Childhood Epilepsy

Objective: To determine the community-based prevalence of childhood epilepsy and its treatment gap in rural and urban population in Punjab, Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Gujranwala District, from March to June 2007. Methodology: Ten out of 52 Union Councils of District Gujranwala, Pakistan, were randomly selected. Field officers, specifically trained for screening children with active epilepsy, performed a door-to-door survey in the selected Union Councils using area vaccinators as key informants. Final confirmation of active epilepsy and treatment details were ascertained by a qualified paediatrician and a paediatric neurologist, where required. Treatment gap was defined as relative (when treated inappropriately) and complete (complete lack of treatment). Results: Among a total, under 16 years population of 92254, prevalence of childhood epilepsy was found to be 7.0/1000 (n = 643) with similar distribution between urban and rural residents. Up to 66% (n = 424) patients were being managed by an unqualified person including paramedics and faith healers. Treatment gap was found in 88% (n = 566) patients. Conclusion: Childhood epilepsy is common in both urban and rural areas of District Gujranwala. Area vaccinators may be incorporated into screening and referral program to bridge the treatment gap utilizing minimum available resources.