Presidential Oration: The 18 ^th Annual Conference of the Indian Academy of Neurology, Trichi, Tamil Nadu, September 24-26, 2010, Epilepsy Care in Developing Countries

Abstract

Nearly 80% of the 50 million people with epilepsy worldwide reside in developing countries that are least equipped to tackle the enormous medical, social and economic challenges posed by epilepsy. These include widespread poverty, illiteracy, inefficient and unevenly distributed health care systems, and social stigma and misconceptions associated with epilepsy. Several studies have reported that a large proportion of patients with epilepsy in developing countries never receive appropriate treatment for their condition, and many, though diagnosed and initiated on treatment, soon discontinue treatment. Unaffordable cost of treatment, unavailability of antiepileptic drugs, and superstitious and cultural beliefs contribute to high epilepsy treatment gap in resource-poor countries. A significant proportion of the current burden of epilepsy in developing countries can be minimized by educating the public about the positive aspects of life with epilepsy and the primary and secondary physicians about current trends in the management of epilepsies, scaling up routine availability of low-cost antiepileptic drugs, and developing cost-effective epilepsy surgery programs.

Results of an Action-Research on Epilepsy in Rural Mali

“…Unfortunately, in resource-poor countries the limited medical means, infrastructure and the lack of health personnel represent some of the main existing obstacles to the promotion of such local health-care strategies [3] , [4] . Actually, it was estimated that the neurologist-to-population ratio in sub-Saharan Africa is 3/10,000,000 [5] while, the ideal ratio should be 1 per 100,000 [6] , [7] . Furthermore, nearly two-thirds of people in resource-poor countries reside in rural areas, whereas all the neurologists practice in or close to big cities and towns [8] .…”

Noninvasive investigations are essential tools for epilepsy surgery in developing countries: Extrapolating results from Chinese studies

“…[1] Inspite of being an oration, it does show a wide overview of the current status of epilepsy treatments prevalent in developing countries at present, which is nonetheless, a magnanimous task for compilation. As the author points out, it is true that the surgical treatments of epilepsy in developing countries are far lagging behind the demand.…”

“…We congratulate Kurupath Radhakrishnan for his concise yet adequately detailed presidential oration in the 18th Annual Conference of the Indian Academy of Neurology entitled: “Epilepsy care in Developing Countries”. [ 1 ] Inspite of being an oration, it does show a wide overview of the current status of epilepsy treatments prevalent in developing countries at present, which is nonetheless, a magnanimous task for compilation. As the author points out, it is true that the surgical treatments of epilepsy in developing countries are far lagging behind the demand.…”