Abstract / Summary
Abstract Background and Objectives: Epilepsy, a significant neurological disorder prevalent globally, poses considerable challenges in India due to lifestyle changes, increased life expectancy, and varied healthcare access. Its prevalence in India contributes to 20% of the global burden, with notable treatment gaps and stigmatization affecting patients’ quality of life and economic stability. This study aims to assess the prevalence of epilepsy and determinants of treatment gaps in rural Ludhiana. Methods: This community-based cross-sectional study, conducted in rural Ludhiana, Punjab, involved door-to-door screening of 31,043 individuals using the Placencia 9-item questionnaire. The entire population of the field practice area was screened using a census approach. Data on sociodemographic profile, seizure history, treatment gap, clinical and treatment-related factors, and medical history were included. Institutional ethics approval and informed consent from participants were obtained. Results: Of the 31,043 individuals screened, 195 were identified as screen positive for epilepsy, and 61 (32.6%) had active epilepsy. The lifetime prevalence of epilepsy was 2.5 per 1,000 individuals, and the prevalence of active epilepsy was 1.96 per 1,000 individuals. A bimodal age distribution of epilepsy was noted, with the highest lifetime prevalence among people aged ≥80 years. A significant treatment gap was observed, with 49.2% of individuals with active epilepsy not receiving appropriate treatment, influenced by factors such as age, gender, education, marital status, and socioeconomic status. Conclusions: The study underscores the significant prevalence and treatment gap of epilepsy in rural Ludhiana, highlighting the need for improved awareness, targeted healthcare strategies, and rehabilitation efforts. Strengthening counseling services at the primary healthcare level may substantially improve treatment adherence. A multifaceted approach is required considering socioeconomic, educational, and cultural factors.