Radhakrishnan Kurupath
R. Madhavan Nayar Center for Comprehensive Epilepsy Care, Sree Chitra Tirunal Institute for Medical sciences and Technology, Trivandrum, Kerala, India.
Ann Indian Acad Neurol. 2010 Oct;13(4):236-40. doi: 10.4103/0972-2327.74184.
Nearly 80% of the 50 million people with epilepsy worldwide reside in developing countries that are least equipped to tackle the enormous medical, social and economic challenges posed by epilepsy. These include widespread poverty, illiteracy, inefficient and unevenly distributed health care systems, and social stigma and misconceptions associated with epilepsy. Several studies have reported that a large proportion of patients with epilepsy in developing countries never receive appropriate treatment for their condition, and many, though diagnosed and initiated on treatment, soon discontinue treatment. Unaffordable cost of treatment, unavailability of antiepileptic drugs, and superstitious and cultural beliefs contribute to high epilepsy treatment gap in resource-poor countries. A significant proportion of the current burden of epilepsy in developing countries can be minimized by educating the public about the positive aspects of life with epilepsy and the primary and secondary physicians about current trends in the management of epilepsies, scaling up routine availability of low-cost antiepileptic drugs, and developing cost-effective epilepsy surgery programs.
全球5000万癫痫患者中,近80%生活在发展中国家,这些国家应对癫痫所带来的巨大医疗、社会和经济挑战的能力最为薄弱。这些挑战包括普遍贫困、文盲、低效且分布不均的医疗保健系统,以及与癫痫相关的社会耻辱感和误解。多项研究报告称,发展中国家很大一部分癫痫患者从未得到过针对其病情的适当治疗,许多患者虽被诊断并开始接受治疗,但很快就停止了治疗。治疗费用高昂、抗癫痫药物难以获取,以及迷信和文化信仰导致资源匮乏国家的癫痫治疗缺口很大。通过向公众宣传癫痫患者积极的生活方面,向基层和二级医生普及癫痫管理的当前趋势,扩大低成本抗癫痫药物的常规供应,并制定具有成本效益的癫痫手术项目,可以将发展中国家目前很大一部分癫痫负担降至最低。