RESUMEN
In Lao PDR, the care of patients with epilepsy faces many challenges. There are around 50,000 people living with epilepsy (PWE) but only 10% have access to antiepileptic medication. The mortality is high among untreated PWE. Misconception about the disease and stigma are common in the general population. The availability of antiepileptic medication is poor. Knowledge on epilepsy among health personnel is poor. Improvement in the management of epilepsy in Lao PDR requires training of health workers on epilepsy, a system to provide antiepileptic drugs and improvement of knowledge on the causes and effective treatment of epilepsy among PWE and the public. The Lao Association for Patients with Epilepsy (APE) was established in 2011 with four main activities: organizing scientific conferences on epilepsy in Laos; providing three days training on epilepsy to health personal at both provincial and district levels; supporting the provision of antiepileptic drugs through a revolving drug fund at provincial and district hospitals; and promoting the dissemination of information on epilepsy to the public. Up to now, 31 health professionals among 52 who were trained on epilepsy provide consultations at both provincial and the district levels. A total of 129,200 tablets of a first line antiepileptic drug (phenobarbital) have been provided to provincial and district hospitals. An estimated 1,112 PWE are currently under treatment. There is a daily information campaign through the media; pamphlets and posters are disseminated at epilepsy clinics. A Lao medical network has been established that will improve access to treatment by PWE.
Asunto(s)
EpilepsiaRESUMEN
In Lao PDR, the care of patients with epilepsy faces many challenges. There are around 50,000 people living with epilepsy (PWE) but only 10% have access to antiepileptic medication. The mortality is high among untreated PWE. Misconception about the disease and stigma are common in the general population. The availability of antiepileptic medication is poor. Knowledge on epilepsy among health personnel is poor. Improvement in the management of epilepsy in Lao PDR requires training of health workers on epilepsy, a system to provide antiepileptic drugs and improvement of knowledge on the causes and effective treatment of epilepsy among PWE and the public. The Lao Association for Patients with Epilepsy (APE) was established in 2011 with four main activities: organizing scientific conferences on epilepsy in Laos; providing three days training on epilepsy to health personal at both provincial and district levels; supporting the provision of antiepileptic drugs through a revolving drug fund at provincial and district hospitals; and promoting the dissemination of information on epilepsy to the public. Up to now, 31 health professionals among 52 who were trained on epilepsy provide consultations at both provincial and the district levels. A total of 129,200 tablets of a first line antiepileptic drug (phenobarbital) have been provided to provincial and district hospitals. An estimated 1,112 PWE are currently under treatment. There is a daily information campaign through the media; pamphlets and posters are disseminated at epilepsy clinics. A Lao medical network has been established that will improve access to treatment by PWE.
RESUMEN
In Lao PDR research conducted over the last 7 years has highlighted the diffi cult challenges that the 52,000 patients living with epilepsy (PWE) have to face. Mortality and morbidity is high among untreated patients. The treatment gap is 90% or more. The highly traditional and poor knowledge of the disease and its treatment, low trust in modern treatment, restricted access to anti-epileptic drugs (phenobarbital is the fi rst line drug), and ignorance of requirement for long term treatment explain the high treatment gap. Stigma, misconceptions, and fear of the disease are common. Knowledge of medical staffs regarding epilepsy diagnosis and treatment is poor. The neurology investigational facilities are basic and mainly concentrated in the capital city. Using lessons from program of neighboring countries, the authors have been developing a step-by-step treatment intervention project since 2009. The intervention was adapted to the local constraints and a limited budget, which demanded regular feedbacks, analysis and reorientation of the activities.