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Boumediene F, Chhour C, Chivorakoun P, et al. Community-based management of epilepsy in Southeast Asia: Two intervention strategies in Lao PDR and Cambodia. Lancet Reg Health West Pac. 2020;4:100042doi: 10.1016/j.lanwpc.2020.100042.
Boumediene, F., Chhour, C., Chivorakoun, P., Souvong, V., Odermatt, P., Hun, C., Thebaut, C., Bounlu, M., Chum, N., Vorachit, S., Ros, S., Chan, S., & Preux, P. M. (2020). Community-based management of epilepsy in Southeast Asia: Two intervention strategies in Lao PDR and Cambodia. The Lancet regional health. Western Pacific, 4100042. https://doi.org/10.1016/j.lanwpc.2020.100042
Boumediene, Farid, et al. "Community-based management of epilepsy in Southeast Asia: Two intervention strategies in Lao PDR and Cambodia." The Lancet regional health. Western Pacific vol. 4 (2020): 100042. doi: https://doi.org/10.1016/j.lanwpc.2020.100042
Boumediene F, Chhour C, Chivorakoun P, Souvong V, Odermatt P, Hun C, Thebaut C, Bounlu M, Chum N, Vorachit S, Ros S, Chan S, Preux PM. Community-based management of epilepsy in Southeast Asia: Two intervention strategies in Lao PDR and Cambodia. Lancet Reg Health West Pac. 2020 Oct 09;4:100042. doi: 10.1016/j.lanwpc.2020.100042. eCollection 2020 Nov. PMID: 34327389; PMCID: PMC8315387.
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Lancet Reg Health West Pac. 2020 Oct 09;4:100042. doi: 10.1016/j.lanwpc.2020.100042. eCollection 2020 Nov.

Community-based management of epilepsy in Southeast Asia: Two intervention strategies in Lao PDR and Cambodia.

The Lancet regional health. Western Pacific

Farid Boumediene, Channara Chhour, Phetvonsinh Chivorakoun, Vimalay Souvong, Peter Odermatt, Chamroeun Hun, Clémence Thebaut, Mayoura Bounlu, Navuth Chum, Somchit Vorachit, Sina Ros, Samleng Chan, Pierre-Marie Preux

Affiliations

  1. INSERM U1094, Univ. Limoges, CHU Limoges, IRD, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 2 rue du Docteur Marcland, 87025 Limoges, France.
  2. Cambodia Society of Neurology, Phnom Penh, Cambodia.
  3. Association for Patient with Epilepsy in Laos, Vientiane, Lao Democratic People's Republic.
  4. Swiss Tropical and Public Health Institute, Basel, Switzerland.
  5. University of Basel, Basel, Switzerland.

PMID: 34327389 PMCID: PMC8315387 DOI: 10.1016/j.lanwpc.2020.100042

Abstract

BACKGROUND: Epilepsy affects more than 50 million people worldwide, 80% of whom live in low- and middle-income countries (LMICs). In Southeast Asia, the prevalence is moderate (6‰), and the main public health challenge is reducing the treatment gap, which reaches more than 90% in rural areas.

METHODS: This 12-month comparative study (intervention vs. control areas) assessed the community effectiveness of two different strategies for the identification and home follow-up of people with epilepsy by Domestic Health Visitors for epilepsy (DHVes). In Lao PDR, DHVes were health center staff covering several villages via monthly visits; in Cambodia, DHVes were health volunteers living in the villages.

FINDINGS: At baseline, the treatment gap was >95% in Lao PDR and 100% in Cambodia. After 12 months, the treatment gap in Lao PDR decreased by 5·5% (range: 4·0-12·2) in the intervention area and 0·5% (range: 0·4-0·8) in the control area (

INTERPRETATION: The treatment gap was significantly reduced with both intervention strategies, but the effect was larger in Cambodia. The results of this cost analysis pave the way for scaling-up in rural areas of Lao PDR and Cambodia, and experimental adaptation in other LMICs.

FUNDING: The study was funded by the Global Health Department of Sanofi and Grand Challenges Canada (grant number 0325-04).

© 2020 The Author(s).

Conflict of interest statement

Dr. Boumediene, Dr. Preux, Dr. Hun, Dr. Thebaut, Dr. Chhour, Dr. Chum, Dr. Ros, and Dr. Samleng report grants from Sanofi Global Health Programs,  during the conduct of the study; Dr. Boumediene and D

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