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Bhidayasiri R, Sringean J, Van Le T, Lim TT, Navuth C, Phoumindr A, Aye YM, Phumphid S, Vorachit S, Veasna K, Ibrahim NM, Thit WM, Rosales RL, Le M, Tran NT. Movement disorders in Indochina: Resource challenges and future solutions. J Neural Transm (Vienna) 2023:10.1007/s00702-023-02662-1. [PMID: 37306791 DOI: 10.1007/s00702-023-02662-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023]
Abstract
Movement disorders are a major cause of disability worldwide and their increasing prevalence predicts a substantial future burden of care. Impactful patient care requires availability of, and accessibility to, effective medications, knowledge, and disease awareness among both medical professionals and patients, driven by skilled personnel to harness and manage resources. The highest burden of movement disorders is in low-to-middle income countries where resources are often limited and infrastructure is insufficient to meet growing demands. This article focuses on the specific challenges faced in the management and delivery of care for movement disorders in Indochina, the mainland region of Southeast Asia comprising the neighboring countries of Cambodia, Laos, Malaysia, Myanmar, Thailand, and Vietnam. The first Indochina Movement Disorders Conference was held in August 2022 in Ho Chi Minh City, Vietnam, to provide a platform to better understand the situation in the region. Future management of movement disorders in Indochina will require progressive adaptation of existing practices to reflect modern approaches to care delivery. Digital technologies offer an opportunity to strengthen these processes and address the challenges identified in the region. Ultimately, a long-term collaborative approach by regional healthcare providers is key.
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Affiliation(s)
- Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
- The Academy of Science, The Royal Society of Thailand, Bangkok, Thailand.
| | - Jirada Sringean
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Tuan Van Le
- Neurology Department, University Medical Centre, University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thien Thien Lim
- Neurology Unit, Island Hospital, Georgetown, Penang, Malaysia
| | - Chum Navuth
- Department of Neurology, Khmer-Soviet Friendship Hospital, Phnom Penh, Cambodia
| | - Appasone Phoumindr
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
- Sethathirath Hospital, University of Health Sciences, Vientiane, Laos
| | - Yin Minn Aye
- Department of Neurology, Yangon General Hospital, University of Medicine, Yangon, Myanmar
| | - Saisamorn Phumphid
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Somchit Vorachit
- Sethathirath Hospital, University of Health Sciences, Vientiane, Laos
| | - Keo Veasna
- Department of Neurology, Khmer-Soviet Friendship Hospital, Phnom Penh, Cambodia
| | - Norlinah Mohamed Ibrahim
- Faculty of Medicine, Neurology Unit, Department of Medicine, Hospital Canselor Tuanku Muhriz, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Win Min Thit
- Department of Neurology, Yangon General Hospital, University of Medicine, Yangon, Myanmar
| | - Raymond L Rosales
- Department of Neurology and Psychiatry, Neuroscience Institute, University of Santo Tomas Hospital, Manila, Philippines
| | - Minh Le
- Neurology Department, University Medical Centre, University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ngoc Tai Tran
- Neurology Department, University Medical Centre, University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Bounlu M, Auditeau E, Vorachit S, Chivorakoun P, Souvong V, Soukhasem T, Sannikone S, Preux PM, Boumediene F. Management of epilepsy in Laos: Perceptions of healthcare professionals from Vientiane Capital province and traditional healers in Southern Laos. J Tradit Complement Med 2021; 11:46-52. [PMID: 33511061 PMCID: PMC7817710 DOI: 10.1016/j.jtcme.2019.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/21/2019] [Accepted: 12/26/2019] [Indexed: 11/03/2022] Open
Abstract
Background and aim Traditional practices are deeply rooted in Lao people's perceptions and beliefs about health and illness.The objective of the study was to understand the perceptions of healthcare professionals and traditional healers regarding the management of epilepsy in Laos, and their reciprocal views. Experimental procedure An observational study was carried out in two areas of Laos from February to May 2017. Semi directive questionnaires were used to collect quantitative and qualitative data. Semiotic square was carried out to highlight relationships between attitudes of traditional healers and healthcare professionals. For quantitative approach, the proportions were reported, and the test used was Fisher's test for nominal variables. The mean and standard deviation expressed the continuous variables and the Student's t-test was used. Results and conclusion Epilepsy was cited by 90.9% of traditional healers as a convulsive disease with saliva or urine, and herbal medicines were predominantly used (86.4%) to treat it. Few healthcare professionals (26.5%) pointed out that they knew remedies to treat epilepsy other than antiepileptic drugs (AEDs), and 76.5% of healthcare professionals mentioned that epilepsy was a disease which only AEDs could treat. On the other hand, 54.5% of traditional healers confirmed a traditional remedy could cure completely epilepsy through long-term use. Ninety percent of traditional healers said the collaboration with healthcare professionals was a good idea and 44.1% of the healthcare professionals group said was complicated.The combination of these medicines for the management of epilepsy needs to be adapted to Lao's medical context.
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Affiliation(s)
- Mayoura Bounlu
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Emilie Auditeau
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Somchit Vorachit
- Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Phetvongsinh Chivorakoun
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Vimalay Souvong
- Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Thidachanh Soukhasem
- Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Sonesimmaly Sannikone
- Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Pierre-Marie Preux
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Farid Boumediene
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
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Sengxeu N, Dufat H, Boumediene F, Vorachit S, Chivorakoun P, Souvong V, Manithip C, Preux P, Ratsimbazafy V, Jost J. Availability, affordability, and quality of essential antiepileptic drugs in Lao PDR. Epilepsia Open 2020; 5:550-561. [PMID: 33336126 PMCID: PMC7733656 DOI: 10.1002/epi4.12432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/19/2020] [Accepted: 08/27/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Epilepsy is a chronic condition treatable by cost-effective antiepileptic drugs (AEDs), but limited access to treatment was documented. The availability and affordability of good quality of AEDs play a significant role in access to good health care. This study aimed to assess the availability, affordability, and quality of long-term AEDs in Lao PDR. METHOD A cross-sectional study was performed in both public and private drug supply chains in urban and rural areas in Lao PDR. Data on AEDs availability and price were obtained through drug suppliers. Affordability was estimated as the number of day wages the lowest-paid government employee must work to purchase a monthly treatment. Samples of AEDs were collected, and the quality of AEDs was assessed through Medicine Quality Assessment Reporting Guidelines. RESULTS Out of 237 outlets visited, only 50 outlets (21.1% [95% CI 16.1-26.8]) had at least one AED available. The availability was significantly different between urban (24.9%) and rural areas (10.0%), P = .017. Phenobarbital 100 mg was the most available (14.3%); followed by sodium valproate 200 mg (9.7%), phenytoin 100 mg (9.7%), and carbamazepine 200 mg (8.9%). In provincial/district hospitals and health centers, AEDs were provided free of charge. In other healthcare facilities, phenytoin 100 mg and phenobarbital 100 mg showed the best affordability (1.0 and 1.2 day wages, respectively) compared to carbamazepine 200 mg (2.3 days) and other AEDs. No sample was identified as counterfeit, but 15.0% [95% CI 7.1-26.6] of samples were classified as of poor quality. SIGNIFICANCE We quantified and qualified the various factors contributing to the high treatment gap in Lao PDR, adding to diagnostic issues (not assessed here). Availability remains very low and phenobarbital which is the most available and affordable AED was the worst in terms of quality. A drug policy addressing epilepsy treatment gap would reduce these barriers.
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Affiliation(s)
- Noudy Sengxeu
- INSERMUniv. Limoges, CHU LimogesIRDU1094 Tropical NeuroepidemiologyInstitute of Epidemiology and Tropical NeurologyGEISTLimogesFrance
- Faculty of pharmacyUniversity of Health sciencesVientianeLao PDR
| | - Hanh Dufat
- Natural Products, Analysis and SynthesisCiTCoM‐UMR 8038 CNRS/Université de Paris, Faculty of Health‐Pharmacy, Université de ParisParisFrance
| | - Farid Boumediene
- INSERMUniv. Limoges, CHU LimogesIRDU1094 Tropical NeuroepidemiologyInstitute of Epidemiology and Tropical NeurologyGEISTLimogesFrance
| | | | | | | | | | - Pierre‐Marie Preux
- INSERMUniv. Limoges, CHU LimogesIRDU1094 Tropical NeuroepidemiologyInstitute of Epidemiology and Tropical NeurologyGEISTLimogesFrance
| | - Voa Ratsimbazafy
- INSERMUniv. Limoges, CHU LimogesIRDU1094 Tropical NeuroepidemiologyInstitute of Epidemiology and Tropical NeurologyGEISTLimogesFrance
| | - Jeremy Jost
- INSERMUniv. Limoges, CHU LimogesIRDU1094 Tropical NeuroepidemiologyInstitute of Epidemiology and Tropical NeurologyGEISTLimogesFrance
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Boumediene F, Chhour C, Chivorakoun P, Souvong V, Odermatt P, Hun C, Thebaut C, Bounlu M, Chum N, Vorachit S, Ros S, Chan S, Preux PM. Community-based management of epilepsy in Southeast Asia: Two intervention strategies in Lao PDR and Cambodia. Lancet Reg Health West Pac 2020; 4:100042. [PMID: 34327389 PMCID: PMC8315387 DOI: 10.1016/j.lanwpc.2020.100042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/14/2020] [Accepted: 09/23/2020] [Indexed: 11/22/2022]
Abstract
Background Epilepsy affects more than 50 million people worldwide, 80% of whom live in low- and middle-income countries (LMICs). In Southeast Asia, the prevalence is moderate (6‰), and the main public health challenge is reducing the treatment gap, which reaches more than 90% in rural areas. Methods This 12-month comparative study (intervention vs. control areas) assessed the community effectiveness of two different strategies for the identification and home follow-up of people with epilepsy by Domestic Health Visitors for epilepsy (DHVes). In Lao PDR, DHVes were health center staff covering several villages via monthly visits; in Cambodia, DHVes were health volunteers living in the villages. Findings At baseline, the treatment gap was >95% in Lao PDR and 100% in Cambodia. After 12 months, the treatment gap in Lao PDR decreased by 5·5% (range: 4·0–12·2) in the intervention area and 0·5% (range: 0·4–0·8) in the control area (p<0·0001). In Cambodia, the treatment gap decreased by 34·9% (range: 29·0–44·1) in the intervention area and 8·1% (range: 6·7–10·2) in the control area (p<0·0001). Among the PWEs followed at home by the DHVes, the proportion adhering to drug treatment was 85·2% in Lao PDR and 78·1% in Cambodia. The cost associated with strategy implemented in Cambodia, compared with the control area, was lower than the cost associated with strategy implemented in Lao PDR.” Interpretation The treatment gap was significantly reduced with both intervention strategies, but the effect was larger in Cambodia. The results of this cost analysis pave the way for scaling-up in rural areas of Lao PDR and Cambodia, and experimental adaptation in other LMICs. Funding The study was funded by the Global Health Department of Sanofi and Grand Challenges Canada (grant number 0325–04).
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Affiliation(s)
- Farid Boumediene
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 2 rue du Docteur Marcland, 87025 Limoges, France
| | | | | | - Vimalay Souvong
- Association for Patient with Epilepsy in Laos, Vientiane, Lao Democratic People's Republic
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Clémence Thebaut
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 2 rue du Docteur Marcland, 87025 Limoges, France
| | - Mayoura Bounlu
- Association for Patient with Epilepsy in Laos, Vientiane, Lao Democratic People's Republic
| | - Navuth Chum
- Cambodia Society of Neurology, Phnom Penh, Cambodia
| | - Somchit Vorachit
- Association for Patient with Epilepsy in Laos, Vientiane, Lao Democratic People's Republic
| | - Sina Ros
- Cambodia Society of Neurology, Phnom Penh, Cambodia
| | - Samleng Chan
- Cambodia Society of Neurology, Phnom Penh, Cambodia
| | - Pierre-Marie Preux
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 2 rue du Docteur Marcland, 87025 Limoges, France
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Phokaewvarangkul O, Vorachit S, Phoumindr A, Keosodsay S, Postuma RB, Meissner WG, Bhidayasiri R. Addressing knowledge gaps in Parkinson's disease: a report on the Movement Disorder Society's Centre-to-Centre initiative to improve Parkinson's disease services in Lao People's Democratic Republic. BMC Med Educ 2020; 20:239. [PMID: 32727429 PMCID: PMC7392705 DOI: 10.1186/s12909-020-02161-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Lao People's Democratic Republic (Lao PDR) has only nine neurologists for seven million people; none have formal training in Parkinson's disease (PD). Medical specialists require sufficient PD knowledge to provide high-quality care. METHODS This study outlines a Centre-to-Centre programme for developing PD expertise in underserved regions through a tailored two-year educational enterprise between an established movement disorder mentor centre at Chulalongkorn University in Thailand and mentee centres in Lao PDR. Background knowledge of 80 Laotian physicians was assessed using a validated PD knowledge questionnaire containing 26 questions divided into 3 sections (diagnosis, therapeutic options, disease course) before and immediately after one-day kick-start training. Responses were compared across physicians' demographic groups. RESULTS Of 80 respondents, 50 (62.5%) were board-certified physicians, of which 27 (54%) specialised in internal medicine. Apparent knowledge gaps were shown by a 51.2% correct response rate for total score, 52.8% for diagnosis, 50.6% for therapeutic options, and 48.2% for disease course. No significant differences in total score or any domain sub-scores between neurologists and other specialties were found. Many did not know which non-motor symptoms could occur as prodromal symptoms or late in course of PD. Incorrect responses mainly reflected a lack of knowledge of the impact of medication on disease. Total and domain sub-scores significantly improved after the course (p < 0.05, each). The size of difference of the means was significant for the total score (d = 0.82), therapeutic option (d = 0.56), and disease course (d = 0.68) sub-scores. CONCLUSIONS Significant improvement of PD knowledge amongst Laotian physicians is demonstrated after a training course, focusing on practical management of PD. Our findings highlight the importance of continued medical education, especially PD-specific training.
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Affiliation(s)
- Onanong Phokaewvarangkul
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Thai Red Cross Society, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, 10330, Thailand
| | | | | | | | - Ronald B Postuma
- Department of Neurology, Montreal General Hospital, Montreal, Quebec, Canada
| | - Wassilios G Meissner
- Service de Neurologie, CHU Bordeaux, 33000 Bordeaux, France and Institut des Maladies Neurodégénératives, Université de Bordeaux, UMR 5293, 33000, Bordeaux, France
- Department of Medicine, Christchurch, and New Zealand Brain Research Institute, University of Otago, Christchurch, New Zealand
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Thai Red Cross Society, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, 10330, Thailand.
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Bhidayasiri R, Panyakaew P, Trenkwalder C, Jeon B, Hattori N, Jagota P, Wu YR, Moro E, Lim SY, Shang H, Rosales R, Lee JY, Thit WM, Tan EK, Lim TT, Tran NT, Binh NT, Phoumindr A, Boonmongkol T, Phokaewvarangkul O, Thongchuam Y, Vorachit S, Plengsri R, Chokpatcharavate M, Fernandez HH. Delivering patient-centered care in Parkinson's disease: Challenges and consensus from an international panel. Parkinsonism Relat Disord 2020; 72:82-87. [PMID: 32146380 DOI: 10.1016/j.parkreldis.2020.02.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/20/2020] [Accepted: 02/22/2020] [Indexed: 02/05/2023]
Abstract
An international panel of movement disorders specialists explored the views and perceptions of people with Parkinson's disease (PD) about their condition and its treatment, including the potential mismatch between the clinician's view of the patient's condition and their own view of what aspects of the disease most affect their daily lives. The initiative was focused on Asian countries, so participants comprised experts in the management of PD from key centers in Asia, with additional insight provided by European and the North American movement disorders experts. Analysis of peer-reviewed publications on patient perceptions of PD and the factors that they consider important to their wellbeing identified several contributing factors to the mismatch of views, including gaps in knowledge of PD and its treatment, an understanding of the clinical heterogeneity of PD, and the importance of a multidisciplinary approach to patient care. The faculty proposed options to bridge these gaps to ensure that PD patients receive the personalized treatment they need to achieve the best possible outcomes. It was considered essential to improve patient knowledge about PD and its treatment, as well as increasing the awareness of clinicians of PD heterogeneity in presentation and treatment response. A multidisciplinary and shared-care approach to PD was needed alongside the use of patient-centered outcome measures in clinical trials and clinical practice to better capture the patient experience and improve the delivery of individualized therapy.
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Affiliation(s)
- Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
| | - Pattamon Panyakaew
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Claudia Trenkwalder
- Department of Neurosurgery, University Medical Centre Goettingen, Paracelsus-Elena Hospital, Kassel, Germany
| | - Beomseok Jeon
- Movement Disorder Centre at Seoul National University Hospital, Seoul, South Korea
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Priya Jagota
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Yih-Ru Wu
- Department of Neurology, Chang-Gung Memorial Hospital, Linkou Medical Centre and Chang-Gung University College of Medicine, Taipei, Taiwan
| | - Elena Moro
- Movement Disorder Centre, Centre Hospitalier Universitaire (CHU) of Grenoble, Grenoble Alpes University, INSERM U1216, France
| | - Shen-Yang Lim
- Division of Neurology, Department of Medicine and the Mah Pooi Soo and Tan Chin Nam Centre for Parkinson's and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Huifang Shang
- Department of Neurology, West China Hospital, Sichuan University, China
| | - Raymond Rosales
- Neuroscience Institute, Department of Neurology and Psychiatry, University of Santo Tomas Hospital, Manila, Philippines
| | - Jee-Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center & Seoul National University College of Medicine, Seoul, South Korea
| | - Win Min Thit
- Department of Neurology, University of Medicine, Yangon General Hospital, Yangon, Myanmar
| | - Eng-King Tan
- National Neuroscience Institute, DUKE NUS Medical School, Singapore
| | | | - Ngoc Tai Tran
- Movement Disorder Unit, Neurology Department, University Medical Centre, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh, Viet Nam
| | - Nguyen Thanh Binh
- Department of Neurology, Hanoi Medical University and National Geriatric Hospital, Hanoi, Viet Nam
| | | | - Thanatat Boonmongkol
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Onanong Phokaewvarangkul
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | - Yuwadee Thongchuam
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand
| | | | - Rachaneewan Plengsri
- Chulalongkorn Parkinson Patients' Support Group, Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Bangkok, Thailand
| | - Marisa Chokpatcharavate
- Chulalongkorn Parkinson Patients' Support Group, Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Bangkok, Thailand
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Thuy Le MA, Fong SL, Lim KS, Gunadharma S, Sejahtera DP, Visudtibhan A, Chan D, Vorachit S, Chan S, Ohnmar, Chua AE, Cabral-Lim L, Yassin N, Le VT, Tan CT. Underutilization of epilepsy surgery in ASEAN countries. Seizure 2019; 69:51-56. [PMID: 30974407 DOI: 10.1016/j.seizure.2019.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/13/2019] [Accepted: 04/04/2019] [Indexed: 11/17/2022] Open
Abstract
PURPOSE This survey was performed to determine the availability of epilepsy surgery, and understand the limiting factors to epilepsy surgery in ASEAN countries with total of 640 million population. METHOD A cross-sectional survey was completed by national representatives in all ASEAN countries (Brunei, Cambodia, East Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam). RESULTS Overall facilities for initial epilepsy pre-surgical evaluation are available in most countries, but further non-invasive and invasive investigations are limited. Three countries (Brunei, Cambodia, and East Timor) have no epilepsy center, and 2 countries (Laos, Myanmar) have level 2 centers doing tumor surgery only. Level-3 epilepsy centers are available in 6 countries (Indonesia, Malaysia, Philippine, Singapore, Thailand, Vietnam); only 5 countries (Indonesia, Malaysia, Philippine, Singapore, Thailand) has at least one level-4 epilepsy care facility. Indonesia with 261 million population only has one level 3 and another level 4 center. The costs of presurgical evaluation and brain surgery vary within and among the countries. The main barriers towards epilepsy surgery in ASEAN include lack of expertise, funding and facilities. CONCLUSIONS Epilepsy surgery is underutilized in ASEAN with low number of level 3 centers, and limited availability of advanced presurgical evaluation. Lack of expertise, facilities and funding may be the key factors contributing to the underutilization.
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Affiliation(s)
- Minh-An Thuy Le
- Department of Neurology, Faculty of Medicine, University of Medicine and Pharmacy of Ho Chi Minh city, Ho Chi Minh City, Viet Nam
| | - Si-Lei Fong
- Division of Neurology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kheng-Seang Lim
- Division of Neurology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Suryani Gunadharma
- Faculty of Medicine, Padjadjaran University, Hasan Sadikin Hospital, Bandung, Indonesia
| | - Desin Pambudi Sejahtera
- Department of neurology, Sardjito general hospital, Yogyakarta, Indonesia; Epilepsy subdivision, department of neurology, faculty of medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Anannit Visudtibhan
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Derrick Chan
- Division of Neurology, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Somchit Vorachit
- Faculty of Medicine, University of Health Sciences, Vientiane, Laos
| | - Samleng Chan
- University of Health Sciences, Phnom Penh, Cambodia
| | - Ohnmar
- Department of Neurology, University of Medicine 1, Yangon, Myanmar
| | - Annabell E Chua
- Department of Neurosciences, College of Medicine-Philippine General Hospital, The Health Sciences Center, University of the Philippines Manila, Manila, Philippines
| | - Leonor Cabral-Lim
- Department of Neurosciences, College of Medicine-Philippine General Hospital, The Health Sciences Center, University of the Philippines Manila, Manila, Philippines
| | - Norazieda Yassin
- Neurology Unit, Department of Internal Medicine. Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, Brunei; Brunei Neurosciences, Stroke and Rehabilitation Centre (BNSRC), Brunei
| | - Viet-Thang Le
- Department of Neurosurgery, Faculty of Medicine, University of Medicine and Pharmacy of Ho Chi Minh city, Ho Chi Minh city, Viet Nam
| | - Chong-Tin Tan
- Division of Neurology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Vorachit S, Chankrachang S, Chariyalertsak S, Kingkeow C. PO29-FR-07 Mobile phone exposure as a risk factor of migraine: an intervention study. J Neurol Sci 2009. [DOI: 10.1016/s0022-510x(09)71195-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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