Prevalence and treatment gap of active convulsive epilepsy: A large community-based survey in rural West China
Prevalence and treatment gap of active convulsive epilepsy: A large community-based survey in rural West China
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DOI：
10.1016/j.seizure.2014.01.007
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发表时间：
2014-05-01
影响因子：
3
通讯作者：
Chen, Xiao-fang
中科院分区：
文献类型：
--
作者：
Hu, Jia;Si, Yang;Chen, Xiao-fang
目的：活动性惊厥癫痫（ACE）对患者的影响很大，特别是在患者得不到适当治疗的低收入国家。在本研究中，我们测量了中国西部农村ACE的患病率和治疗缺口（TG）。方法：选取2007 - 2009年中国西部6个农村地区总人口3541319人，采用线索调查法对ACE患病率和TG进行估算。线索调查是在特定人群中开展的以社区为基础的筛查策略，需要雇用训练有素的当地医生/卫生工作者在研究期间收集所有可用的线索，以发现/识别/招募患者。采用问卷访谈法对ACE患者进行识别，并在调查过程中获取信息。计算ACE的患病率和TG。结果：共发现6547例ACE患者。一般人群中ACE的估计患病率为1.8 / 1000，男性和女性的患病率分别为2.0 / 1000和1.7 / 1000 （p < 0.001）。一般人群TG为66.3%，男性和女性分别为66.6%和66.0% （p < 0.05）。TG随年龄增长而下降，30岁以上升高。60岁及以上患者TG最高（77.8%）；病程少于10年的患者表现出较大的TG，而每年经历2 - 5次癫痫发作的患者表现出明显较大的TG（70.6%）。此外，研究中只有63.9%的ACE患者意识到这种疾病并咨询了医生。结论：西部农村ACE存在较大的TG。其中大多数人曾经咨询过医生，但未能接受或坚持适当的治疗方案。要填补这一空白，必须进行管理，包括公共教育和培训当地医生。英国癫痫协会版权所有。Elsevier Ltd.出版。版权所有。
Purpose: Active convulsive epilepsy (ACE) impacts patients greatly, especially in low-income countries where patients do not receive appropriate treatment. In the present study, we measured the prevalence and treatment gap (TG) of ACE in rural West China.Methods: Six rural areas in West China that have a total population of 3,541,319 were selected to conduct prevalence and TG estimates of ACE via a clue survey from 2007 to 2009. Clue survey here is a community-based screening strategy among defined population which requires employed well-trained local physicians//health workers to collect all clues available to discover/identify/recruit patients within a study period. Questionnaire-based interviews were used for the identification of ACE patients, and information was obtained during the survey. Prevalence and TG of ACE were calculated.Results: A total of 6547 patients with ACE were identified. The estimated prevalence of ACE was 1.8 per 1000 in the general population, with the prevalences in males and females determined to be 2.0 and 1.7, respectively (p < 0.001). The TG in the general population was 66.3%, and it was 66.6% and 66.0% in males and females, respectively (p > 0.05). The TG figures dropped with advancing age and increased above 30 years of age. Patients aged 60 years or older had the largest TG (77.8%); those with disease course less than 10 years showed a larger TG and those who experienced two to five seizures annually had a significantly larger TG (70.6%). Additionally, only 63.9% of the ACE patients included in the study were aware of the disease and had consulted a doctor.Conclusions: There exists a large TG of ACE in West China rural areas. Majority of those ever consulted a doctor but failed to receive or adhere to an appropriate treatment program. Management including public education as well as training of local physicians were necessary to fill that gap. Crown Copyright (C) 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.