Epilepsy in Cambodia-treatment aspects and policy implications: a population-based representative survey
| العنوان: | Epilepsy in Cambodia-treatment aspects and policy implications: a population-based representative survey |
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| المؤلفون: | Michel Dumas, Robert Sebbag, Kimly Chea, Michel Druet-Cabanac, Pierre Huc, Daniel Gérard, Devender Bhalla, Vichea Chan, Pierre-Marie Preux, Samleng Chan, Chamroeun Hun, Sophal Oum |
| المساهمون: | Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Sanofi-Aventis R&D, SANOFI Recherche, Service de Santé au Travail [CHU Limoges], CHU Limoges, Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM) |
| المصدر: | PLoS ONE, Vol 8, Iss 9, p e74817 (2013) PLoS ONE PLoS ONE, Public Library of Science, 2013, 8 (9), pp.e74817. ⟨10.1371/journal.pone.0074817⟩ |
| بيانات النشر: | Public Library of Science (PLoS), 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Male, Pediatrics, Health Services Accessibility, Epilepsy, 0302 clinical medicine, Surveys and Questionnaires, House call, Medicine, Young adult, Child, Multidisciplinary, Health Policy, Health Care Costs, Prognosis, 3. Good health, House Calls, Treatment Outcome, Patient Satisfaction, Workforce, Anticonvulsants, Female, Cambodia, medicine.drug, Research Article, Adult, medicine.medical_specialty, Adolescent, Science, Medication Adherence, 03 medical and health sciences, Young Adult, Patient satisfaction, Pharmacotherapy, Seizures, 030225 pediatrics, Humans, Adverse effect, business.industry, Community Health Centers, medicine.disease, Regimen, Phenobarbital, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, 030217 neurology & neurosurgery, Follow-Up Studies |
| الوصف: | 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. |
| اللغة: | English |
| تدمد: | 1932-6203 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::84bbbd85aaa118ded15c72b1c23e367d https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24040345/pdf/?tool=EBI |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....84bbbd85aaa118ded15c72b1c23e367d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
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