Prevalence, treatment gap and misconceptions about epilepsy among general population in Ecuador.

Jaime Luna (1) , Mandy Nizard (1) , D. Becker (2) , Alejandro Cruz (3) , Michel Dumas (1) , Marcelo Cruz (4) , Pierre-Marie Preux (1, 5, 6)

1 NET - Neuroépidémiologie Tropicale
2 HUP - Hospital of the University of Pennsylvania
3 Neurologic International, Quito
4 Ecuadorian of neuroscience, Quito
5 SIME - Service de l'Information Médicale et de l'Évaluation [CHU Limoges]
6 Laboratoire de Biostatistique et d'Informatique Médicale

Purpose: To report epidemiological data from a crosssectional doortodoor survey concerning prevalence, treatment gap and misconceptions about epilepsy in urban and rural areas in Ecuador. Method: A study to determine the barriers to access to antiepileptic drugs was conducted in Ecuador from January 2015 until May 2016. A doortodoor survey was performed in Turubamba (urban district in Quito city, Andean region) and Archidona (rural district in Napo province, Amazonian region). All study participants were 15 years of age or older and lived more than 6 months in the study areas. A probabilistic systematic sampling was used to determine the selected households. Participants were interviewed using a validated and standardized questionnaire for epilepsy in tropical countries. A neurologist evaluated all the suspected cases to confirm epilepsy diagnosis. Treatment gap was estimated to a direct method. A specific questionnaire was administered concerning knowledge, attitudes and practice toward epilepsy in general population. Results: Two hundred eighteen suspect cases were identified from 1,531 screened subjects, and 17 cases were confirmed with epilepsy in the urban area. Two hundred fortythree suspect cases were identified from 1,551 screened, and 21 cases were confirmed in the rural area. The crude prevalence was 11.1/1,000 [confidence interval (IC) 95%, 5.8 16.3] in the urban area and 13.5/1,000 [IC 95%, 7.8 19.2] in the rural area. The treatment gap was 47.1% and 66.7% in the urban and rural area, respectively. Epilepsy was related to supernatural or insanity. Significant differences were found concerning misconceptions about epilepsy in the study areas and ethnic groups. Conclusion: The crude prevalence is similar compared to reports from Latin America. Treatment gap continues to be a disturbing issue mainly in rural areas. Misconceptions about epilepsy compromise the access to treatment. Thus, sociocultural education strategies are needed to increase knowledge and understanding of epilepsy.

Domaines: Santé publique et épidémiologie

Jaime Luna, Mandy Nizard, D. Becker, Alejandro Cruz, Michel Dumas, et al.. Prevalence, treatment gap and misconceptions about epilepsy among general population in Ecuador.. 32nd International Epilepsy Congress, Sep 2017, Barcelone, Spain. 2017. ⟨hal-01613486⟩