Evidence map›Paper›PMID 36577550›Full record

ArticleEpilepsy & behavior : E&B2023

Does the presence of a specialist doctor reduce the burden of disease in people with epilepsy in low-resource settings? A comparison of two epilepsy clinics in rural Tanzania.

Ana Klein, Toni Christoph Berger, Alexander Hapfelmeier, Matthias Schaffert, William Matuja, Erich Schmutzhard, Andrea S Winkler

Abstract read
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In one paragraph

Article in Epilepsy & behavior : E&B, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Diagnostic pathways and barriers in multiple sclerosis in Zambia: A qualitative study.Multiple sclerosis journal - experimental, translational and clinical
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 4 countries.

Ana KleinCenter for Global Health, Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Germany. Electronic address: ana-katharina.klein@eleve.ehesp.fr.
Toni Christoph BergerCenter for Global Health, Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Germany; Department of Neurology, Oslo University Hospital, Oslo, Norway. Electronic address: t.c.berger@medisin.uio.no.
Alexander HapfelmeierInstitute of General Practice and Health Services Research, School of Medicine, Technical University of Munich, Germany; Institute of AI and Informatics in Medicine, School of Medicine, Technical University of Munich, Germany. Electronic address: Alexander.Hapfelmeier@mri.tum.de.
Matthias SchaffertParacelsus Medical University, Department for Paediatric and Adolescent Surgery, Salzburg, Austria. Electronic address: m.schaffert@salk.at.
William MatujaDepartment of Neurology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Electronic address: matujaw@gmail.com.
Erich SchmutzhardDepartment of Neurology, Medical University of Innsbruck, Austria. Electronic address: erich.schmutzhard@i-med.ac.at.
Andrea S WinklerCenter for Global Health, Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Germany; Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway. Electronic address: andrea.winkler@tum.de.
Klinikum rechts der Isar · DEInnsbruck Medical University · ATMuhimbili University of Health and Allied Sciences · TZParacelsus Medical University · ATTechnical University of Munich · DEUniversity of Oslo · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWith an estimated lifetime prevalence of epilepsy of 7.6 per 1,000 people, epilepsy represents one of the most common neurological disorders worldwide, with the majority of people with epilepsy (PWE) living in low-income and middle-income countries (LMICs). Adequately treated, up to 70 % of PWE will become seizure-free, however, as many as 85% of PWE worldwide, mostly from LMICs, do not receive adequate treatment.

objectiveTo assess the impact of the presence of a neurologist on the management of PWE in Tanzania.

methodsTwo epilepsy clinics in rural Tanzania, one continuously attended by a neurologist, and one mainly attended by nurses with training in epilepsy and supervised intermittently by specialist doctors (neurologists/psychiatrists) were comparatively analyzed by multivariable linear and logistic regression models with regard to the outcome parameters seizure frequency, the occurrence of side effects of antiepileptic medication and days lost after a seizure.

resultsThe presence of a neurologist significantly reduced the mean number of seizures patients experienced per month by 4.49 seizures (p < 0.01) while leading to an increase in the occurrence of reported side effects (OR: 2.15, p = 0.02).

conclusionThe presence of a neurologist may play a substantial role in reducing the burden of the disease of PWE in LMICs. Hence, specialist training should be encouraged, and relevant context-specific infrastructure established.

Indexed as

EpilepsyAnticonvulsantsCost of IllnessHumansSeizuresTanzaniaAnticonvulsantsEpilepsyLMICPWE

Identifiers

PMID36577550
OpenAlexW4312220296

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.