DEMOGRAPHIC, SOCIOECONOMIC, AND CLINICAL INSIGHTS INTO EPILEPTIC PATIENTS IN PAKISTAN: CHALLENGES AND TREATMENT PATTERNS

Authors

  • Sajid Ali Resident Neurology, Pakistan Instute of Medical Sciences
  • Zaid Waqar Senior Resident Neurology, Pakistan Instute of Medical Sciences
  • Soban Khan Resident Neurology, Pakistan Instute of Medical Sciences
  • Mansoor Iqbal Assistant Professor Neurology, Pakistan Instute of Medical Sciences
  • Ijaz Ali Resident Neurology, Pakistan Instute of Medical Sciences
  • Bushra Khalid Senior Resident Neurology, Pakistan Instute of Medical Sciences

DOI:

https://doi.org/10.69723/njms.03.03.0420

Keywords:

epilepsy, stigma, Demographic-socioeconomic Characteristics, quality of life, unemployment, people with epilepsy

Abstract

BACKGROUND: Epilepsy is the most common among many neurological disorders. Approximately 70 million people worldwide are impacted by it. It presents a unique challenge in low income countries like Pakistan with complexities in managing this syndrome is heightened by demographic, socioeconomic and clinical factors that shape the experience of these patients.

OBJECTIVE: To assess the demographic, socioeconomic, and clinical characteristics of epileptic patients in Pakistan and to examine the prescription patterns of antiepileptic drugs.

METHODOLOGY: This cross-sectional study was conducted by the Department of Neurology at the Pakistan Institute of Medical Sciences, Islamabad. The duration was six months (25/12/2022 to 26/6/2023). Data was collected from patient records. This study included the medical records of 100 admitted individuals within two and a half years. The patients' medical histories were reviewed, and Electroencephalography, Computed tomography, or Magnetic Resonance Imaging brain scans were studied.  The study assessed the frequency of socioeconomic status, employment, education and drugs used by epileptic patients. Data was analyzed using SPSS version 25.

RESULTS: The study examined epilepsy patients in Pakistan, with a mean age of 33 years. Male patients constitute 72% of the cases. A significant portion (52%) were unemployed, and over half belonged to lower socioeconomic classes. Majority of the patients educational attainment was low, with only 2 patients holding a master’s degree. Most patients (52%) were unmarried. Clinically, the majority showed normal Electroencephalogram, Computed tomography, and Magnetic resonance imaging results. Valproate was the most commonly prescribed antiepileptic drug, while phenobarbitone and vigabatrin were the least used, highlighting treatment patterns within the population.

CONCLUSION: The study highlights the demographic, social, and clinical challenges faced by epilepsy patients in Pakistan. Most patients were aged 20-30, with a mean age of 33. Many of them were unemployed, had limited education and a majority belonging to low socioeconomic class. The findings emphasize the need for improved social and medical support for patients living with epilepsy.

KEYWORDS: epilepsy, People with epilepsy, unemployment, education

References

DeFelipe J, DeFelipe-Oroquieta J, Furcila D, Muñoz-Alegre M, Maestú F, Sola RG, Blázquez-Llorca L, Armañanzas R, Kastanaskaute A, Alonso-Nanclares L, Rockland KS. Neuroanatomical and psychological considerations in temporal lobe epilepsy. Front. Neurosci. 2022 Dec 14;16:995286. https://doi.org/10.3389/fnana.2022.995286

Mogal Z, Aziz H. Epilepsy treatment gap and stigma reduction in Pakistan: a tested public awareness model. E&B. 2020 Jan 1;102:106637. https://doi.org/10.1016/j.yebeh.2019.106637

Khan TA, Hussain S, Ikram A, Mahmood S, Riaz H, Jamil A, Amin A, Haider YG, Sandhu M, Mushtaq A, Barbui C. Prevalence and treatment of neurological and psychiatric disorders among tertiary hospitals in Pakistan; findings and implications. Hosp. Pract. 2020 May 26;48(3):145-60. https://doi.org/10.1080/21548331.2020.1762366

Hu M, Zhang C, Xiao X, Guo J, Sun H. Effect of intensive self-management education on seizure frequency and quality of life in epilepsy patients with prodromes or precipitating factors. Seizure. 2020 May 1;78:38-42. https://doi.org/10.1016/j.seizure.2020.03.003

Sattar S, Chaudhry AG, Khan SE. The Understanding of Epilepsy and Epileptic Patients and General Public to Create A Supportive Community. GSR. 2019;1:18-25. http://dx.doi.org/10.31703/gsr.2019(IV-I).03

Naseem F, ul Amin LC, Shah SM. Socio-Economic Causes and Rights of Differently Abled Persons in Pakistan: An Analysis. sjesr. 2021 Sep 17;4(2):500-7. https://doi.org/10.36902/sjesr-vol4-iss2-2021(500-507)

Jennum P, Debes NM, Ibsen R, Kjellberg J. Long-term employment, education, and healthcare costs of childhood and adolescent onset of epilepsy. E&B. 2021 Jan 1;114:107256. https://doi.org/10.1016/j.yebeh.2020.107256

Maroney M, Markovic M. Anti-epileptic medications. InSide effects of drugs annual 2021 Jan 1 (Vol. 43, pp. 99-121). Elsevier. https://doi.org/10.1016/bs.seda.2021.09.014

Pandita R, Patel R. Impact of Care Gaps in Epileptic Patients in India—A Review. https://doi.org/10.20944/preprints202405.1147.v1

Odhiambo M, Kariuki SM, Newton CR. Therapeutic monitoring of anti-seizure medications in low-and middle-income countries: a systematic review. Wellcome Open Res. 2021;6. https://doi.org/10.12688%2Fwellcomeopenres.16749.3

Pandey DK, Dasgupta R, Levy J, Wang H, Serafini A, Habibi M, Song W, Shafer PO, Loeb JA. Enhancing epilepsy self-management and quality of life for adults with epilepsy with varying social and educational backgrounds using PAUSE to Learn Your Epilepsy. E&B. 2020 Oct 1;111:107228. https://doi.org/10.1016/j.yebeh.2020.107228

Asadi-Pooya AA, Homayoun M, Keshavarz S. Education, marriage, and employment in people with epilepsy: The barriers that patients perceive. IJEP. 2020;6(02):50–3. DOI: 10.1055/s-0040-1715767

Chan MH, Leung WC, Lou WV, Lo CN, Chang RS. Employment among people with epilepsy in Hong Kong. E&B. 2021 Nov 1;124:108329. https://doi.org/10.1016/j.yebeh.2021.108329

Ullah S, Ali N, Khan A, Ali S, Nazish HR. The epidemiological characteristics of epilepsy in the province of Khyber Pakhtunkhwa, Pakistan. Front. Neurol. 2018 Nov 6;9:845. https://doi.org/10.3389%2Ffneur.2018.00845

Li S, Chen J, Abdulaziz AT, Liu Y, Wang X, Lin M, Qin Y, Liu X, Zhou D. Epilepsy in China: factors influencing marriage status and fertility. Seizure. 2019 Oct 1;71:179-84. https://doi.org/10.1016/j.seizure.2019.07.020

Joshi R, Tripathi M, Gupta P, Gulati S, Gupta YK. Prescription pattern of antiepileptic drugs in a tertiary care center of India. Indian J. Pharmacol. 2020 Jul 1;52(4):283-9. http://dx.doi.org/10.4103/ijp.IJP_507_17

Shah SH, Aalia B, Raza MA, Najeeb S, Gillani S, Aitazaz F. Demographic and clinical features of childhood idiopathic epilepsy at tertiary care hospital of Pakistan. PJP. 2021 Sep 30;17(3):45-9. https://doi.org/10.69656/pjp.v17i3.1320

Published

09/30/2024

How to Cite

DEMOGRAPHIC, SOCIOECONOMIC, AND CLINICAL INSIGHTS INTO EPILEPTIC PATIENTS IN PAKISTAN: CHALLENGES AND TREATMENT PATTERNS. (2024). NORTHWEST JOURNAL OF MEDICAL SCIENCES, 3(3), 30-36. https://doi.org/10.69723/njms.03.03.0420