Mohammad Quazi Deen, Saha Narayan Chandra, Alam Md Badrul, Hoque Seikh Azimul, Islam Ariful, Chowdhury Rajib Nayan, Hussain Mohammad Enayet, Chowdhury Yamin Shahriar, Hossain Sakhawat, Chowdhury Mahmood Ahmed, Rahman Matiur, Majumder Bikash Kumar, Salam Abdus, Sarker Amitabh, Uddin Md Kafil, Moniruzzaman Mohammad, Hakim Ferdous, Bhuiyan Rijwan, Anwar Nazneen, Zaman Mohammad Mostafa
National Institute of Neurosciences and Hospital Dhaka Bangladesh.
Department of Pediatric Neurology National Institute of Neurosciences and Hospital Dhaka Bangladesh.
Epilepsia Open. 2020 Sep 18;5(4):526-536. doi: 10.1002/epi4.12430. eCollection 2020 Dec.
To determine the prevalence and types of epilepsy in Bangladesh.
We conducted a nationwide population-based cross-sectional survey among Bangladeshi population of all ages, except children under one month. We surveyed 9839 participants (urban, 4918; rural, 4920) recruited at their households using multistage cluster sampling. Trained physicians with neurology background confirmed the diagnosis of suspected epilepsy cases identified by interviewer-administered questionnaires. We reported the overall and sex, residence, and age groups-specific prevalence of epilepsy per 1000 populations with 95% confidence interval.
The national prevalence of epilepsy per 1000 was 8.4 (95% CI 5.6-11.1), urban 8.0 (4.6-11.4), and rural 8.5 (5.60-11.5). The prevalence in adult males and females was 9.2 (5.7-12.6) and 7.7 (3.6-11.7), respectively. The prevalence in children aged <18 years (8.2, 3.4-13.0 was similar to adults (8.5 (5.4-11.4). Among all epilepsy cases, 65.1% had active epilepsy. Their (active epilepsy) prevalence was 5.8 (3.5-8.1). Of them, 63.4% were not receiving treatment. Moreover, those who received allopathy treatment, 72.5% had low adherence leading to a high treatment gap.
Our findings out of this first-ever national survey were similar to other Asian countries. However, the prevalence of active epilepsy and treatment gap were considerably higher. This study serves useful evidence for tailoring interventions aimed to reduce the burden of epilepsy-primarily through targeted community awareness program-and access to antiepileptic treatment in health facilities in Bangladesh.
确定孟加拉国癫痫的患病率及类型。
我们在除1个月以下儿童外的所有年龄段孟加拉人群中开展了一项基于全国人口的横断面调查。我们采用多阶段整群抽样方法,在9839名参与者(城市4918名,农村4920名)家中进行了调查。由具有神经学背景的经过培训的医生对通过访员管理的问卷识别出的疑似癫痫病例进行诊断确认。我们报告了每1000人口中癫痫的总体患病率以及按性别、居住地和年龄组划分的患病率,并给出95%置信区间。
每1000人中癫痫的全国患病率为8.4(95%置信区间5.6 - 11.1),城市为8.0(4.6 - 11.4),农村为8.5(5.60 - 11.5)。成年男性和女性的患病率分别为9.2(5.7 - 12.6)和7.7(3.6 - 11.7)。18岁以下儿童的患病率(8.2,3.4 - 13.0)与成年人(8.5(5.4 - 11.4)相似。在所有癫痫病例中,65.1%患有活动性癫痫。他们(活动性癫痫)的患病率为5.8(3.5 - 8.1)。其中,63.4%未接受治疗。此外,在接受西医治疗的患者中,72.5%依从性低,导致治疗缺口很大。
我们这项首次全国性调查的结果与其他亚洲国家相似。然而,活动性癫痫的患病率和治疗缺口要高得多。本研究为制定旨在减轻癫痫负担的干预措施提供了有用证据,主要是通过有针对性的社区宣传项目以及在孟加拉国卫生设施中提供抗癫痫治疗。