Abstract
Epilepsy is an important and common worldwide public health problem that affects people of all ages. A significant number of individuals with epilepsy will be intractable to medication. These individuals experience an elevated mortality rate and negative psychosocial consequences of recurrent seizures. Surgery of epilepsy is highly effective to stop seizures in well-selected individuals, and seizure freedom is the most desirable result of epilepsy treatment due to the positive improvements in psychosocial function and the elimination of excess mortality associated with intractable epilepsy. Globally, there is inadequate data to fully assess epilepsy-related quality of life and stigma, although the preponderance of information we have points to a significant negative impact on people with epilepsy (PWE) and families of PWE. This review of the psychosocial impact of epilepsy focuses on regions of Asia and Sub-Saharan Africa that have been analyzed with population study approaches to determine the prevalence of epilepsy, treatment gaps, as well as factors impacting psychosocial function of PWE and their families. This review additionally identifies models of care for medically intractable epilepsy that have potential to significantly improve psychosocial function.
Highlights
Epilepsy is an important and common worldwide public health problem that affects people of all ages
Epidemiology studies of epilepsy in Pakistan and India have identified twice the epilepsy prevalence in rural compared with urban areas (6.23 versus 3.04 per 1000), and this difference was not related to neurocysticercosis infection rates [12,13]
The treatment gap in epilepsy can be defined as the proportion of people with epilepsy who require treatment but do not receive it, and this parameter has been proposed as a useful concept to compare quality of care of epilepsy patients across regions and countries [26]
Summary
Epilepsy is an important public health problem representing 0.6% of the global burden of disease [1] that impacts the people living in the lowest income countries where epilepsy incidence may be 10 fold more than in the developed world. In a cross-sectional study using a survey questionnaire of rural and urban dwelling population in Kampala, Uganda and surrounding countryside, Kaddumukasa, et al identified an overall epilepsy prevalence of 13.3% [6]. Undertook a population-based cross-sectional and case-control study of prevalence and risk factors of convulsive epilepsy in five African Health and Demographic Surveillance System centres (Kilifi, Kenya; Agincourt, South Africa; Iganga-Mayuge, Uganda; Ifakara, Tanzania; and Kintampo, Ghana) to evaluate the reasons for significant variation in estimates of prevalence in different African regions. Epidemiology studies of epilepsy in Pakistan and India have identified twice the epilepsy prevalence in rural compared with urban areas (6.23 versus 3.04 per 1000), and this difference was not related to neurocysticercosis infection rates [12,13]. The full epidemiological burden of epilepsy is likely underestimated in the door-to-door survey methodology most commonly employed in population studies of epilepsy in the developing world. Additional possible factors impacting higher rates of epilepsy in rural areas include exposure to environmental etiologies of epilepsy such as parasites and less knowledge in rural areas of medical treatment options and greater reliance on traditional healers
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
