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In Lao PDR, the care of patients with epilepsy faces many challenges. There are around 50,000 people living with epilepsy (PWE) but only 10% have access to antiepileptic medication. The mortality is high among untreated PWE. Misconception about the disease and stigma are common in the general population. The availability of antiepileptic medication is poor. Knowledge on epilepsy among health personnel is poor. Improvement in the management of epilepsy in Lao PDR requires training of health workers on epilepsy, a system to provide antiepileptic drugs and improvement of knowledge on the causes and effective treatment of epilepsy among PWE and the public. The Lao Association for Patients with Epilepsy (APE) was established in 2011 with four main activities: organizing scientific conferences on epilepsy in Laos; providing three days training on epilepsy to health personal at both provincial and district levels; supporting the provision of antiepileptic drugs through a revolving drug fund at provincial and district hospitals; and promoting the dissemination of information on epilepsy to the public. Up to now, 31 health professionals among 52 who were trained on epilepsy provide consultations at both provincial and the district levels. A total of 129,200 tablets of a first line antiepileptic drug (phenobarbital) have been provided to provincial and district hospitals. An estimated 1,112 PWE are currently under treatment. There is a daily information campaign through the media; pamphlets and posters are disseminated at epilepsy clinics. A Lao medical network has been established that will improve access to treatment by PWE. [ABSTRACT FROM AUTHOR]

In Lao PDR research conducted over the last 7 years has highlighted the difficult challenges that the 52,000 patients living with epilepsy (PWE) have to face. Mortality and morbidity is high among untreated patients. The treatment gap is 90% or more. The highly traditional and poor knowledge of the disease and its treatment, low trust in modern treatment, restricted access to anti-epileptic drugs (phenobarbital is the first line drug), and ignorance of requirement for long term treatment explain the high treatment gap. Stigma, misconceptions, and fear of the disease are common. Knowledge of medical staffs regarding epilepsy diagnosis and treatment is poor. The neurology investigational facilities are basic and mainly concentrated in the capital city. Using lessons from program of neighboring countries, the authors have been developing a step-by-step treatment intervention project since 2009. The intervention was adapted to the local constraints and a limited budget, which demanded regular feedbacks, analysis and reorientation of the activities. [ABSTRACT FROM AUTHOR]

Background and Aim: Traditional practices are deeply rooted in Lao people's perceptions and beliefs about health and illness.The objective of the study was to understand the perceptions of healthcare professionals and traditional healers regarding the management of epilepsy in Laos, and their reciprocal views., Experimental Procedure: An observational study was carried out in two areas of Laos from February to May 2017. Semi directive questionnaires were used to collect quantitative and qualitative data. Semiotic square was carried out to highlight relationships between attitudes of traditional healers and healthcare professionals. For quantitative approach, the proportions were reported, and the test used was Fisher's test for nominal variables. The mean and standard deviation expressed the continuous variables and the Student's t-test was used., Results and Conclusion: Epilepsy was cited by 90.9% of traditional healers as a convulsive disease with saliva or urine, and herbal medicines were predominantly used (86.4%) to treat it. Few healthcare professionals (26.5%) pointed out that they knew remedies to treat epilepsy other than antiepileptic drugs (AEDs), and 76.5% of healthcare professionals mentioned that epilepsy was a disease which only AEDs could treat. On the other hand, 54.5% of traditional healers confirmed a traditional remedy could cure completely epilepsy through long-term use. Ninety percent of traditional healers said the collaboration with healthcare professionals was a good idea and 44.1% of the healthcare professionals group said was complicated.The combination of these medicines for the management of epilepsy needs to be adapted to Lao's medical context., Competing Interests: We declare no competing interests. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors., (© 2020 Center for Food and Biomolecules, National Taiwan University. Production and hosting by Elsevier Taiwan LLC.)