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Development of an interventional strategy for the management of epilepsy in South-East Asia.

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Résumé

Background The prevalence of epilepsy is 7.7‰ in Laos and 5.8‰ in Cambodia, and the treatment gap exceeds 90% in both countries. Objective Our research program aims to measure the effectiveness of two community-based health care approaches using two different types of Domestic Health Visitors (DHV) trained to screen and follow patients with epilepsy (PWE): (1) in Laos, DHV were chosen from health center staff (2) in Cambodia, DHV were health volunteers residing in the villages. Patients and Methods / Material and Methods Between 2015 and 2017, these two quasi-experimental studies were conducted in rural districts over a 12- months period comparing an intervention area and a control area. Our intervention included an Information, Education and Communication campaign, specific training of the DHV staff, and regular monitoring. In Laos, the treatment gap was reduced by 5.5% (20 to 43 cases under treatment of the 418 expected) in the intervention area versus 0.5% (21 to 25 cases under treatment of the 788 expected) in the control area (p<0.0001). In Cambodia, after a 6-month period (ongoing study) in area, it was reduced by 31.1% (0 to 55 cases out of the 177 expected) in the intervention compared to a 7.0% decrease (0 to 23 cases out of the 327 expected) in the control area (p<0.0001). Conclusion The strategy is more successful when the DHV lives in the village where he/she is going to perform his/her duty. The results of the intervention in Laos have resulted in an Advocacy Policy Plan which has been favorably received by the Lao Ministry of Health.
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Dates et versions

hal-01597696 , version 1 (28-09-2017)

Identifiants

  • HAL Id : hal-01597696 , version 1

Citer

Farid Boumédiène, C Chhour, Phetvongsinh Chivorakul, Vimalay Souvong, Peter Odermatt, et al.. Development of an interventional strategy for the management of epilepsy in South-East Asia.. XXIII World Congress of neurology, Sep 2017, Kyoto, Japan. ⟨hal-01597696⟩
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