RESUMO
AIMS: To perform a systematic literature review of studies in peer reviewed journals on the epidemiology, economics, and treatment patterns of epilepsy in selected countries in emerging markets. METHODS: A literature search was performed using relevant search terms to identify articles published from 1999 to 2000 on the epidemiology, economics, and treatment patterns of epilepsy. Studies were identified through electronic Embase(®), Cochrane(©), MEDLINE(®), and PubMed(®) databases. Manual review of bibliographies allowed for the detection of additional articles. RESULTS: Our search yielded 65 articles. These articles contained information relevant to epidemiology (n = 16), treatment guidelines (n = 4), treatment patterns (n = 33), unmet needs (n = 4), and economics (n = 8). From a patient perspective, patients with less than or equal to two adverse events (AEs) while taking anti-epileptic drugs (AEDs) had significantly lower annual costs than those having greater than or equal to three AEs, as did patients with fewer seizures. The overall mean annual cost for epilepsy per patient ranged from US$773 in China to US$2646 in Mexico. Prevalence data varied widely and were found for countries including Arab League Members, China, India, and Taiwan. In Turkey, active prevalence rates ranged from 0.08/1000 to 8.5/1000, and in Arab countries, active prevalence ranged from 0.9/1000 in Sudan to 6.5/1000 in Saudi Arabia. Seventeen different AEDs were used in the identified studies. The most common AEDs utilized were phenobarbital (21.7%), valproate (17.5%), and tiagabine (16.4%). In all studies, the use of AEDs resulted in an increase of patients who became seizure free and a reduction in seizure frequency and severity. CONCLUSION: Few studies have examined the prevalence and incidence of epilepsy in emerging markets and study limitations tend to underestimate these rates at all times. More cost-effectiveness, cost-minimization, and cost-benefit analyses must be performed to enhance the data on the economics of epilepsy and its therapy in regions with insufficient resources and those emerging markets which contain the majority of the world's population. And finally, the study found that generic AEDs are frequently used to successfully treat patients with epilepsy in emerging markets.
RESUMO
OBJECTIVE: To identify the common causes and consequences of pediatric injury-related admission to an Australian children's hospital. METHODS: A retrospective study was conducted at a pediatric teaching hospital. Patients < 18 years of age hospitalized between March 1, 2007 and April 30, 2007 were included. Patient medical records were reviewed if an admission diagnosis was injury related. Data collected included date of birth, gender, date of admission, date of discharge, diagnosis, procedure, and causes and outcomes of the injury. RESULTS: A total of 184 patients were admitted as a result of injury during the study period. Of these, one neonate, six infants, 38 toddlers, 111 children, and 28 teenagers were included in this study. The most common cause of injury-related hospital admission was a fall (n = 109, 59%). Other causes of injury included crushing (8%, n = 15), the spilling of fluids (5.4%, n = 10), and bites (4.3%, n = 8). The most common consequence of an injury for children (43/111, 38.7%) and teenagers (12/28, 43%) was bone fracture. However, head injuries were the most common injury in toddlers (11/38, 29%), infants (5/6, 83.3%), and neonates (1/1, 100%). The radius and/or ulna (36/63, 57%) were the most common bones fractured. The majority (32/37, 86.5%) of patients who suffered head injuries were diagnosed as having a minor injury. CONCLUSION: The main cause of injury-related admission to the hospital for children was a fall, with the most common consequences being fractures and head injuries.
