Epilepsy care delivery during COVID-19 in resource-limited countries: A survey in collaboration with International Epilepsy Equity Group

• Published in: Epilepsy & behavior 2023-01, Vol.138, p.108998-108998, Article 108998
• Main Authors: von Gaudecker, Jane R., Clarke, Dave F., Perkins, Susan, Ali, Amza, Sanjuan, Daniel, Vidaurre, Jorge
• Format: Article
• Language: English
• Subjects: Adult; Care delivery; Child; Communicable Disease Control; COVID-19; COVID-19 - epidemiology; Cross-Sectional Studies; Delivery of Health Care; Developing Countries; Epilepsy; Epilepsy - epidemiology; Epilepsy - therapy; Healthcare professionals; Humans; Pandemics; Resource-limited countries; SARS-CoV-2; World Bank Ranking
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2022.108998

•COVID-19 affected the already fragile healthcare system globally.•Reduction of in-person care, restricted health services, and fiscal difficulties impacted epilepsy care delivery.•Reaching the healthcare provider was the biggest barrier for persons with epilepsy.•The World Bank Ranking system negates true intra-comparisons between countries.•Implementing measures to improve access to care unique to the healthcare system of each country is essential. The impact of pandemic has had worse effects in countries with already stretched healthcare resources. study’s The study aimed to explore changes in epilepsy care delivery in resource-limited countries during and since the acute phase of the COVID-19 pandemic. A cross-sectional survey was conducted in 22 countries among healthcare providers (HCPs) caring for persons with epilepsy (PWE), in collaboration with newly formed global collaborators, the International Epilepsy Equity Group. Findings were compared based on the World Bank Ranking (WBR) and HCPs’ practice type. Data were analyzed using Chi-square tests (α = 0.05) and pairwise multiple comparisons with α = 0.017 (Bonferroni adjustment). Open-ended responses were analyzed using thematic analysis. A total of 241 HCPs participated in the study. Of these, 8.30%, 65.98%, and 21.99% were from high-income (HIC), upper-middle-income (UMIC), and lower-middle-income countries (LMICs), respectively. Among HCPs, 31.12% were adult specialists, and 43.98% were pediatric specialists. During the acute phase of the pandemic, HCPs reported that the major barrier for PWE was difficulty reaching physicians/healthcare providers. Except for difficulty reaching physicians/healthcare providers (WBR P = 0.01 HIC