Big treatment gap for epilepsy
PREMATURE death in people with epilepsy is three times higher than for the general population, yet a large number of people living with epilepsy do not get the treatment they need.
This is according to the World Health Organisation (WHO), which published a report highlighting issues around access to treatment.
WHO’s head of mental health and substance abuse, Dr Tarun Dua, said: “The treatment gap for epilepsy is unacceptably high when we know that 70% of people with the condition can be seizure-free when they have access to medicines that can cost as little as R70 per year and can be delivered through primary health systems.”
The report referenced a previous report published in 2000, which had found that in South Africa, at the time, there was only one public facility and two private facilities which provided epilepsy surgery compared with at least 10 in the UK.
“Epilepsy care, namely diagnosis, treatment and referral for specialist care, is highlighted in general, primary and hospital care guidelines that are regularly updated and released by the National Department of Health. The guidelines are based on principles and practices developed by the South African Medical Association,” the report read.
It added that in South Africa, nurses were often the primary providers of epilepsy care in government clinics, particularly in rural areas.
“Nurses can initiate basic treatment, then refer to primary care physicians for a definitive diagnosis and supplementary treatment. Complex cases may be further referred to neurologists for further investigations or combination therapy. Nurses and other primary care providers receive little or no training in epilepsy care in India, Kazakhstan, Kenya and the Russian Federation.”
According to the organisation, roughly half of adults with epilepsy have at least one other health condition, the most common being depression and anxiety.
“Mental health conditions such as these can make seizures worse. Development and learning difficulties are experienced by 30-40% of children with epilepsy,” WHO said.
The president of the International League Against Epilepsy, Dr Samuel Wiebe, said: “We know how to reduce the epilepsy treatment gap. Now action to introduce the measures needed to make a difference needs to be accelerated. Ensuring uninterrupted supply of access to anti-seizure medicines is one of the highest priorities, as is the training of non-specialist health providers working in primary healthcare centres.”