Global disparities in the epilepsy treatment gap: a systematic review
Ana-Claire Meyer, Tarun Dua, Juliana Ma, Shekhar Saxena & Gretchen Birbeck
Volume 88, Number 4, April 2010, 260-266
Table 1. Studies used for estimating epilepsy treatment gap based on the prevalence of active epilepsy, by country
| Country | Location | Year | No. of cases | % treatment gap | Setting/population | Study |
|---|---|---|---|---|---|---|
| Argentina | Junin | 1991 | 64 | 22 | Town | Kochen S, Melcon MO. Prognosis of epilepsy in a community-based study: 8 years of follow-up in an Argentine community. Acta Neurol Scand 2005;112:370-4. doi:10.1111/j.1600-0404.2005.00519.x PMID:16281918 |
| Argentina | Buenos Aires | 1991 | 84 | 7 | Urban, primary school | Somoza MJ, Forlenza RH, Brussino M, Licciardi L. Epidemiological survey of epilepsy in the primary school population in Buenos Aires. Neuroepidemiology 2005;25:62-8. doi:10.1159/000086285 PMID:15947492 |
| Brazil | Mato Grosso state | 2000 | 9 | 67 | Rural, Bakairi indians | Borges MA, Barros EP, Zanetta DM, Borges AP. Prevalence of epilepsy in Bakairi indians from Mato Grosso State, Brazil. Arq Neuropsiquiatr 2002;60:80-5 [Portuguese.]. PMID:11965413 |
| Brazil | Rio de Janeiro | 2000 | 5 | 0 | Urban, low-income | Gomes M, Zeitoune R, Kropf L, Van Beeck E. A house-to-house survey of epileptic seizures in an urban community of Rio de Janeiro, Brazil. Arq Neuropsiquiatr 2002;60:708-11. PMID:12364934 |
| Brazil | Barao Geraldo, Campinas; Jaguare and Santo Antonio, Sao Jose do Rio Preto, south-eastern Brazil | 2002 | 290 | 38 | Mixed | Noronha AL, Borges M, Marques L, Zanetta D, Fernandes P, De Boer H, et al. Prevalence and pattern of epilepsy treatment in different socioeconomic classes in Brazil. Epilepsia 2007;48:880-885. doi:10.1111/j.1528-1167.2006.00974.x PMID:17326788 |
| China | 5 provinces: Heilongjiang, Ningxia, Henan, Shanxi, Jiangsu | 2003a | 257 | 63 | Mixed | Wang WZ, Wu JZ, Wang DS, Dai XY, Yang B, Wang TP, et al. The prevalence and treatment gap in epilepsy in China: an ILAE/IBE/WHO study. Neurology 2003;60:1544-5. PMID:12743252 |
| China, Province of Taiwan | 20 districts and townships in Ilan County, NE Taiwan | 1993–95 | 25 | 4 | Mixed, adults > 40 yrs old | Su CL, Chang SF, Chen ZY, Lee CS, Chen RC. Neuroepidemiological survey in Ilan, Taiwan (NESIT): Prevalence of epilepsy. Acta Neurol Taiwan 1998;7:75-84. |
| China | Tibet Autonomous Region | 2006 | 35 | 97 | Rural | Zhao Y, Zhang Q, Tsering T, Sangwan, Hu X, Liu L, et al. Prevalence of convulsive epilepsy and health-related quality of life of the population with convulsive epilepsy in rural areas of Tibet Autonomous Region in China: An initial survey during a verbal episodic memory task. Epilepsy Behav 2008;12:373-81. doi:10.1016/j.yebeh.2007.10.012 PMID:18180204 |
| Ecuador | Atahualpa | 2003 | 18 | 28 | Rural | Del Brutto OH, Santibanez R, Idrovo L, Rodriguez S, Diaz-Calderon E, Navas C, et al. Epilepsy and neurocysticercosis in Atahualpa: a door-to-door survey in rural coastal Ecuador. Epilepsia 2005;46:583-7. doi:10.1111/j.0013-9580.2005.36504.x PMID:15816956 |
| Ecuador | El Carchi and Imbabura regions, northern Ecuador | 1992a | 575 | 79 | Rural | Placencia M, Shorvon SD, Paredes V, Bimos C, Sander JW, Suarez J, et al. Epileptic seizures in an Andean region of Ecuador. Incidence and prevalence and regional variation. Brain 1992;115:771-82. doi:10.1093/brain/115.3.771 PMID:1628201 |
| Ethiopia | Zay society | 2006a | 34 | 53 | Rural | Almu S, Tadesse Z, Cooper P, Hackett R. The prevalence of epilepsy in the Zay Society, Ethiopia – an area of high prevalence. Seizure 2006;15:211-3. doi:10.1016/j.seizure.2006.01.004 PMID:16488161 |
| Ethiopia | Meskan and Mareko sub-district, Haykoch and Butajira district | 1986–1988 | 306 | 98 | Rural | Tekle-Haimanot R, Forsgren L, Abebe M, Gebre-Mariam A, Heijbel J, Holmgren G, et al. Clinical and electroencephalographic characteristics of epilepsy in rural Ethiopia: a community based study. Epilepsy Res 1990;7:230-9. doi:10.1016/0920-1211(90)90020-V PMID:2289482 |
| Ethiopia | Meskan and Mareko sub-district, Haykoch and Butajira district | 1990 | 139 | 87 | Rural | Tekle-Haimanot R, Forsgren L, Ekstedt J. Incidence of epilepsy in rural central Ethiopia. Epilepsia 1997;38:541-6. doi:10.1111/j.1528-1157.1997.tb01138.x PMID:9184599 |
| France | Paris, Seine et Marne, Seine Saint-Denis, Val de Marne | 1987–1988 | 149 | 7 | Urban | Jallon P. Evaluation of epilepsy prevalence rate in young recruits in a military selection centre. Rev Neurol 1991;147:319-22. PMID:2063084 |
| Gambia | Farafenni | 1997, 1999 | 69 | 100 | Rural | Coleman R, Loppy L, Walraven G. The treatment gap and primary health care for people with epilepsy in rural Gambia. Bull World Health Organ 2002;80:378-83. PMID:12077613 |
| Honduras | Salama County | 1997 | 100 | 58 | Rural | Medina MT, Duron RM, Martinez L, Osorio JR, Estrada AL, Zuniga C, et al. Prevalence, incidence, and etiology of epilepsies in rural Honduras: the Salama Study. Epilepsia 2005;46:124-31. doi:10.1111/j.0013-9580.2005.11704.x PMID:15660778 |
| India | Parsi community of Bombay | 1985 | 50 | 22 | Urban | Bharucha NE, Bharucha E, Bharucha A, Bhise A, Schoenberg B. Prevalence of epilepsy in the Parsi community of Bombay. Epilepsia 1988;29:111-5. doi:10.1111/j.1528-1157.1988.tb04405.x PMID:3258234 |
| India | Calicut district, Kerala | 1997a | 26 | 50 | Mixed | Hackett RJ, Hackett L, Bhakta P. The prevalence and associated factors of epilepsy in children in Calicut District, Kerala, India. Acta Paediatr 1997;86:1257-60. doi:10.1111/j.1651-2227.1997.tb14857.x PMID:9401524 |
| India | Kuthar Valley, Anantnag district, South Kashmir | 1986 | 157 | 75 | Rural | Koul R, Razdan S, Motta A. Prevalence and pattern of epilepsy (Lath/Mirgi/Laran) in Rural Kashmir, India. Epilepsia 1988;29:116-22. doi:10.1111/j.1528-1157.1988.tb04406.x PMID:3258235 |
| India | Yelandur, Karnataka, south India | 1990–1991 | 457 | 78 | Rural | Mani KS, Rangan G, Srinivas HV, Kalyanasundaram S, Narendran S, Reddy AK. The Yelandur study: a community-based approach to epilepsy in rural South India – epidemiological aspects. Seizure 1998;7:281-8. doi:10.1016/S1059-1311(98)80019-8 PMID:9733402 |
| India | West Bengal | 1995–1996 | 90 | 90 | Rural | Pal DK, Das T, Sengupta S. Comparison of key informant and survey methods for ascertainment of childhood epilepsy in West Bengal, India. Int J Epidemiol 1998;27:672-6. doi:10.1093/ije/27.4.672 PMID:9758124 |
| India | Thrissur, Palakkad, Malappuram districts, Kerala, south India; High literacy and health awareness | 1996 | 1175 | 38 | Semi-urban | Radhakrishnan K, Pandian JD, Santhoshkumar T, Thomas SV, Deetha TD, Sarma PS, et al. Prevalence, knowledge, attitude, and practice of epilepsy in Kerala, South India. Epilepsia 2000;41:1027-35. doi:10.1111/j.1528-1157.2000.tb00289.x PMID:10961631 |
| India | Baruipur block, west Bengal, east India | 1992–1993 | 75 | 65 | Rural | Saha SP, Bhattacharya S, Das SK, Maity B, Roy T, Raut DK. Epidemiological study of neurological disorders in a rural population of Eastern India. J Indian Med Assoc 2003;101:299-300. PMID:14575218 |
| India | Churu Tehsil, Rajasthan | 2005 | 517 | 40 | Rural | Sureka RK, Sureka R. Prevalence of epilepsy in rural Rajasthan – a door-to-door survey. J Assoc Physicians India 2007;55:741-2. PMID:18173034 |
| Kenya | Kilifi district | 2003 | 408 | 85 | Rural | Edwards T, Scott AG, Munyoki G, Odera VM, Chengo E, Bauni E, et al. Active convulsive epilepsy in a rural district of Kenya: a study of prevalence and possible risk factors. Lancet Neurol 2008;7:50-6. doi:10.1016/S1474-4422(07)70292-2 PMID:18068520 |
| Lao People's Democratic Republic | District Hinheub | 2003–2004 | 33 | 97 | Rural | Tran DS, Odermatt P, Le TO, Huc P, Druet-Cabanac M, Barennes H, et al. Prevalence of epilepsy in a rural district of central Lao People's Democratic Republic PDR. Neuroepidemiology 2006;26:199-206. doi:10.1159/000092407 PMID:16569936 |
| Madagascar | Grand Antananarivo | 2001 | 25 | 32 | Urban | Andriantseheno L, Ralaizandriny D. Prevalence communautaire de l'epilepsie chez les Malgaches. Epilepsies 2004;16:83-6. |
| Mali | 18 villages in Tyenfala, Baguineda | 2000 | 70 | 65 | Rural | Farnarier G, Diop S, Coulibaly B, Arborio S, Dabo A, Diakite M, et al. [Onchocerciasis and epilepsy. Epidemiological survey in Mali]. Med Trop (Mars) 2000;60:151-5. PMID:11100441 |
| Mali | Comune IV and Comune VI, Bamako district | 1998 | 46 | 76 | Urban | Traore M, Tahny R, Sacko M. Prevalence de l'epilepsie chez les enfants de 3 a 15 ans dans 2 communes du district de Bamako. Rev Neurol (Paris) 2000;156: Suppl 1:S18. |
| Nigeria | Igbo-Ora | 1982 | 101 | 96 | Town | Osuntokun BO, Adeuja A, Nottidge V, Bademosi O, Olumide A, Ige O, et al. Prevalence of the epilepsies in Nigerian Africans: a community based study. Epilepsia 1987;28:272-9. doi:10.1111/j.1528-1157.1987.tb04218.x PMID:3582291 |
| Norway | Vaga community, southern Norway | 1995–1997 | 12 | 0 | Rural | Brodtkorb E, Sjaastad O. Epilepsy prevalence by individual interview in a Norwegian community. Seizure 2008;17:646-50. doi:10.1016/j.seizure.2008.03.005 PMID:18434213 |
| Norway | Oppland county | 2001 | 35 | 3 | Mixed | Svendsen T, Lossius M, Nakken KO. Age-specific prevalence of epilepsy in Oppland County, Norway. Acta Neurol Scand 2007;116:307-11. doi:10.1111/j.1600-0404.2007.00909.x PMID:17922724 |
| Pakistan | Sind Province, Mirpur Sakro | 1987 | 126 | 98 | Rural | Aziz H, Ali S, Frances P, Khan M, Hasan K. Epilepsy in Pakistan: a population-based epidemiologic study. Epilepsia 1994;35:950-8. doi:10.1111/j.1528-1157.1994.tb02539.x PMID:7925166 |
| Pakistan | Karachi | 1987 | 115 | 73 | Urban | Aziz H, Ali S, Frances P, Khan M, Hasan K. Epilepsy in Pakistan: a population-based epidemiologic study. Epilepsia 1994;35:950-8. doi:10.1111/j.1528-1157.1994.tb02539.x PMID:7925166 |
| Panama | Changuinola, Bocas del Toro province | 1988 | 19 | 100 | Small town, Guaymi Indians | Gracia F, deLao S, Castillo L, Larreategui M, Archbold C, Brenes M, et al. Epidemiology of epilepsy in Guaymi Indians from Bocas del Toro Province, Republic of Panama. Epilepsia 1990;31:718-23. doi:10.1111/j.1528-1157.1990.tb05512.x PMID:2245802 |
| Senegal | Pikine Health District, suburb of Dakar | 2005 | 64 | 23 | Suburban | Ndoye NF, Sow AD, Diop AG, Sessouma B, Sene-Diouf F, Boissy L, et al. Prevalence of epilepsy its treatment gap and knowledge, attitude and practice of its population in sub-urban Senegal an ILAE/IBE/WHO study. Seizure 2005;14:106-11. doi:10.1016/j.seizure.2004.11.003 PMID:15694563 |
| South Africa | Bushbuckridge, Northern Province | 2000 | 45 | 51 | Rural, children | Christianson AL, Zwane ME, Manga P, Rosen E, Venter A, Kromberg JG. Epilepsy in rural South African children – prevalence, associated disability and management. S Afr Med J 2000;90:262-6. PMID:10853404 |
| South Africa | Nkalukeni village | 2003 | 38 | 88 | Rural | Del Rio-Romero A, Foyaca-Sibat H, Ibanez-Valdes L, Vega-Novoa E. Prevalence of Epilepsy and General Knowledge about Neurocysticercosis at Nkalukeni Village, South Africa. Internet Journal of Neurology 2005;3:1-12. |
| Spain | Madrid | 1984 | 9 | 56 | Urban | Cruz Gutierrez-del-Olmo M, Schoenberg BS, Portera-Sanchez A. Prevalence of neurological diseases in Madrid, Spain. Neuroepidemiology 1989;8:43-7. doi:10.1159/000110164 PMID:2643061 |
| Togo | 10 of 13 villages in Nadoba, Batamariba district; Batamariba or Tamberma tribe | 2002 | 92 | 100 | Rural | Balogou AA, Grunitzky K, Belo M, Sankaredja M, Djagba D, Tatagan-Agbi K, et al. Managment of Epilepsy Patients in Batamariba District, Togo. Acta Neurol Scand 2007;116:211-6. doi:10.1111/j.1600-0404.2007.00871.x PMID:17824896 |
| Togo | Tone | 1995 | 170 | 78 | Mixed | Balogou AA, Doh A, Grunitzky K. Affections neurologiques et endemie goitreuse: analyse comparative de deux provinces du Togo. Bull Soc Pathol Exot 2001;94:406-10. PMID:11889943 |
| Turkey | Central Anatolia (Elmadag township and Kutludugun village) and Demirlirbahce district of Anakara city | 1987 | 59 | 70 | Mixed | Aziz H, Guvener A, Akhtar SW, Hasan KZ. Comparative epidemiology of epilepsy in Pakistan and Turkey: population-based studies using identical protocols. Epilepsia 1997;38:716-22. doi:10.1111/j.1528-1157.1997.tb01242.x PMID:9186255 |
| Turkey | Sivas | 1997 | 33 | 76 | Urban | Topalkara K, Akyuz A, Sumer H, Bekar D, Topaktas S, Dener S, et al. Siva il Merkezinde Tabakali Ornekleme Yontemi ile Gerceklestirilen Epilepsi Prevalans Calismasi. Epilepsia 1999;5:24-9. |
| Turkey | Bursa city center | 2004–2005 | 18 | 50 | Urban | Calişir N, Bora I, Irgil E, Boz M. Prevalence of Epilepsy in Bursa City Center, an Urban Area of Turkey. Epilepsia 2006;47:1691-9. doi:10.1111/j.1528-1167.2006.00635.x PMID:17054692 |
| Turkey | Silivri | 1994 | 49 | 45 | Mixed | Karaagaç N, Yeni SN, Senocak M, Bozluolcay M, Savrun FK, Ozdemir H, et al. Prevalence of epilepsy in Silivri, a rural area of Turkey. Epilepsia 1999;40:637-42. doi:10.1111/j.1528-1157.1999.tb05567.x PMID:10386534 |
| Turkey | 47 villages in Ulas town, Sivas city, middle Anatolia region of Turkey | 125 | 78 | Mixed | Sahin A, Bolayir E, Sumer H, Tas A, Mollaoglu M, Dener S. Epidemiologic evaluation of epileptic and nonepileptic seizures in Sivas region of Middle Anatolia. Neurol Psychiatry Brain Res 2004;11:97-102. | |
| Uganda | Kabende parish, Kabarole district | 1994 | 61 | 100 | Rural | Kaiser C, Kipp W, Asaba G, Mugisa C, Kabagambe G, Rating D, et al. The prevalence of epilepsy follows the distribution of onchocerciasis in a west Ugandan focus. Bull World Health Organ 1996;74:361-7. PMID:8823957 |
| United Kingdom of Great Britain and Northern Ireland | National child survey | 1988 | 124 | 2 | National, children only | Kurtz Z, Tookey P, Ross E. Epilepsy in young people: 23 year follow up of the British national child development study. BMJ 1998;316:339-42. PMID:9487166 |
| United Republic of Tanzania | Nachingwea district | 1999 | 42 | 95 | Rural | Dent W, Helbok R, Matuja WB, Scheunemann S, Schmutzhard E. Prevalence of active epilepsy in a rural area in South United Republic of Tanzania: a door-to-door survey. Epilepsia 2005;46:1963-9. doi:10.1111/j.1528-1167.2005.00338.x PMID:16393163 |
| United Republic of Tanzania | Ulanga district | 1989–1990 | 185 | 100 | Rural | Rwiza H, Kilonzo G, Haule J, Matuja W, Mteza I, Mbena P, et al. Prevalence and incidence of epilepsy in Ulanga, a rural Tanzanian district: a community-based study. Epilepsia 1992;33:1051-6. doi:10.1111/j.1528-1157.1992.tb01758.x PMID:1464263 |
| United States of America | Washington Heights, Inwood, New York City | 2004–2005 | 42 | 7 | Urban | Kelvin EA, Hesdorffer DC, Bagiella E, Andrews H, Pedley TA, Shih TT, et al. Prevalence of self-reported epilepsy in a multiracial and multiethnic community in New York City. Epilepsy Res 2007;77:141-50. doi:10.1016/j.eplepsyres.2007.09.012 PMID:18023147 |
| United States of America | California | 2003 | 322 | 10 | Mixed | Kobau R, Zahran H, Grant D, Thurman DJ, Price PH, Zack MM. Prevalence of active epilepsy and health-related quality of life among adults with self-reported epilepsy in California: California Health Interview Survey, 2003. Epilepsia 2007;48:1904-13. doi:10.1111/j.1528-1167.2007.01161.x PMID:17565591 |
| United States of America | 19 states | 2005 | 919 | 7 | Mixed | Kobau R, Zahran H, Thurman DJ, Zack MM, Henry TR, Schachter SC, et al. Epilepsy surveillance among adults — 19 States, Behavioural Risk Factor Surveillance System, 2005. MMWR Surveill Summ 2008;57:1-20. PMID:18685554 |
| Zambia | Chikankata catchment area | 2000–2001 | 799 | 97 | Rural | Birbeck GL, Kalichi EM. Epilepsy prevalence in rural Zambia: a door-to-door survey. Trop Med Int Health 2004;9:92-5. doi:10.1046/j.1365-3156.2003.01149.x PMID:14728612 |
a Prevalence year not reported in manuscript, therefore publication year substituted.