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EFFECTIVE EPILEPSY CONTROL IN RURAL AREAS OF LESS-DEVELOPED COUNTRIES
April 25, 2001Inexpensive drugs given by appropriately trained health workers to compliant patients could help control epilepsy in rural areas of less-developed countries, conclude authors of a study in this weeks issue of THE LANCET .
Epilepsy is a controllable disorder if detected and treated early. For most families in rural areas of less-developed countries, however, treatment is often delayed because of the inaccessibility of specialist neurological assessment facilities. K S Mani and colleagues from Bangalore, India, aimed to find a practical solution to rural epilepsy control by doing a non-randomised trial in south India.
135 patients with epileptic seizures agreed to long-term treatment with phenobarbital (68 patients), phenytoin (60 patients), or both (7 patients). Drugs were given once daily by trained primary-care physicians and health workers. The primary outcome measure was the absence of seizures for at least two years.
The proportion of patients with remission at each of 4 successive years of follow-up ranged from 58% to 66% for those who were drug compliant and who had a lifetime total of 30 or fewer generalised tonic-clonic seizures. The corresponding range for patients who were not compliant and who had ever had more than 30 such seizures was 6-16%. Statistical analysis confirmed that strict drug compliance and early treatment were important predictors of a 2-year remission.
D K Subbakrishna (one of the investigators) comments: "The Yelandur project can be used as a model for epilepsy control in rural areas of developing countries where primary health centers without major investigating facilities can coordinate and train health workers to detect epilepsy in population and provide and supply treatment. Governmental agencies may provide Phenobarbital Phenytoin free to the patients so that at least 60 % of the cases can be helped to achieve remission". (quote by e-mail; does not appear in published paper).
Contact: Dr D K Subbakrishna, Neurological Clinic, No 1 Old Veterinary Hospital Road, Basavanagudi, Bangalore 560 004, India; T) +91 80 661 2778; F) +1 91 80 664 4429; E) g_rangan@vsnl.com
Lancet
The proportion of patients with remission at each of 4 successive years of follow-up ranged from 58% to 66% for those who were drug compliant and who had a lifetime total of 30 or fewer generalised tonic-clonic seizures. The corresponding range for patients who were not compliant and who had ever had more than 30 such seizures was 6-16%. Statistical analysis confirmed that strict drug compliance and early treatment were important predictors of a 2-year remission.
D K Subbakrishna (one of the investigators) comments: "The Yelandur project can be used as a model for epilepsy control in rural areas of developing countries where primary health centers without major investigating facilities can coordinate and train health workers to detect epilepsy in population and provide and supply treatment. Governmental agencies may provide Phenobarbital Phenytoin free to the patients so that at least 60 % of the cases can be helped to achieve remission". (quote by e-mail; does not appear in published paper).
Contact: Dr D K Subbakrishna, Neurological Clinic, No 1 Old Veterinary Hospital Road, Basavanagudi, Bangalore 560 004, India; T) +91 80 661 2778; F) +1 91 80 664 4429; E) g_rangan@vsnl.com
Lancet
Epilepsy Current Events and Epilepsy News RSSGreater certainty in monitoring 3 therapeutic medications is facilitated by new CRMs
To help bring greater certainty to the measurement of medication levels in a patient's bloodstream for three drugs with narrow therapeutic ranges, the U.S. Pharmacopeial Convention (USP) is releasing new certified reference materials (CRMs).
Theory about long and short-term memory questioned by UCL scientists
The long-held theory that our brains use different mechanisms for forming long-term and short-term memories has been challenged by new research from UCL, published today in PNAS.
Developmental delay could stem from nicotinic receptor deletion
The loss of a gene through deletion of genetic material on chromosome 15 is associated with significant abnormalities in learning and behavior, said a consortium of researchers led by Baylor College of Medicine (www.bcm.edu) in a report that appears online today in the journal Nature Genetics.
Protein critical for insulin secretion may be contributor to diabetes
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Packages of care for epilepsy in low- and middle-income countries
In the second in a six part series on treating mental health problems in resource-poor settings, Caroline Mbuba and Charles Newton (Centre for Geographic Medicine Research, Kenya Medical Research Institute, Kilifi, Kenya) discuss "packages of care" for treating epilepsy.
Study pinpoints key mechanism in brain development, raising question about use of antiseizure drug
Researchers at the Stanford University School of Medicine have identified a key molecular player in guiding the formation of synapses - the all-important connections between nerve cells - in the brain.
tudy: The new buzz on detecting tinnitus
It's a ringing, a buzzing, a hissing or a clicking - and the patient is the only one who can hear it. Complicating matters, physicians can rarely pinpoint the source of tinnitus, a chronic ringing of the head or ears that can be as quiet as a whisper or as loud as a jackhammer.
Researchers find a key mechanism in the development of nerve cells
Chaos brews in the brains of newborns: the nerve cells are still bound only loosely to each other.
How mitochondrial gene defects impair respiration, other major life functions
Researchers are delving into abnormal gene function in mitochondria, structures within cells that power our lives. Mitochondria are the place where energy is generated from the most basic molecules of food. Because this function is essential to life, defects in mitochondria may affect a wide range of organ systems in humans and animals.
Pancreatic fat levels may help predict diabetes, UT Southwestern researchers say
Researchers have long suspected that overweight people tend to have large fat deposits in their pancreases, but they've been unable to confirm or calculate how much fat resides there because of the organ's location. Until now.
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