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Intervention strategy for the management of epilepsy in South-East Asia


Purpose: The prevalence of epilepsy is 7.7& in Laos and 5.8 & in Cambodia, the treatment gap exceeds 95% in both countries. Our research program aims to measure the effectiveness of two new 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 chosen from health center staff (2) an identical strategy in Cambodia where DHV duty was carried out by health volunteers residing in the villages. Method: 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, training of the DHV staff, a number of surveys on general population about Knowledge, attitudes and practices (KAP) and regular monitoring. Results: In Laos after a 12-month intervention period, the treatment gap was reduced by 5.5% (20 to 43 cases under treatment of the 418 expected) in the intervention vs. 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 in area with a treatment gap of 100%, he was reduced by 31.1% (55 cases out of the 177 expected) in the intervention compared to a 7.0% decrease (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. Observations on KAP in the general population and among health staff, in addition to the therapeutic pathway of PWE will enlighten our results. 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-01910166 , version 1 (31-10-2018)


  • HAL Id : hal-01910166 , version 1


Farid Boumédiène, Phetvongsinh Chivorakul, C Chhour, Vimalay Souvong, Peter Odermatt, et al.. Intervention strategy for the management of epilepsy in South-East Asia. 32nd International Epilepsy Congress, Sep 2017, Barcelone, Spain. pp.S5 - S199. ⟨hal-01910166⟩
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