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1. Development of an interventional strategy for the management of epilepsy in South-East Asia

Author

Pierre-Marie Preux, Channara Chhour, Farid Boumediene, Daniel Gérard, Vimalay Souvong, Sina Ros, Phetvongsinh Chivorakul, Samleng Chan, Peter Odermatt, Neuroépidémiologie Tropicale ( NET ), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST ), Université de Limoges ( UNILIM ) -Université de Limoges ( UNILIM ) -CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de la Francophonie pour la Médecine Tropicale ( IFMT ), Swiss Tropical Institute ( STI ), Department Public Health and Epidemiology, Sanofi-Aventis R&D, SANOFI Recherche, Service de l'Information Médicale et de l'Évaluation [CHU Limoges] ( SIME ), CHU Limoges, Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges ( UNILIM ), Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Institut de la Francophonie pour la Médecine Tropicale (IFMT), Swiss Tropical Institute (STI), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Université de Limoges (UNILIM), Grelier, Elisabeth, Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), and Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
medicine.medical_specialty, business.industry, 0211 other engineering and technologies, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, 02 engineering and technology, medicine.disease, 3. Good health, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Neurology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, Intervention (counseling), 021105 building & construction, Health care, Control area, Medicine, Christian ministry, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), South east asia, business, 030217 neurology & neurosurgery
Abstract

Background The prevalence of epilepsy is 7.7‰ in Laos and 5.8‰ in Cambodia, and the treatment gap exceeds 90% in both countries. Objective Our research program aims to measure the effectiveness of two community-based health care approaches using two different types of Domestic Health Visitors (DHV) trained to screen and follow patients with epilepsy (PWE): (1) in Laos, DHV were chosen from health center staff (2) in Cambodia, DHV were health volunteers residing in the villages. Patients and Methods / Material and Methods Between 2015 and 2017, these two quasi-experimental studies were conducted in rural districts over a 12- months period comparing an intervention area and a control area. Our intervention included an Information, Education and Communication campaign, specific training of the DHV staff, and regular monitoring. In Laos, the treatment gap was reduced by 5.5% (20 to 43 cases under treatment of the 418 expected) in the intervention area versus 0.5% (21 to 25 cases under treatment of the 788 expected) in the control area (p

Published
2017

2. Peut-on réduire le déficit de traitement de l’épilepsie dans les pays en développement ? Étude comparée Cambodge – Laos

Author

Samleng Chan, Channara Chhour, Phetvongsinh Chivorakoun, Sina Ros, Pierre-Marie Preux, Farid Boumediene, Peter Odermatt, Neuroépidémiologie Tropicale ( NET ), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST ), Université de Limoges ( UNILIM ) -Université de Limoges ( UNILIM ) -CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire de Géographie Physique et Environnementale ( GEOLAB ), Centre National de la Recherche Scientifique ( CNRS ) -Institut Sciences de l'Homme et de la Société ( IR SHS UNILIM ), Université de Limoges ( UNILIM ) -Université de Limoges ( UNILIM ) -Institut national de recherches archéologiques préventives ( Inrap ) -Université Blaise Pascal - Clermont-Ferrand 2 ( UBP ) -Université Clermont Auvergne ( UCA ), Swiss Tropical Institute ( STI ), Department Public Health and Epidemiology, Service de l'Information Médicale et de l'Évaluation [CHU Limoges] ( SIME ), CHU Limoges, Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges ( UNILIM ), Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Laboratoire de Géographie Physique et Environnementale (GEOLAB), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Institut Sciences de l'Homme et de la Société (IR SHS UNILIM), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), Swiss Tropical and Public Health Institute [Basel], Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Université de Limoges (UNILIM), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Université Clermont Auvergne (UCA)-Institut Sciences de l'Homme et de la Société (IR SHS UNILIM), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-Centre National de la Recherche Scientifique (CNRS), and Swiss Tropical Institute (STI)

Subjects
03 medical and health sciences, 0302 clinical medicine, Neurology, Laos, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine, Neurology (clinical), Cambodge, 030217 neurology & neurosurgery, Épilepsie
Abstract

International audience; IntroductionAlors que les prévalences en Asie du sud-est (7,7‰ au Laos et 5,8‰ au Cambodge) sont proches de celle observée en France (6‰), l’enjeu de santé publique pour ces pays relève avant tout du déficit thérapeutique qui est supérieur à 95 % au Laos comme au Cambodge. L’objectif principal de notre programme de recherche était de mesurer l’efficience d’une nouvelle approche des soins de santé de proximité en testant deux stratégies : (1) des visites villageoises mensuelles des personnels des centres de santé (nommés DHV) formés au dépistage et au suivi des patients épileptiques au Laos vs (2) une stratégie identique où les missions du DHV étaient assurées par les volontaires de santé résidant dans les villages au Cambodge.MéthodeCes deux études quasi-expérimentales d’une durée de 12 mois (réalisées en 2015–2016 au Laos et en 2016–2017 au Cambodge) ont été conduites dans des districts ruraux grâce à une approche comparée entre une zone d’intervention et une zone contrôle. Notre recherche a ainsi permis des analyses comparatives « avant–après et ici–ailleurs » pour démontrer l’efficacité de l’intervention dans chaque pays, ainsi qu’une comparaison entre les deux stratégies d’intervention.RésultatsAu Laos, après 12 mois d’expérimentation, le déficit de traitement a baissé de 5,5 % dans la zone d’intervention contre 0,5 % dans la zone contrôle (p = 0,0001). Dans la zone d’intervention, 36,1 % des épileptiques ont refusé le traitement, 27,8 % ont préféré être soigné sans passer par le centre de santé primaire (circuit de proximité) ; et parmi ceux qui ont adhéré, le suivi à domicile a permis d’augmenter de 27,6 % le nombre de compliants (p = 0,019). Au Cambodge, après 6 mois d’expérimentation, la stratégie a permis de baisser significativement le déficit de traitement de 31,1 % dans la zone d’intervention, au regard des 7,0 % de baisse dans la zone contrôle (p = 0,0001). Incontestablement, la stratégie est plus efficace lorsque le DHV réside dans le village.ConclusionD’ores et déjà, les points positifs de l’expérimentation au Laos ont permis la rédaction d’une « Advocacy Policy » (promotion et politique) favorablement accueillis par le Ministère de la Santé au Laos, comme cela est également envisagé au Cambodge à la fin de notre intervention en juin 2017.

Published
2017
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3. Undue regulatory control on phenobarbital--an important yet overlooked reason for the epilepsy treatment gap

Author

Donna Bergen, Phetvongsinh Chivorakoun, Gretchen L. Birbeck, Dismand Houinato, Peter Odermatt, Hasan Aziz, Sangeeta Ravat, Esper A. Cavalheiro, Pierre-Marie Preux, Charles R. Newton, J. Helen Cross, Devender Bhalla, Erich Schmutzhard, Arturo Carpio, Neuroépidémiologie Tropicale ( NET ), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST ), Université de Limoges ( UNILIM ) -Université de Limoges ( UNILIM ), Swiss Tropical Institute ( STI ), Department Public Health and Epidemiology, Service de l'Information Médicale et de l'Évaluation [CHU Limoges] ( SIME ), CHU Limoges, Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges ( UNILIM ), Grelier, Elisabeth, Neuroépidémiologie Tropicale (NET), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-CHU Limoges-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Swiss Tropical and Public Health Institute [Basel], Université de Limoges (UNILIM), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), and Swiss Tropical Institute (STI)

Subjects
medicine.medical_specialty, Treatment outcome, Antiepileptic drug, Epilepsy treatment, Article, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Epilepsy Treatment, medicine, Humans, 030212 general & internal medicine, Psychiatry, ComputingMilieux_MISCELLANEOUS, business.industry, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.disease, 3. Good health, Clinical neurology, Treatment Outcome, Regulatory control, Neurology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Phenobarbital, Drug and Narcotic Control, Anticonvulsants, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), business, 030217 neurology & neurosurgery, medicine.drug
Abstract

International audience; Epilepsy is a major chronic noncommunicable neurologic disorder. Although a simple, safe, efficacious, and low-cost treatment has been available for nearly 100 years, the treatment gap remains disturbingly high in many low- and middle-income countries (LMICs).[1] Treatment gap is generally defined as a “difference between the number of people with active epilepsy and the number being appropriately treated.” There are many reasons for this treatment gap; one important reason is an overly restrictive regulation on barbiturates such as phenobarbital (PB). These restrictive regulations deserve a wider and open discussion, even though epileptologists and others are intensely engaged on reducing the epilepsy treatment gap. With this article, we provide our viewpoint with an aim of raising an extremely important issue: undue regulatory restriction on phenobarbital, an essential lifesaving antiepileptic drug (AED).

Published
2015
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4. Impact of Human Immunodeficiency Virus on the Severity of Buruli Ulcer Disease: Results of a Retrospective Study in Cameroon

Author

Akoa Tsoungui, Eric Comte, Laura Ciaffi, Vanessa Christinet, Alexandra Calmy, Ludovic Rossel, Alain-Bertrand Nomo, Peter Odermatt, Cécile Delhumeau, Patrick Nkemenang, Micaela Serafini, Annick Antierens, Geneva University Hospital (HUG), Médecins sans Frontières [Genève] (MSF), Swiss Tropical and Public Health Institute [Basel], University of Basel (Unibas), Akonolinga District Hospital [Akonolinga, Cameroon], Hôpitaux Universitaires de Genève (HUG), and Comte, Eric

Subjects
Buruli ulcer, medicine.medical_specialty, Tuberculosis, medicine.medical_treatment, Mycobacterium ulcerans disease, Major Articles, Acquired immunodeficiency syndrome (AIDS), Internal medicine, medicine, Cameroon, ddc:616, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Hazard ratio, virus diseases, HIV, Immunosuppression, Retrospective cohort study, medicine.disease, Confidence interval, 3. Good health, Infectious Diseases, Oncology, Immunology, Leprosy, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

The impact of human immunodeficiency virus (HIV) infection on Buruli ulcer (BU) severity and prevalence remains unclear. This study shows that patients who are HIV positive are at risk for BU. Notably, HIV-induced immunosuppression seems to have an impact on BU clinical presentation and disease evolution., Background. Buruli ulcer is the third most common mycobacterial disease after tuberculosis and leprosy and is particularly frequent in rural West and Central Africa. However, the impact of HIV infection on BU severity and prevalence remains unclear. Methods. This was a retrospective study of data collected at the Akonolinga District Hospital, Cameroon, from January 1, 2002 to March 27, 2013. Human immunodeficiency virus prevalence among BU patients was compared with regional HIV prevalence. Baseline characteristics of BU patients were compared between HIV-negative and HIV-positive patients and according to CD4 cell count strata in the latter group. Buruli ulcer time-to-healing was assessed in different CD4 count strata, and factors associated with BU main lesion size at baseline were identified. Results. Human immunodeficiency virus prevalence among BU patients was significantly higher than the regional estimated prevalence in each group (children, 4.00% vs 0.68% [P < .001]; men, 17.0% vs 4.7% [P < .001]; women, 36.0% vs 8.0% [P < .001]). Individuals who were HIV positive had a more severe form of BU, with an increased severity in those with a higher level of immunosuppression. Low CD4 cell count was significantly associated with a larger main lesion size (β-coefficient, −0.50; P = .015; 95% confidence interval [CI], −0.91–0.10). Buruli ulcer time-to-healing was more than double in patients with a CD4 cell count below 500 cell/mm3 (hazard ratio, 2.39; P = .001; 95% CI, 1.44–3.98). Conclusion. Patients who are HIV positive are at higher risk for BU. Human immunodeficiency virus-induced immunosuppression seems to have an impact on BU clinical presentation and disease evolution.

Published
2014
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5. Sociocultural and psychological features of perceived stigma reported by people with epilepsy in Benin

Author

Florentina, Rafael, Dismand, Houinato, Philippe, Nubukpo, Catherine-Marie, Dubreuil, Duc Si, Tran, Peter, Odermatt, Jean-Pierre, Clément, Mitchell G, Weiss, Pierre-Marie, Preux, Neuroépidémiologie Tropicale et Comparée (NETEC), Université de Limoges (UNILIM)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Unité d'Enseignement et de Recherche de Neurologie (UER neurologie FSS), University of Abomey Calavi (UAC), Centre de Mémoire de Ressources et de Recherches [Limoges] (CMRR Limoges), CHU Limoges-CH Esquirol [Limoges] (CH Esquirol), Hôpital Psychiatrique La Valette, Service Universitaire de la Formation Permanente (SUFOP), Université de Limoges (UNILIM), Swiss Tropical Institute (STI), Department Public Health and Epidemiology, Service de Psychiatrie [CHU Limoges], CHU Limoges, Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Laboratoire de Biostatistique et d'Informatique Médicale, and Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Université de Limoges (UNILIM)

Subjects
Adult, Male, Adolescent, Culture, MESH: Stereotyping, Social Environment, MESH: Perception, Young Adult, MESH: Benin, Benin, Humans, MESH: Data Collection, Aged, MESH: Adolescent, MESH: Social Environment, MESH: Aged, Stereotyping, Epilepsy, MESH: Middle Aged, MESH: Humans, Data Collection, MESH: Adult, Middle Aged, MESH: Male, MESH: Young Adult, MESH: Epilepsy, Female, Perception, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Culture, MESH: Female
Abstract

International audience; PURPOSE: Stigma is a major burden of epilepsy. In sub-Saharan Africa the few studies that addressed epilepsy stigma emphasize enacted, rather than perceived, stigma. This inattention may compromise clinical management and delay help seeking, thereby contributing to the treatment gap. We assessed perceived stigma and identified sociocultural and psychological factors explaining greater stigma among people with epilepsy (PWE) in Benin. METHODS: PWE included in this study were ascertained using a door-to-door survey in the general population in a Beninese rural area. We applied both qualitative and quantitative research methods to assess stigma and patient's experience and beliefs. An Explanatory Model Interview Catalogue (EMIC) and verbally administered questionnaires provided data for demographic, clinical, and sociocultural features. Sociocultural features were evaluated in terms of illness-related experience and sociocultural representations of epilepsy. Depression and anxiety were also screened. RESULTS: Eighty PWE were included. About 68.7% reported feeling stigmatized. Multivariate regression revealed that factors independently associated with perceived stigma were experience of social isolation (p < 0.001), experience of marital problems (p < 0.01), and presence of anxiety disorder (p < 0.01). DISCUSSION: Perceived stigma is an important issue in epilepsy in Benin. Social factors seem to be more influential than sociocultural representation of epilepsy. Insofar as research is needed in other African countries to determine the nature and relevant features of stigma to improve treatment and control.

Published
2010
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6. Neglected psychiatric comorbidity in people with epilepsy in developing countries--response to Tellez-Zenteno et al

Author

Pierre-Marie Preux, Mitchell G. Weiss, Peter Odermatt, Victor Doku, Swiss Tropical Institute (STI), Department Public Health and Epidemiology, Neuroépidémiologie Tropicale et Comparée (NETEC), Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Université de Limoges (UNILIM), Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), CHU Limoges, Kintampo Surveillance Demographic System, and Kintampo Health Research Centre, Ghana

Subjects
medicine.medical_specialty, MESH: Poverty, 030231 tropical medicine, MESH: Depressive Disorder, MESH: Delivery of Health Care, Poison control, Developing country, MESH: Comorbidity, Suicide prevention, Occupational safety and health, MESH: Cause of Death, 03 medical and health sciences, Epilepsy, 0302 clinical medicine, Injury prevention, Medicine, MESH: Mental Disorders, Psychiatry, MESH: Developing Countries, ComputingMilieux_MISCELLANEOUS, MESH: Prevalence, MESH: Humans, business.industry, MESH: Research Design, Human factors and ergonomics, medicine.disease, Comorbidity, MESH: Suicide, Neurology, MESH: Epilepsy, MESH: Anxiety Disorders, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), Medical emergency, business, 030217 neurology & neurosurgery
Abstract

International audience

Published
2008
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7. The challenge of epilepsy control in deprived settings: Low compliance and high fatality rates during a community-based phenobarbital program in rural Laos

Author

Pierre-Marie Preux, Pierre Huc, Jie Zen, Luc Delneuville, Hubert Barennes, Peter Odermatt, Duc Si Tran, Michel Strobel, Neuroépidémiologie Tropicale et Comparée (NETEC), Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Université de Limoges (UNILIM), Swiss Tropical Institute (STI), Department Public Health and Epidemiology, Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), CHU Limoges, and Institut de la Francophonie pour la Médecine Tropicale

Subjects
Male, Medically Underserved Area, MESH: Epilepsy, Generalized, Epilepsy, 0302 clinical medicine, Epidemiology, Prevalence, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, media_common, MESH: Treatment Outcome, Community based, Health Care Costs, MESH: Follow-Up Studies, MESH: Patient Compliance, MESH: Phenobarbital, Democracy, Community Mental Health Services, 3. Good health, MESH: Medically Underserved Area, Treatment Outcome, Neurology, Laos, Phenobarbital, Anticonvulsants, Epilepsy, Generalized, Female, Medical emergency, Adult, medicine.medical_specialty, Patient Dropouts, media_common.quotation_subject, MESH: Health Care Costs, MESH: Community Mental Health Services, Compliance (psychology), 03 medical and health sciences, MESH: Patient Dropouts, MESH: Anticonvulsants, medicine, Humans, Mortality, China, MESH: Prevalence, MESH: Humans, MESH: Mortality, business.industry, Public health, MESH: Adult, medicine.disease, MESH: Male, MESH: Laos, Family medicine, Patient Compliance, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), business, MESH: Female, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

∗Institut de la Francophonie pour la Medecine Tropicale, Vientiane, Lao Peoples’ Democratic Republic; †Kunming Medical College, Kunming, Yunnan, China; ‡Department of Public Health and Epidemiology, Swiss Tropical Institute, Basel, Switzerland; §Institut d’Epidemiologie Neurologique et de Neurologie Tropicale (EA 3174), Limoges, France; ¶Handicap International, Vientiane, Lao Peoples’ Democratic Republic

Published
2007
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8. Epilepsy in Laos: knowledge, attitudes, and practices in the community

Author

Peter Odermatt, Hubert Barennes, Pierre-Marie Preux, Michel Druet-Cabanac, Duc Si Tran, Michel Strobel, Soukhanthone Singphuoangphet, Neuroépidémiologie Tropicale et Comparée (NETEC), Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Université de Limoges (UNILIM), Swiss Tropical Institute (STI), Department Public Health and Epidemiology, Service de Santé au Travail [CHU Limoges], CHU Limoges, Unité Fonctionnelle Registre Général des Cancers du Limousin (UFRGC), Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM), and Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME)

Subjects
Adult, Male, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Adolescent, MESH: Health Knowledge, Attitudes, Practice, Epilepsy treatment, Disease, 03 medical and health sciences, Behavioral Neuroscience, Epilepsy, 0302 clinical medicine, Seizures, MESH: Child, medicine, First Aid, Humans, MESH: Data Collection, 030212 general & internal medicine, Psychiatry, Child, MESH: First Aid, MESH: Adolescent, MESH: Humans, business.industry, Data Collection, MESH: Adult, medicine.disease, MESH: Seizures, MESH: Male, 3. Good health, Neurology, MESH: Laos, Laos, Family medicine, Data Interpretation, Statistical, MESH: Epilepsy, Pork meat, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), business, MESH: Data Interpretation, Statistical, MESH: Female, 030217 neurology & neurosurgery
Abstract

Objective. We evaluated beliefs about, attitudes toward, and stigma associated with epilepsy in four districts of central Laos. Method. For this study, 83 people with epilepsy, 83 family members, and 166 matched villagers in Vientiane Province were interviewed. Results. From patients to families to villagers, there existed a significantly increasing gradient of misbeliefs. Dubbed locally as ‘‘mad pig disease,’’ epilepsy was viewed as having a supernatural origin by 25–42% of respondents, a life-threatening disease by 60%, a disease transmissible by consumption of pork meat by 10–21%, and a disease transmissible by contact with patients’ saliva by 14.5% of patients and 44% of villagers (P < 0.01). Stigma was high. People thought that they should avoid contact or sharing meals with patients (15% of patients, 62% of family members, P < 0.001), and that persons with epilepsy should not get a job, get married (29 and 42%, P < 0.016), or raise children (33–42%). Conclusion. Wrong beliefs may lead to stigma and hamper access to or compliance with modern epilepsy treatment. In traditional countries, education is the cornerstone of epilepsy management. 2007 Elsevier Inc. All rights reserved.

Published
2007
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