The current availability of antiepileptic drugs in Zambia: implications for the ILAE/WHO "out of the shadows" campaign.
Recent concerns regarding antiepileptic drug (AED) availability in Zambia led us to conduct a study in the Lusaka and Southern Provinces to quantify the availability and cost of AEDs and assess determinants. Among 111 pharmacies, almost one-half did not carry AEDs (N = 54; 49.1%). Available AEDs were phenobarbitone (21; 18.9%), carbamazepine (27; 24.3%), valproic acid (4; 3.6%), and phenytoin (3; 2.7%). Adult out-of-pocket monthly costs ranged from US $7 to $30. Pediatric syrups were universally unavailable. Interviews revealed several barriers to AED provision, including that handling phenobarbitone (historically the most affordable AED) has become increasingly difficult because of newly enforced regulatory requirements. Personal communications with epilepsy-care providers in other low income countries suggest that this problem may be widespread. Improved enforcement of existing drug regulations may be contributing to the AED shortage. Social programs aimed at encouraging people with epilepsy to come "out of the shadows" must be preceded by improved AED access.
Chomba
Elwyn Nachanya
EN
Department of Paediatrics and Child Health, University of Zambia, Lusaka, Zambia. embewe2001@yahoo.com
Haworth
Alan
A
Mbewe
Edward
E
Atadzhanov
Masharip
M
Ndubani
Philimon
P
Kansembe
Henry
H
Birbeck
Gretchen Lano
GL
D000927:Anticonvulsants / Q000191:economics / Q000600:supply & distribution* / Q000627:therapeutic use; D016527:Drug Costs; D004827:Epilepsy / Q000188:drug therapy; D006297:Health Services Accessibility; D006801:Humans; D015024:Zambia
D000927:Anticonvulsants
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