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Page 37
Volume 3
Journal of Neurology and Clinical Neuroscience
Neurosurgery 2019 & Neuroimmunology 2019
May 22-23, 2019
Neurosurgery and Neurological Surgeons
Neuroscience and Neuroimmunology
May 22-23, 2019 London, UK
6
th
Annual Meeting on
9
th
Global Summit on
&
J Neurol Clin Neurosci, Volume 3
Empowerment of primary health care to bridge the childhood epilepsy treatment gap in
an outreach financially-constrained district in Pakistan
Muhammad Akbar Malik
Top-Down-Bottom-Up-Childhood-Epilepsy-Programme-Brain Associates, Pakistan
Introduction:
There is huge childhood epilepsy treatment gap (CETG) in developing countries because of nonadherence to
antiepileptic drugs (AEDs), and this can adversely affect the course of childhood epilepsy (CE). There is a dearth of data in such
countries on the effectiveness-assessment of community interventions regarding treatment improvement for the children with
epilepsy (CWE).
Study type:
Case control interventional study.
Objectives:
This study was designed to determine the effectiveness of interventions through free community childhood epilepsy
center by combining outreach monthly free pediatric neurology camps and Telepaedsneurology aiming at bridging the huge
treatment among CWE.
Methods:
After integration and implementing childhood epilepsy (CE) into primary care for last two years, in a case control
interventional study, 240 CWE (160 being treated and followed in the free community childhood epilepsy center and 80 as
control, not being treated at this center). The age ranged from4months to 18years, in whom treatment initiated with antiepileptic
drugs (AEDs) for the past 3 months prior to the data collection date were evaluated. Data was collected by a questionnaire
divided into three parts 1) demographical information about patients, 2) information about childhood epilepsy treatment and
AED(s) medication adherence profile using the Morisky Medication Adherence Scale-8 (MMAS-8) and 3) data on intervention-
effectiveness of the community childhood epilepsy center (CCEC) on bridging the treatment gap in comparison with cohort not
being intervened by this center. Ethical approval was obtained from the institutional ethics committee.
Results:
Male to female ratio was 1.26:1.After two years of intervention by Top-Down-Bottom-up-Childhood-Epilepsy-Program
–Center (TDBUCEPC), childhood epilepsy treatment gap (CETG) dropped to 20% (was 90% in 2014), however the treatment
gap was 82.5% among the cohort not being intervened at this center. Adherence to antiepileptic drugs by self-report was 85% (was
42% in 2014 without community intervention) among the children being treated, provided free AEDs with consultations and
followed at the epilepsy center, whereas, currently adherence was 37.5% among the children not being intervened at this center.
Conclusion:
Integration and implementation of CE into primary health care in outreach financially-constrained districts in
Pakistan is one of the best strategies to bridge the huge TGCE, by empowering the local communities to provide free treatment
for CWE.
docmalikpk2000@yahoo.co.in