Ana?Claire Meyer|Tarun Dua|W. John Boscardin|José J. Escarce|Shekhar Saxena|Gretchen L. Birbeck
Critical determinants of the epilepsy treatment gap: A cross?national analysis in resource?limited settings
University of California, San Francisco|World Health Organization|University of California, San Francisco|University of California, Los Angeles|World Health Organization|Michigan State University
epilepsy one common serious neurologic disorders worldwide objective determine economic health care neurology epilepsyspecific resources associated untreated epilepsy resourceconstrained settingsa systematic review literature identified communitybased studies resourceconstrained settings calculated epilepsy treatment gap proportion untreated epilepsy prevalent active epilepsy cases economic health care neurology epilepsyspecific resources taken existing datasets poisson regression models jackknifed standard errors used create bivariate multivariate models comparing association treatment status economic health resource indicators relative risks reportedfortyseven studies 8285 individuals 24 countries met inclusion criteria bivariate analysis demonstrated individuals residing rural locations significantly higher risks untreated epilepsy relative risk rr 163 95 confidence interval ci 126211 significantly lower risks untreated epilepsy observed higher physician density rr 065 95 ci 055078 presence lay rr 074 95 ci 060091 professional association epilepsy rr 073 95 ci 059091 postgraduate neurology training program rr 067 95 ci 055082 multivariate models higher physician density maintained significant effects rr 067 95 ci 052088even among resourcelimited regions people epilepsy countries fewer economic health care neurology epilepsyspecific resources likely untreated epilepsy communitybased epilepsy care programs improved access treatment order decrease epilepsytreatment gap poverty inequalities health care neurology epilepsy resources must dealt local national global levels