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| Author(s): |
Ana Lucia Andrade Noronha Kanashiro
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Institution: | Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas |
| Defense date: | 2006-06-30 |
| Examining board members: |
Ronaldo Guimarães Fonseca;
João Pereira Leite;
Gastão Wagner de Sousa Campos;
Tânia Aparecida Marchiori de Oliveira Cardoso
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| Advisor: | Li Li Min |
| Abstract | |
The worldwide prevalence of epilepsy is estimated at 10/1,000; however, access to treatment is variable. Many people go untreated, particularly in resource-poor countries. In Brazil, the epidemiologic studies never have approached the pharmacological treatment gap of epilepsy. The objectives of this study are: 1) to determine the epilepsy prevalence in two urban areas in South-East of Brazil; 2) to determine the epilepsy pharmacological treatment gap in people with active epilepsy identified in those regions; and 3) extrapolate the epidemiological data to Brazil. The epilepsy treatment gap had been indirect estimated, and the results prompted us to further investigate this situation. Subsequently, we carried out an epidemiologic survey, using a validated screening questionnaire (sensitivity 95.8%, specificity 97.8%) and a validated instrument for socio-economic classification, to determine the epilepsy prevalence and treatment gap and the influence of socioeconomic factor in two urban areas in South-East of Brazil. According to estimative at the first step of the study, the epilepsy pharmacological treatment gap in Campinas was 56% and in São José do Rio Preto was 59%. At the second step of the study, a epidemiological survey in 96.300 people, we found the cumulative prevalence of 9.2/1,000 people [CI 95% 8.4-10.0] and the active epilepsy prevalence of 5.4/1,000 people [CI 95% 4.8-6.0]. The pharmacological treatment gap in the catchment area was 37.6%. We could identify the differences among social classes in epilepsy prevalence, as the wealthier ones (A and B) had smaller prevalence active prevalence than in poorer ones (C and D+E): 1.6 and 3.1/1,000 people for class A and B and 6.3 and 7.5/1,000 people for class C and D+E. There was not social class interference over treatment gap. Epilepsy prevalence in our studied area is similar to other countries, and the pharmacological treatment gap is high. Epilepsy is more prevalent among the less wealth people. Commitment of the Brazilian health system towards improvement of the quality of health management for people with epilepsy and the continue education about the condition are urgently needed. (AU) | |