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Prevalence and Pattern of Epilepsy Treatment in Different Socioeconomic Classes in Brazil
Author(s) -
Noronha Ana L. A.,
Borges Moacir A.,
Marques Lucia H. N.,
Zanetta Dirce M. T.,
Fernandes Paula T.,
De Boer Hanneke,
Espíndola Javier,
Miranda Claudio T.,
Prilipko Leonid,
Bell Gail S.,
Sander Josemir W.,
Li Li M.
Publication year - 2007
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2006.00974.x
Subject(s) - epilepsy , socioeconomic status , medicine , population , social class , pediatrics , demography , environmental health , psychiatry , sociology , political science , law
Summary: Purpose: The worldwide prevalence of epilepsy is variable , estimated at 10//1,000 people, and access to treatment is also variable. Many people go untreated, particularly in resource‐poor countries. Objective: To estimate the prevalence of epilepsy and the proportion of people not receiving adequate treatment in different socioeconomic classes in Brazil, a resource‐poor country. Methods: A door‐to‐door survey was conducted to assess the prevalence and treatment gap of epilepsy in three areas of two towns in Southeast Brazil with a total population of 96,300 people. A validated screening questionnaire for epilepsy (sensitivity 95.8%, specificity 97.8%) was used. A neurologist further ascertained positive cases. A validated instrument for socioeconomic classification was used. Results: Lifetime prevalence was 9.2/1,000 people [95% CI 8.4–10.0] and the prevalence of active epilepsy was 5.4/1,000 people. This was higher in the more deprived social classes (7.5/1,000 compared with 1.6/1,000 in the less deprived). Prevalence was also higher in elderly people (8.5/1,000). Thirty‐eight percent of patients with active epilepsy had inadequate treatment (19% on no medication); the figures were similar in the different socioeconomic groups. Conclusion: The prevalence of epilepsy in Brazil is similar to other resource‐poor countries, and the treatment gap is high. Epilepsy is more prevalent among less wealthy people and in elderly people. There is an urgent need for education in Brazil to inform people that epilepsy is a treatable, as well as preventable, condition.