BMC Medicine201210:107
https://doi.org/10.1186/1741-7015-10-107© Katchanov and Birbeck; licensee BioMed Central Ltd. 2012
Received: 10 July 2012Accepted: 24 September 2012Published: 24 September 2012
In 2011, the World Health Organization’s (WHO) mental health Gap Action Programme (mhGAP) r...eleased evidence-based epilepsy-care guidelines for use in low and middle income countries (LAMICs). From a
geographical, sociocultural, and political perspective, LAMICs represent a heterogenous group with significant differences in the epidemiology, etiology, and perceptions of epilepsy. Successful implementation of
the guidelines requires local adaptation for use within individual countries. For effective implementation and sustainability, the sense of ownership and empowerment must be transferred from the global health authorities to the local people. Sociocultural and financial barriers that impede the implementation of the guidelines should be
identified and ameliorated. Impact assessment and program revisions should be planned and a budget allocated to them. If effectively implemented, as intended, at the primary-care level, the mhGAP
guidelines have the potential to facilitate a substantial reduction in the epilepsy treatment gap and improve the quality of epilepsy care in resource-limited settings.
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Q10: For carers of people with dementia, does respite care when compared to care as usual, produce benefits/harm in the specified outcomes?
Q5: For people with dementia, which cognitive/psychosocial interventions (such as cognitive stimulation, cognitive rehabilitation, reality orientation, reminiscence therapy) when compared to placebo/comparator produce benefits/harm in the specified outcomes?
Q6: Can dementia be diagnosed at first or second level care by non-specialist health care providers? What should be the assessment process for the diagnosis of dementia?
Q9. In adults and children with convulsive epilepsy in remission, when should treatment be discontinued?
Q3: Can febrile seizures (simple or complex) be managed at first or second level care by non-specialist health care providers in low and middle income country settings? What is the role of diagnostic tests in the management of febrile seizures by non-specialists in low and middle income settings? Fo...r prophylaxis to prevent recurrence of simple or complex febrile seizures, which of the pharmacological interventions when compared with placebo/comparator produce benefit/harm in specified outcomes?
- continuous anticonvulsant therapy - intermittent anticonvulsant therapy - intermittent antipyretic treatment
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Q 7: For adults and children with convulsive epilepsy, which standard antiepileptic drugs (phenobarbital, phenytoin, carbamazepine, valproic acid) when compared to placebo/a comparator produce benefits/harm in the specified outcomes?
Q9: For carers of people with dementia, do interventions (psychoeducational, cognitive-behavioural therapy counseling/case management, general support, training of caregivers, multi-component interventions and miscellaneous interventions) when compared to placebo/comparator, produce benefits/harm in... the specified outcomes?
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Q4: For people with dementia with associated depression, do antidepressants when compared to placebo/comparator produce benefits/harm in the specified outcomes?
Q2: For people with dementia, does memantine, when compared to placebo/comparator, produce benefits/harm in the specified outcomes in non-specialist health settings?
Q3: For behavioural and psychological symptoms in people with dementia, do following drugs, when compared to placebo/comparator, produce benefits/harm in the specified outcomes?
Q 10: In adults and children with epilepsy, which psychological interventions used as adjunctive therapies with antiepileptic drugs when compared to placebo/comparator produce benefits/harm in specified outcomes?
Q6: What is the added advantage of doing neuroimaging in people with convulsive epilepsy in non-specialist settings in low and middle income countries?
Q8. Should Anti-Epileptic Drug (AED) treatment be started after first unprovoked seizure in non-specialist health settings?
Q4: Can convulsive epilepsy be diagnosed at first level care by a non-specialist health care provider in low and middle income country settings?
Q11: 11a). In women with epilepsy, should antiepileptic therapy be prescribed as monotherapy or polytherapy to decrease the risk of fetal malformations?
11b). Does the use of folic acid preconceptually decrease the risk of foetal malformations in women with epilepsy?
11c). Do phenytoin, phenobarbi...tal, valproic acid or carbamazepine enter breast milk in quantities which are clinically significant to the baby?
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