The World Health Organization estimates that 80% of the 50 million people in the world with epilepsy live in developing countries (WHO, 2004). The true prevalence of children with epilepsy in Africa is not known, but figures range from 2.9-26 per 1000 children. More importantly, the treatment gap (defined as the proportion of cases with active convulsive epilepsy without drug treatment) is an astonishing 70.3%. The attributed causes for the treatment gap are related to inadequacies of the health systems, mainly inadequate skilled manpower, cost of treatment and unavailability of drugs for epilepsy. While most countries have access to general pediatricians, few have pediatric neurology services and only 4 out of 15 African countries have an established pediatric neurology association or society. In response to these inadequacies, the present proposal seeks funding to hold a 3-day research program on the clinical aspects of childhood epilepsy in Africa in an effort to collect th necessary data aimed at determining how to elevate the standard of epilepsy diagnosis and treatment in sub-Saharan African countries. We seek to invite a colloquium of specialists from Africa and abroad to discuss optimal epilepsy care for children in sub-Saharan Africa. Research questions that will be addressed are: (i) the status quo of childhood epilepsy in sub-Saharan Africa, (i) guidelines for the optimal management of children with epilepsy through current practice parameters from organizations such as World Health Organization (WHO) and International League Against Epilepsy (ILAE) and whether and to what extent these guidelines are viable to be applied in sub-Saharan Africa, (iii) causes for the knowledge gap in relation to children with epilepsy in sub-Saharan Africa, and (iv) defining the best strategies to reduce the treatment gap in children with epilepsy in sub- Saharan Africa. The research data collected from this workshop and subsequent implementation of changes will be presented in a series of publications. PUBLIC HEALTH RELEVANCE: The relevance of this proposal for public health is the potential for collecting the necessary data aimed at determining how to elevate the standard of epilepsy diagnosis and treatment in sub-Saharan African countries. Moreover, this 3-day meeting will allow the formulation of new strategies aimed at reducing the treatment gap in children with epilepsy in sub-Saharan Africa. Disclaimer: Please note that the following critiques were prepared by the reviewers prior to the Study Section meeting and are provided in an essentially unedited form. While there is opportunity for the reviewers to update or revise their written evaluation, based upon the group's discussion, there is no guarantee that individual critiques have been updated subsequent to the discussion at the meeting. Therefore, the critiques may not fully reflect the final opinions of th individual reviewers at the close of group discussion or the final majority opinion of the group. Thus the Resume and Summary of Discussion is the final word on what the reviewers actually considered critical at the meeting.
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