Tadokoro Award 2021 Best clinical oral presentation

Best clinical oral presentation

Abstract #221

Significant treatment gap identified in a three staged epidemiological survey of pediatric epilepsy conducted in rural suburbs of India
K. SRIVASTAVA¹, E. AGARWAL¹, R. DESHMUKH¹, V. KULKARNI¹, S. RAJADHYAKSHA¹, P. DOKE^1
1Bharati Vidyapeeth Deemed University Medical College, Pune, India

Purpose: This study was done to determine point prevalence of pediatric epilepsy in two rural clusters of Pune District. The study also determined etiology and distribution of types of seizures and epilepsy syndromes, along with the treatment gap. Knowledge, attitude and practice regarding epilepsy among caregivers of the affected children were also assessed.

Method: This was a three stage cross sectional epidemiological survey in two rural suburbs adjoining Pune city in India. The questionnaires used were validated by pilot study. In first stage, house to house survey was conducted by trained health care workers, to screen for any seizure like events amongst children aged 2 months to 18 years of age. In the second stage, the houses which screened positive were visited by pediatric neurologist and evaluated in detail. In the third stage, those children who were diagnosed with epilepsy on the basis of history and examination underwent EEG at the local health centre to ensure compliance. Treatment gap and knowledge, attitude and practice (KAP) of caregivers were evaluated on a standard questionnaire. Strict quality control measures were applied.

Results: 75,455 population residing in 61 villages was screened, 355 children screened positive for seizure like events, 66 were diagnosed with epilepsy. Point prevalence of pediatric epilepsy was determined to be 3.44 per 1000 children. Focal epilepsy was the commonest type (53%), epilepsy syndrome was identified in 31.8%. 44% children with epilepsy had a comorbidity. Etiology could be identified in 68% cases, commonest being perinatal brain insult. Treatment gap was found to be 48.3%.

Conclusion: There is a significant diagnosis, treatment and knowledge gap in the rural population of India regarding pediatric epilepsy. Epilepsy needs to be integrated into existing rural health care facilities to aid in the optimum care of these children, along with identification and remedies for the associated co-morbidities.