Closing the Treatment Gap for Neurological Diseases in Less Resourced Countries (I7-5B)

Objectives: The Mental Health unit of the World Health Organization South East-Asia Regional Office launched pilot projects to estimate the approximate number of patients not getting appropriate care (“treatment gap”) and then developing strategies to close the treatment gap. The estimated treatment gap for epilepsy in pilot projects conducted in Bangladesh, Bhutan, Indonesia, Myanmar and Timor Leste was 87[percnt], 40[percnt], 90[percnt], 95[percnt], 71[percnt] respectively. Background: There is a great scarcity of trained neurologists in less resourced countries. Moreover, the neurologists are concentrated in urban metropolitan areas. This leaves a vast majority of the population (approximately 70[percnt]) living in rural areas without neurological care. Methods: We developed a simple questionnaire to identify patients with generalized tonic-clonic seizures (GTCS). This questionnaire has 6 questions and GTCS is suspected if 4 questions are positive. Then village-based health workers were trained to identify suspected cases of GTCS and get the nearest general practitioner to begin treatment with phenobarbitone. Results: Using this strategy, the treatment gap was reduced to 5[percnt], 26[percnt], 5[percnt] and 54[percnt] in Bangladesh, Bhutan, Myanmar and Timor Leste respectively. The strategy is being expanded to depression and psychosis. Conclusion: Using this strategy many more patients will be provided treatment. Disclosure: Dr. Chandra has nothing to disclose. Dr. Nazneen has nothing to disclose.