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February 25, 2020

Higher prevalence of epilepsy in low and middle-income countries

By GlobalData Healthcare

Epilepsy is a common neurological condition where abnormal activity in the brain leads to seizures. This condition is usually diagnosed after a person has experienced two or more unprovoked seizures. Seizures can vary in type and frequency for each individual.

Although many underlying disease mechanisms can result in epilepsy, the cause in 50% of cases is unknown. In 2019, the World Health Organization (WHO) published the Epilepsy: a public health imperative report, which found that 50 million people are living with the condition worldwide. The report also noted that 80% of those people are living in low and middle-income countries.

The WHO has looked into the difference in the average annual incidence of epilepsy in men and women, all ages, in low and middle-income countries compared with high-income countries. The WHO found that the average annual incidence of the condition in high-income countries is approximately 49 per 100,000 population. In comparison, the average annual incidence of epilepsy in low and middle-income countries was 139 per 100,000 population.

The higher average incidence of the disorder in low and middle-income countries is an indication of why the lifetime prevalence of epilepsy (%) might be higher in some regions than others. GlobalData epidemiologists have reported lifetime prevalence (%) of epilepsy in men and women, ages 18 years and older, in Mexico and Canada.

In Mexico, a middle-income country, GlobalData epidemiologists have forecast an approximate lifetime prevalence of 2.0% in 2020. In Canada, a high-income country, GlobalData epidemiologists have forecast an approximate lifetime prevalence of 1.0% in 2020.

The higher incidence of epilepsy in low and middle-income countries has been linked to higher exposure to risk factors. With less developed transport infrastructure, poorer hygiene standards, more violent attacks, and less robust medical systems, the risk of head trauma, central nervous system infections, and perinatal injuries in low and middle-income countries are all much more common than in high-income countries. More research into direct causes of the condition in less developed regions is needed to understand ways to reduce the incidence of epilepsy caused by preventable risk factors.

The treatment gap is also thought to be much greater in low and middle-income countries. According to the WHO, 73% of people living in rural areas of less-developed regions do not receive the treatment they require to be seizure-free. This indicates that alongside higher prevalence, there is a lack of control of the disease in these regions.

The WHO has reported that 70% of people diagnosed with epilepsy worldwide could be seizure-free with the right treatment and diagnosis. It is therefore vital that the prevention and control of epilepsy be a focal point in low and middle-income countries moving forward to better control the condition globally.

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