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Prevalence of Epilepsy in the Philippines Population of 83 million and an estimated prevalence of...
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Transcript of Prevalence of Epilepsy in the Philippines Population of 83 million and an estimated prevalence of...
Prevalence of Epilepsy in the Philippines
• Population of 83 million and an estimated prevalence of 0.9%
• an estimated 750,000 people with epilepsy in the country– majority in the productive years of their life (Chua
2007)
Chua, Annabelle. Epilepsy surgery in the Philippines Neurology Asia 2007; 12 (Supplement 2) : 43 – 45
WHO Western Pacific Region 2004 Key data on epilepsy: Epilepsy Professionals
Philippines Malaysia Singapore Australia
Specialist neurologists
Specialist Neurologists
Specialist neurologists
Specialist Neurologists
Neurosurgeons Neurosurgeons Neurosurgeons
Neuropediatricians Neuropediatricians Neuropediatricians Neuropsychologists
Neurophysiologists
Social workers Social workers
Neurological nurses Neurological nurses
World Health Organization. "Epilepsy in the Western Pacific Region: A call to action." Global Campaign Against Epilepsy, 2004.
WHO Western Pacific Region 2004 Key data on epilepsy: Epilepsy equipment, facilities, etc
Philippines Malaysia Singapore Australia
•CT • CT • CT • CAT
•MRI • MRI • MRI • MRI
•EEG • EEG • EEG • PET
•Therpeutic Drug Monitoring
•Therpeutic Drug Monitoring
• SPECT • SPECT
•Long-term video/EEG monitoring
•Long-term video/EEG monitoring
•Long-term video/EEG monitoring
•Long-term video/EEG monitoring
•Epilepsy surgery •Epilepsy surgery •Epilepsy surgery •Epilepsy surgery including intracranial electrophysiology
•Neuropsychological services
•Neuropsychological services
•Neuropsychological services
•Psychiatric counseling
•Psychiatric counseling
•Psychiatric counseling
•Special education
World Health Organization. "Epilepsy in the Western Pacific Region: A call to action." Global Campaign Against Epilepsy, 2004.
WHO Western Pacific Region 2004 Key data on epilepsy: Major causes of seizures
Philippines Malaysia Singapore Australia
• Cerebrovascular accidents
• Idiopathic • Post-traumatic • Hippocampal sclerosis
•CNS infection (TB meningitis, bacterial meningitis)
• Post-traumatic • Post-cerebrovascular accident
• Post-traumatic
•Head Injury • Birth related injury/insult
• CNS infections • Stroke
•Brain tumors • Hippocampal sclerosis
• Mesial temporal sclerosis
• Perinatal injury
•Perinatal insults/injuries
• Brain infection • Tumors • Idiopathic
World Health Organization. "Epilepsy in the Western Pacific Region: A call to action." Global Campaign Against Epilepsy, 2004.
WHO Western Pacific Region 2004 Key data on epilepsy: Available AEDs and cost
Philippines Malaysia Singapore Australia
•Phenobarbital, Php1.75 ($0.03)
• Acetazolamide
• Phenytoin,Php18.00 ($0.32)
• Phenytoin, 4¢ per 100mg ($0.11)
• Phenytoin, 9 ¢ per 100mg ($0.53)
• Clozabam, Diazepam
• Carbamazepine, Php16.00 ($0.29)
• Carbamazepine, 20¢ per 200mg ($0.05)
• Carbamazepine, 9¢ per 200mg ($0.53)
• Ethosuximide
• Valproate, Php18.00 ($0.32)
• Valproate, 20¢ per 200mg ($0.05)
• Valproate 24¢ per 200mg ($0.14)
• Gabapentin
• Lamotrigine, Php27.00 ($0.49)
• Lamotrigine, RM2.52 ($0.66) • Lamotrigine
•Also available: gabapentin, topiramate, clonazepam, diazepam
• Topimarate, RM 2.86 per 50mg•Gabapentin, RM 2.37 per 300mg• Phenobarbitone, 2¢ per 30mg• Clonazepam (22 per 0.5/24¢ prt mg)
• Often price of consultation includes medication and investigations
• Phenobarbiton, 3¢ per 30mg• Diazepam 3¢ per 5mg
• Levitiracetam, Ocarbazepine, Levitiracam, Nitrazepam, Oxcarbazepine, phenobarbitone, phenytoin, primidone, sulthiame, tiagabine, topimarate, valproate, vigabatrin•Subsidized under a national Pharmaceutical Benefits Scheme (PBS) which limits the cost to AU$ 23 per month’s supply
World Health Organization. "Epilepsy in the Western Pacific Region: A call to action." Global Campaign Against Epilepsy, 2004.
Awareness and understanding of epilepsy among patients, families, caregivers and health workers
• Awareness– 32% of patients and caregivers and 11% of health
workers have not heard or read any information about epilepsy
• Etiology – 17% of health workers and 4% of patients and
caregivers believe that epilepsy is contagious and can be transmitted by either marrying, caring for or living with a person with epilepsy or even by witnessing an epileptic attack
Salonga, A.M. et al. 1999, Epilepsy Education Program: It’s Role In the Comprehensive Management of Children with Epilepsy”
• Treatment – more parents and caregivers (86%) believe
epilepsy can be cured with medications than health workers (68%)
– 54-72% believe epilepsy can be cured with prayer
Awareness and understanding of epilepsy among patients, families, caregivers and health workers
Salonga, A.M. et al. 1999, Epilepsy Education Program: It’s Role In the Comprehensive Management of Children with Epilepsy”
• What to do during an attack – about half of all the respondents will insert a
spoon into the mouth– 1/3-2/3 will fan the patient– 1/3-2/3 will do nothing and wait– A smaller percentage will massage the patient,
blow air on the face, put pressure on the stomach or even bite the patient.
Awareness and understanding of epilepsy among patients, families, caregivers and health workers
Salonga, A.M. et al. 1999, Epilepsy Education Program: It’s Role In the Comprehensive Management of Children with Epilepsy”
Public Attitude and Awareness Towards EpilepsyA Public Pulse in a Tertiary Hospital
• Awareness– 94.84% have heard or
heard about epilepsy– 44.52% knows someone
w/ epilepsy– 69.68% had seen an
epileptic attack
• Understanding epilepsy– 10.32% did not know
what epilepsy was– 3.87% did not know
what an epileptic attack looks like
Piano, Anthony and Joanne Robles. "Public Attitude and Awareness Towards Epilepsy: A Public Pulse in a Tertiary Hospital ." (2008).
Public Attitude and Awareness Towards EpilepsyA Public Pulse in a Tertiary Hospital
• Attitude– 83.87% did not have any objections in having their
children interact w/ persons w/ epilepsy– 31.61% would object to having their children
marry someone w/ seizures– 76.77% believed that people w/ epilepsy should
be employed– 8.39% believed that epilepsy is a form of insanity
Piano, Anthony and Joanne Robles. "Public Attitude and Awareness Towards Epilepsy: A Public Pulse in a Tertiary Hospital ." (2008).
Is Epilepsy a Burden?
• Economic– Medical care is mostly shouldered out-of-pocket– Cost• Phenytoin 100mg/cap TID
– P26/tab x 3 = P78/day
• Levetiracetam 500mg/tab BID– P45/tab x 2 = P90/day
Patient’s Perception Towards Epilepsy
• Personal reaction to having epilepsy – fear– worry– uncertainty– anger,– confusion– self-pity– neutrality– heightened emotionality
Cabral-Lim, Leonor. Epilepsy in the Philippines. September 28, 2001. http://www.plae.org.ph/web/epilepsy_information4.php.
Patient’s Perception Towards Epilepsy
• Difficulties encountered – taunting and irritability from others– difficulty in accomplishing tasks– feeling of being abandoned by family members– inability to pursue work and other activities– feeling of being a burden to family
Patient’s Perception Towards Epilepsy
• Reaction from others – being overprotective and restrictive– making fun of the person and labeling person as crazy– distancing and fear– majority of parents would not want their normal children nor
themselves to marry a person with epilepsy
Cabral-Lim, Leonor. Epilepsy in the Philippines. September 28, 2001. http://www.plae.org.ph/web/epilepsy_information4.php.
Addressing the issues
• Financing and budget – Increase health budget– Reduce OOP and increase health insurance
coverage• Primary Prevention– Social• Increase awareness• Address social stigma
Philippine League Against Epilepsy Awareness Campaigns
http://www.plae.org.ph/web/plae_archives.php
Philippine League Against Epilepsy Awareness Campaigns
• Television Advertisement– "Tsismis" (Gossip)
• Radio Advertisment– " Romy”• Raymonde please embed attached wav file
http://www.plae.org.ph/web/plae_archives.php