause of epilepsy varies , but some factors include genetics , environmental triggers , brain injury , infections , and developmental disorders . Some types of epilepsy can be caused by genetic mutation and inherited traits , while others can be triggered by excessively high temperatures , light exposure , sleep deprivation , and prolonged exposure to dangerous chemicals . Epilepsy risk is also increased by brain complications , such as head injuries , neurodegenerative diseases like Alzheimer ’ s disease , infections that cause inflammation of brain regions , and tumours . Developmental disorders such as autism , cerebral palsy , and attention deficit and hyperactivity disorder that are prevalent at an early age also contribute to epilepsy among children .
Gaps in epilepsy treatment Having epilepsy has broad implications from a personal , social , ecological , economic , and policy standpoint that affects patients , family members , and caregivers . In its investigation of the consequences of the high global disease burden from epilepsy , the WHO discovered that most epileptic individuals did not receive the necessary treatment for seizure management . They also identified gaps in healthcare services that have increased mortality rates among epilepsy patients . This discrepancy varies globally from 50 percent in most middle-income countries to 75 percent in LMIC .
Shortage of qualified medical personnel Epileptic individuals often go undiagnosed or diagnosed late due to a lack of trained medical workers knowledgeable in epilepsy management . Such omissions can result in inaccurate and delayed diagnosis , which disrupts the delivery of appropriate treatment . According to the WHO Neurology Atlas , there is a global shortage of neurologists , marked by significant inequality in medical expertise across different regions . WHO reported an estimated 0.03 neurologists per 100,000 people in LMIC and 4.74 per 100,000 in high-income countries , which highlights the stark divide in local access to quality healthcare . Furthermore , only 23 percent of nations have neurologists in rural areas where people with epilepsy are regularly treated at primary healthcare facilities , although these may not be equipped to provide immediate and long-term care .
Deficiency in local epilepsy knowledge Healthcare access can also be hampered by geographical restrictions which require epilepsy patients to travel long distances to the nearest treatment facility . Persistent stigmatisation is also widely attributed to the epilepsy treatment gap as it socially impacts patients and their families . According to a study by the Makarere University in Uganda , one prevailing misconception about epilepsy in Sub-Saharan Africa stems from a cultural belief that epilepsy is contagious . Featured in the Epilepsy and Behaviour Journal , the study said that such misconceptions impact the delivery of first-aid treatment and further cause epileptic individuals and their acquaintances to be socially excluded from the local community . One result is that patients resort to seeking care from traditional healers , leading to incorrect diagnosis and treatment .
Limited medical resources The underdiagnosis of epilepsy is also caused by the scarcity of diagnostic equipment , such as
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