ArticlePloS one2013
Epilepsy in Cambodia-treatment aspects and policy implications: a population-based representative survey.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- A cluster-randomized trial comparing home-based primary health care and usual clinic care for epilepsy in a resource-limited country.Epilepsia open · 2022Trial
- Global, regional, and national burden of epilepsy, 1990-2021: a Global Burden of Disease study.Journal of global health · 2026Article
- Availability, affordability, and quality of essential anti-seizure medication in Cambodia.Epilepsia open · 2021Article
- A home-based, primary-care model for epilepsy care in India: Basis and design.Epilepsia open · 2019Article
- EFHC1 variants in juvenile myoclonic epilepsy: reanalysis according to NHGRI and ACMG guidelines for assigning disease causality.Genetics in medicine : official journal of the American College of Medical Genetics · 2017Article
- Leukocyte Infiltration Triggers Seizure Recurrence in a Rat Model of Temporal Lobe Epilepsy.Inflammation · 2016Article
- Undue regulatory control on phenobarbital--an important yet overlooked reason for the epilepsy treatment gap.Epilepsia · 2015Article
- Some cross-talks between immune cells and epilepsy should not be forgotten.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2014Review
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionWe tested two treatment strategies to determine: treatment (a) prognosis (seizure frequency, mortality, suicide, and complications), (b) safety and adherence of treatment, (c) self-reported satisfaction with treatment and self-reported productivity, and policy aspects (a) number of required tablets for universal treatment (NRT), (b) cost of management, (c) manpower-gap and requirements for scaling-up of epilepsy care.
methodsWe performed a random-cluster survey (N = 16510) and identified 96 cases (≥1 year of age) in 24 villages. They were screened by using a validated instrument and diagnosed by the neurologists. International guidelines were used for defining and classifying epilepsy. All were given phenobarbital or valproate (cost-free) in two manners patient's door-steps (March 2009-March 2010, primary-treatment-period, PTP) and treatment through health-centers (March 2010-June 2011, treatment-continuation-period, TCP). The emphasis was to start on a minimum dosage and regime, without any polytherapy, according to the age of the recipients. No titration was done. Seizure-frequency was monthly and self-reported.
resultsThe number of seizures reduced from 12.6 (pre-treatment) to 1.2 (end of PTP), following which there was an increase to 3.4 (end of TCP). Between start of PTP and end of TCP, >60.0% became and remained seizure-free. During TCP, ∼26.0% went to health centers to collect their treatment. Complications reduced from 12.5% to 4.2% between start and end of PTP and increased to 17.2% between start and end of TCP. Adverse events reduced from 46.8% to 16.6% between start and end of PTP. Nearly 33 million phenobarbital 100 mg tablets are needed in Cambodia.
conclusionsEpilepsy responded sufficiently well to the conventional treatment, even when taken at a minimal dosage and a simple daily regimen, without any polytherapy. This is yet another confirmation that it is possible to substantially reduce direct burden of epilepsy through means that are currently available to us.
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