Abstracts

Rationale: In Latin America (LA), there is a higher incidence of epilepsy compared to the global average (Beghi 2020, Alva-Díaz, Navarro-Flores et al. 2021) and a staggering 55.4% of people with epilepsy (PWE) do not receive the appropriate treatment for their condition (Mbuba, Ngugi et al. 2008). Despite this high incidence and wide treatment gap, there is limited research on the clinical and social characteristics of PWE in LA, including in Peru.

Methods: This is a descriptive, multicenter, cross-sectional cohort study (Epilepsy Cohort [“EPICO”]) study assessing clinical and social characteristics among PWE from Lima, Peru. Patients 18 years or older with a known epilepsy diagnosis were enrolled from four outpatient neurology clinics. Clinical characteristics (history of perinatal injury, febrile seizures, central nervous system infections, among others) were evaluated along with the following social characteristics: medication adherence (Medication Compliance Questionnaire [MCQ], quality of life (Quality of Life In Epilepsy-10 [QOLIE-10]), depression (Patient Health Questionnaire-9 [PHQ-9]), knowledge of epilepsy (developed by study team), and epilepsy-associated stigma (Taylor’s revised stigma scale), using validated questionnaires.

Results: We enrolled 246 PWE with a mean +/- standard deviation (SD) age of 33 +/- 13 years, 120 (49%) male, and 57 (23%) of the participants had not completed secondary education. The most common clinical characteristics among the participants were history of febrile seizures under age 5 (58 participants, 24%) and history of a moderate or severe head injury (57 participants, 23%). History of central nervous system (CNS) infection was identified in 36 (15%) of the participants. Based on the MCQ, 121 (49%) of the participants were found to be non-adherent to anti-seizure medications (score equal to or below 26). Mean +/- SD scores were as follows: QOLIE-10 score was 23.0 +/- 7.4 (out of 50 points possible, lower score indicates poorer quality of life), knowledge questionnaire score was 13.1 +/- 3.1 (out of 20 points possible, lower score indicates poorer knowledge of epilepsy), and the PHQ-9 score was 8.9 +/- 0.5. On the PHQ-9, 101 (52.9%) of the participants received a score suggestive of the diagnosis of depression (7 or greater). Lastly, 33 (17%) of the participants scored 7 or greater on the Taylor’s revised stigma scale indicating they were feeling highly stigmatized due to their condition.

Conclusions: The clinical and social characteristics explored in the present study likely have a strong influence on control of epilepsy, an association that will be explored further in the EPICO study as we measure seizure recurrence and other outcomes over the course of the subsequent 6 months. These data could direct targeted interventions and future public health policy aimed at mitigating these important factors, which could significantly improve the care and the lives of PWE in Peru.


Funding: Diversity Innovation Hub at Mount Sinai, Fogarty International Center, Universidad César Vallejo, American Academy of Neurology