Advocacy for children with epilepsy: Leveraging the WHA resolution. Advocacy Task Force, Commission of Pediatrics, International League Against Epilepsy

Evolving trends and burden of idiopathic epilepsy among children (0-14 years), 1990-2021: a systematic analysis for the Global Burden of Disease study 2021

Objective

This systematic analysis aims to elucidate the trends and burden of idiopathic epilepsy among children aged 0 to 14 from 1990 to 2021, utilizing Global Burden of Disease (GBD) 2021 data to explore demographic and geographical variations, highlight progress, and identify ongoing challenges.

Methods

Data were sourced from the GBD 2021 database, focusing on children aged 0-14. Annual absolute numbers and age-standardized rates for incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (ASDR) of idiopathic epilepsy were retrieved. Joinpoint regression analyses assessed changes over time, calculating average annual percentage change (AAPC) statistics. Data collation and visualizations were conducted using R software, with statistical significance established at a p-value threshold of 0.05.

Results

In 2021, there were 1,227,191 incident cases, 6,095,769 prevalent cases, 3,564,497 DALYs, and 18,171 deaths due to idiopathic epilepsy globally. The ASIR increased by 0.27% from 55.74 to 61.35 per 100,000 population from 1990 to 2021. In contrast, ASPR (AAPC = -0.03), ASMR (AAPC = -1.60), and ASDR (AAPC = -1.01) all decreased. Regionally, the low-middle SDI region had the highest burden, while the high SDI region had the highest ASIR and ASPR. The low SDI region experienced the highest ASMR and ASDR. Significant regional variations were noted, with the African Region exhibiting the highest ASIR and ASDR, while the Western Pacific Region had the lowest. Nationally, substantial variations were observed across 204 countries, with notable differences in ASIR, ASPR, ASMR, and ASDR.

Conclusion

Despite overall declines in ASPR, ASMR, and ASDR, the slight increase in ASIR and regional disparities highlight ongoing challenges. Low and low-middle SDI regions continue to bear a higher burden, underscoring the need for targeted interventions and improved healthcare access. Future efforts should focus on strengthening healthcare systems, enhancing diagnostic and treatment capabilities, and increasing awareness, particularly in resource-limited regions.

Affiliate stigma and caregiver burden in parents of children with epilepsy

Objective

This study aimed to investigate the current status of affiliated stigma and caregiver burden among parents of children with epilepsy, analyze their correlation, and identify factors influencing affiliated stigma.

Methods

A cross-sectional survey was conducted among 194 parents of children with epilepsy who met the inclusion and exclusion criteria in Shenzhen City, Guangdong Province, China. Data were collected through questionnaires, including a demographic information sheet, an affiliated stigma scale, and a caregiver burden scale.

Results

The results revealed that parents of children with epilepsy experienced a moderate level of affiliated stigma, with an average score of 54.92 ± 10.44. Similarly, caregiver burden scores fell within the moderate range, with an average score of 44.14 ± 16.02. Factors influencing affiliated stigma scores included the frequency of epileptic seizures in children, the types of anti-epileptic medications taken by children, and the place of residence. The total caregiver burden score and scores in various dimensions (emotional, cognitive, and behavioral) of caregivers for epilepsy patients were positively correlated with the affiliated stigma score. Affiliated stigma was found to independently explain 21.3 % of the variation in caregiver burden.

Conclusion

In the future, healthcare professionals should develop targeted interventions for children with epilepsy and their parents to reduce affiliated stigma, decrease caregiver burden, and enhance the caregiving capabilities of parents of children with epilepsy. These measures are essential to improve the overall well-being of both parents and children affected by epilepsy.

Educational interventions improving knowledge about epilepsy in preschool children

OBJECTIVE

Sufficient public knowledge about epilepsy is a starting point for reducing epilepsy-related stigma and improving quality of life of people with this condition. Thus, interventions aimed at improving such knowledge are greatly needed. However, there is a significant lack of such interventions and none have been applied to preschool children. We aimed to develop effective interventions using the educational board game Action Zone! and a technique known as educational story, and by focusing on the acquisition of knowledge about epilepsy in children aged 5-6 years with no previous knowledge of epilepsy.

METHODS

Knowledge about epilepsy was measured using a 20-item test consisting of questions selected from educational game and an 11-item test used successfully in our previous intervention study focused on children aged 9-11 years. Both measures exhibited acceptable internal consistency with Cronbach's alpha of 0.72 and 0.67. In total, 296 children participated in three intervention studies (educational game, educational story, and a revised version of educational story). Level of knowledge was assessed immediately after each intervention and again one month later.

RESULTS

We found that all interventions were effective (p = 0.001) in comparison of retest results with baseline of zero level of knowledge based on the statements of children before intervention. Intervention based on educational game resulted in a higher percentage of correct responses in comparison with educational story (p = 0.020). However, the revised version of educational story developed using participatory action research was superior in comparison with the original version (p < 0.001) and fully comparable with educational game (p = 0.864).

CONCLUSIONS

The results showed the aforesaid interventions were significant and effective ways to establish basic knowledge about epilepsy in the given age group.