Comparative epidemiology of epilepsy in Pakistan and Turkey: population-based studies using identical protocols

Area of Science:

• Neurology
• Epidemiology
• Global Health

Background:

• Epilepsy affects millions globally, with significant variations in prevalence and management across different regions.
• Understanding the epidemiology of epilepsy in diverse populations is crucial for targeted public health interventions.

Purpose of the Study:

• To conduct a comparative analysis of epilepsy prevalence, demographics, seizure types, etiology, and treatment status in Pakistan and Turkey.
• To investigate socio-anthropological factors influencing epilepsy perception and care in these two countries.

Main Methods:

• A population-based, cross-cultural study utilizing standardized International Community-Based Epilepsy Research Group (ICBERG) protocols.
• Simultaneous data collection from unselected urban and rural populations in Pakistan (n=24,130) and Turkey (n=11,497).

Main Results:

• Crude epilepsy prevalence was 9.98/1,000 in Pakistan and 7.0/1,000 in Turkey, with rural rates double urban rates in both countries.
• Generalized tonic-clonic seizures were most common (80.5% Pakistan, 65.4% Turkey). Etiology was attributed in ~37% of cases.
• Treatment with antiepileptic drugs (AEDs) was very low: 3% in Pakistan (urban 27.5%, rural 1.9%) and 30% in Turkey. Belief in supernatural causes was higher in Pakistan (3%) vs. Turkey (71%).

Conclusions:

• Epilepsy prevalence is slightly higher in Pakistan than Turkey, with comparable epidemiological profiles regarding age and sex distribution.
• Significant disparities in treatment access and beliefs about epilepsy causes exist between the two countries.
• Findings align with previous studies using the same protocol in other regions, such as Ecuador.