Community-based management of epilepsy in Southeast Asia: Two intervention strategies in Lao PDR and Cambodia.
Journal
The Lancet regional health. Western Pacific
ISSN: 2666-6065
Titre abrégé: Lancet Reg Health West Pac
Pays: England
ID NLM: 101774968
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
12
06
2020
revised:
14
09
2020
accepted:
23
09
2020
entrez:
30
7
2021
pubmed:
31
7
2021
medline:
31
7
2021
Statut:
epublish
Résumé
Epilepsy affects more than 50 million people worldwide, 80% of whom live in low- and middle-income countries (LMICs). In Southeast Asia, the prevalence is moderate (6‰), and the main public health challenge is reducing the treatment gap, which reaches more than 90% in rural areas. This 12-month comparative study (intervention vs. control areas) assessed the community effectiveness of two different strategies for the identification and home follow-up of people with epilepsy by Domestic Health Visitors for epilepsy (DHVes). In Lao PDR, DHVes were health center staff covering several villages via monthly visits; in Cambodia, DHVes were health volunteers living in the villages. At baseline, the treatment gap was >95% in Lao PDR and 100% in Cambodia. After 12 months, the treatment gap in Lao PDR decreased by 5·5% (range: 4·0-12·2) in the intervention area and 0·5% (range: 0·4-0·8) in the control area ( The treatment gap was significantly reduced with both intervention strategies, but the effect was larger in Cambodia. The results of this cost analysis pave the way for scaling-up in rural areas of Lao PDR and Cambodia, and experimental adaptation in other LMICs. The study was funded by the Global Health Department of Sanofi and Grand Challenges Canada (grant number 0325-04).
Sections du résumé
BACKGROUND
BACKGROUND
Epilepsy affects more than 50 million people worldwide, 80% of whom live in low- and middle-income countries (LMICs). In Southeast Asia, the prevalence is moderate (6‰), and the main public health challenge is reducing the treatment gap, which reaches more than 90% in rural areas.
METHODS
METHODS
This 12-month comparative study (intervention vs. control areas) assessed the community effectiveness of two different strategies for the identification and home follow-up of people with epilepsy by Domestic Health Visitors for epilepsy (DHVes). In Lao PDR, DHVes were health center staff covering several villages via monthly visits; in Cambodia, DHVes were health volunteers living in the villages.
FINDINGS
RESULTS
At baseline, the treatment gap was >95% in Lao PDR and 100% in Cambodia. After 12 months, the treatment gap in Lao PDR decreased by 5·5% (range: 4·0-12·2) in the intervention area and 0·5% (range: 0·4-0·8) in the control area (
INTERPRETATION
CONCLUSIONS
The treatment gap was significantly reduced with both intervention strategies, but the effect was larger in Cambodia. The results of this cost analysis pave the way for scaling-up in rural areas of Lao PDR and Cambodia, and experimental adaptation in other LMICs.
FUNDING
BACKGROUND
The study was funded by the Global Health Department of Sanofi and Grand Challenges Canada (grant number 0325-04).
Identifiants
pubmed: 34327389
doi: 10.1016/j.lanwpc.2020.100042
pii: S2666-6065(20)30042-0
pmc: PMC8315387
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100042Informations de copyright
© 2020 The Author(s).
Déclaration de conflit d'intérêts
Dr. Boumediene, Dr. Preux, Dr. Hun, Dr. Thebaut, Dr. Chhour, Dr. Chum, Dr. Ros, and Dr. Samleng report grants from Sanofi Global Health Programs, during the conduct of the study; Dr. Boumediene and Dr. Preux report grants from Sanofi Global Health Programs, outside the submitted work; Dr. Chivorakoun, Dr. Souvong, Dr. Bounlu, and Dr. Vorachit report grants and non-financial support from Sanofi Global Health Programs and grants from Grand Challenges Canada during the conduct of the study.
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