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 Table of Contents  
LETTER TO EDITOR
Year : 2019  |  Volume : 20  |  Issue : 2  |  Page : 78-79

Strengthening epilepsy-related prevention and control services in middle- and low-income nations


1 Vice-Principal Curriculum, Member of the Medical Education Unit and Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpattu, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpattu, Tamil Nadu, India

Date of Web Publication8-Jan-2020

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Associate Professor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Tiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpattu, Tamil Nadu - 603 108
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AMH.AMH_12_19

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How to cite this article:
Shrivastava SR, Shrivastava PS. Strengthening epilepsy-related prevention and control services in middle- and low-income nations. Arch Ment Health 2019;20:78-9

How to cite this URL:
Shrivastava SR, Shrivastava PS. Strengthening epilepsy-related prevention and control services in middle- and low-income nations. Arch Ment Health [serial online] 2019 [cited 2020 Jan 28];20:78-9. Available from: http://www.amhonline.org/text.asp?2019/20/2/78/275202



Sir,

Epilepsy has been regarded as one of the leading neurological conditions worldwide with more than 50 million people suffering from the disease.[1] In fact, 0.5% of the global disease burden has been attributed to the disease, predominantly due to the impairment of the quality of life and years of life lost to premature deaths.[1] It is quite alarming that four-fifth of the affected individual are from low- and middle-income nations and often are deprived of the desired treatment for a better outcome.[1],[2] Further, the disease has been linked with significant financial implications pertaining to the quality of offered health-care services, premature deaths, and a reduction in productivity.[1]

The epidemiological analysis of the problem has indicated that 7 out of 10 affected persons can live a seizure-free life, nevertheless, owing to the existing diagnostic and treatment gap, millions of people have to face the aftermaths of the disease.[1] It is important to note that a person suffering from the disease has three times more risk than the general population.[2] In fact, the situation further worsens among people from low- and middle-income nations because of the limited access to health system.[2] However, the stigma attributed to the disease cannot be undermined as most of the affected individuals do not access health services and more often than not their basic fundamental rights are compromised.[2]

The available estimates depict that one-fourth of the cases can be prevented through the implementation of a package of public health interventions, namely quality-assured maternal and newborn health care, containment of infectious diseases, screening for complications during the antenatal period, and reduction in the incidence of road traffic injuries/falls.[2] It is very much essential to ensure that the therapeutic services for the disease should be integrated with the primary health care as it will play a major role in warranting the reach of available services to a greater section of the community.[2] Moreover, considering the fact that the duration of treatment is often long, appropriate steps should be taken to enable the availability of affordable drugs in all settings.[1],[2]

The need of the hour is to have a strong leadership and governance, which will obviously depend on the existence of a comprehensive health-care policy.[2] It is indispensable to involve all the concerned stakeholders and aim to accomplish universal health coverage through the training of health-care personnel in primary health-care settings.[2],[3] In addition, interventions should be planned and implemented to ensure that the disease is recognized as a public health priority.[2] This will essentially require conduction of awareness activities regarding the different aspects of the disease in schools or workplace so that the attitude of the general population improves and we do not indulge ourselves in stigma- or discrimination-related actions.[2],[3],[4]

The aim of the offered health care should be to reduce morbidity, avert premature deaths or complications, and this can only happen provided we are well-equipped to deal with the varied needs of the people.[2] Special attention should be given toward low- and middle-income nations and multidisciplinary team should work for the delivery of health care and social services.[2],[3] Further, there is a need to strengthen community-based care to simultaneously minimize the load on the health system. Finally, the research field needs more attention and investment to improve the existing situation.[2]

In conclusion, epilepsy has to be recognized as a public health priority, and there is an immense need to mount a comprehensive response to bridge the existing gaps in the delivery of health-care services, especially in low- and middle-income nations.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Epilepsy – Key Facts. World Health Organization; 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/epilepsy. [Last accessed on 2019 Jun 26].  Back to cited text no. 1
    
2.
World Health Organization. Epilepsy: A Public Health Imperative. Geneva: WHO Press; 2019. p. 1-14.  Back to cited text no. 2
    
3.
Schmidt D, Sillanpää M. Prevention of epilepsy: Issues and innovations. Curr Neurol Neurosci Rep 2016;16:95.  Back to cited text no. 3
    
4.
Agostini M. The prevention of epilepsy. JAMA Neurol 2016;73:375-6.  Back to cited text no. 4
    




 

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