Active epilepsy prevalence, the treatment gap, and treatment gap risk profile in eastern China: A population-based study

• Published in: Epilepsy & behavior Vol. 78; pp. 20 - 24
• Main Authors: Ding, Xiaoyan, Zheng, Yang, Guo, Yi, Shen, Chunhong, Wang, Shan, Chen, Feng, Yan, Shengqiang, Ding, Meiping
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2018
• Subjects: Active epilepsy; Adolescent; Adult; Aged; Anticonvulsants - therapeutic use; Child; Child, Preschool; China - epidemiology; Cross-Sectional Studies; Eastern China; Epilepsy - drug therapy; Epilepsy - epidemiology; Female; Health Services Accessibility; Healthcare Disparities; Humans; Infant; Infant, Newborn; Insurance, Health; Male; Middle Aged; Prevalence; Prevalence rate; Risk Factors; Seizures - drug therapy; Socioeconomic Factors; Surveys and Questionnaires; Treatment; Young Adult; Prevalence rate; Eastern China; Treatment; Active epilepsy; Risk factors
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2017.10.020

We measured the prevalence of active epilepsy and investigated the treatment gap and treatment gap risk profile in eastern China. This was a cross-sectional population-based survey conducted in Zhejiang, China, from October 2013 to March 2014. A total 54,976 people were selected using multi-stage cluster sampling. A two-stage questionnaire-based process was used to identify patients with active epilepsy and to record their demographic, socioeconomic, and epilepsy-related features. Logistic regression analysis was used to analyze risk factors of the treatment gap in eastern China, as adjusted for age and sex. We interviewed 50,035 people; 118 had active epilepsy (2.4‰), among which the treatment gap was 58.5%. In multivariate analysis, failure to receive appropriate antiepileptic treatment was associated with higher seizure frequency of 12–23 times per year (adjusted odds ratio=6.874; 95% confidence interval [CI]=2.372–19.918), >24 times per year (adjusted odds ratio=19.623; 95% CI=4.999–77.024), and a lack of health insurance (adjusted odds ratio=7.284; 95% CI=1.321–40.154). Eastern China has relatively lower prevalence of active epilepsy and smaller treatment gap. Interventions aimed at reducing seizure frequency, improving the health insurance system should be investigated as potential targets to further bridge the treatment gap. •2.4‰ of people in eastern China suffer from active epilepsy.•Among patients with active epilepsy in eastern China, 26% are treatment naïve and 32% are inappropriately treated.•Reducing seizure frequency and improving the health insurance system could possibly bridge the treatment gap.