Prevalence and pattern of epilepsy treatment in different socioeconomic classes in Brazil.
OBJECTIVE
The worldwide prevalence of epilepsy is variable, estimated at 10//1,000 people, and access to treatment is also variable. Many people go untreated, particularly in resource-poor countries.


OBJECTIVE
To estimate the prevalence of epilepsy and the proportion of people not receiving adequate treatment in different socioeconomic classes in Brazil, a resource-poor country.


METHODS
A door-to-door survey was conducted to assess the prevalence and treatment gap of epilepsy in three areas of two towns in Southeast Brazil with a total population of 96,300 people. A validated screening questionnaire for epilepsy (sensitivity 95.8%, specificity 97.8%) was used. A neurologist further ascertained positive cases. A validated instrument for socioeconomic classification was used.


RESULTS
Lifetime prevalence was 9.2/1,000 people [95% CI 8.4-10.0] and the prevalence of active epilepsy was 5.4/1,000 people. This was higher in the more deprived social classes (7.5/1,000 compared with 1.6/1,000 in the less deprived). Prevalence was also higher in elderly people (8.5/1,000). Thirty-eight percent of patients with active epilepsy had inadequate treatment (19% on no medication); the figures were similar in the different socioeconomic groups.


CONCLUSIONS
The prevalence of epilepsy in Brazil is similar to other resource-poor countries, and the treatment gap is high. Epilepsy is more prevalent among less wealthy people and in elderly people. There is an urgent need for education in Brazil to inform people that epilepsy is a treatable, as well as preventable, condition.
Noronha
Ana L A
AL
Department of Neurology, Faculty of Medicine, UNICAMP, Campinas, SP, Brazil.
Borges
Moacir A
MA
Marques
Lucia H N
LH
Zanetta
Dirce M T
DM
Fernandes
Paula T
PT
de Boer
Hanneke
H
Espíndola
Javier
J
Miranda
Claudio T
CT
Prilipko
Leonid
L
Bell
Gail S
GS
Sander
Josemir W
JW
Li
Li M
LM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D019538:Health Care Surveys; D006266:Health Education; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008297:Male; D008489:Medical Indigency / Q000706:statistics & numerical data; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data; D015995:Prevalence; D012923:Social Class; D011795:Surveys and Questionnaires
D000927:Anticonvulsants