Profile of the Epilepsy in Ecuador
NOTE: Translated
using software of
translation of
Spanish to English
Abstract:
The point prevalence of active epilepsy
in Ecuador is between 7/1000 and 12/1000, which is similar to that reported in developed
countries; however, this finding does not necessarily indicate that the risk to develop
epilepsy is the same in these two populations. The incidence of epilepsy in Ecuador is
between 120/100,000 and 172/100,000, which is two to threefold higher than that reported
in developed countries. These results should be confirmed by further studies. In Ecuador,
the frequency of epilepsy is highest during adolescence and adulthood, probably due to the
high prevalence of infectious and parasitic diseases in these age groups. Regarding the
prognosis, seizures recur in 43% of patients with epilepsy.
The risk of recurrence by the Kaplan-Meier actuarial analysis is 30% at 12 months, 51% at 24 months, and 79% at 45 months of
follow-up. Statistically significant risk factors for recurrence are the etiology (52%
recurrence risk in patients with symptomatic epilepsy) and the presence of an abnormal CT
scan (51% recurrence risk in patients with abnormal CT scans). Mortality in patients with
epilepsy is six-fold higher than in the general population of Ecuador (standardized
mortality ratio SMR
of 6.3). The SMR for sudden death in
patients with epilepsy (3.9) is also higher than that reported in developed countries.
These greater mortality ratios probably explain the relatively low prevalence rates in our
country. In 1995, Ecuador spent 4.6% of the gross national product on the health system.
The Ministry of Health, which funds the public health system, contributed only 1.5% of
this amount. This government contribution is
one of the lowest in South America. There are no government programs in Ecuador working to
manage and prevent chronic diseases, such as epilepsy. There are also no laws to protect
patients with epilepsy. This complex background obligates the health authorities,
scientific community, and the society in general, to join together in the fight against
epilepsy, as a bio-psycho- social problem.
Autor:
Ecuadorian
magazine of neurology
