Epilepsy is the most common serious neurological disorder among children worldwide, and approximately 80% of children with epilepsy live in low- and middle-income countries (LMICs), with increased morbidity and increased risk of death. Among children with epilepsy in LMICs, between 67% and 90% are not receiving consistent and appropriate treatment ? a phenomena known as the epilepsy treatment gap. The millions of children with epilepsy living in LMICs have not benefited from the advances in epilepsy care over the past half-century, as the models of epilepsy care in rich countries are not easily adapted to the reality of resource- poor sub-Saharan Africa. ?Bridging the Childhood Epilepsy Treatment Gap in Northern Nigeria (BRIDGE)? will establish a foundation upon which to perform larger definitive studies and clinical trials of innovative epilepsy care systems and therapies by (a) quantifying and mapping the childhood epilepsy treatment gap in Kano, Nigeria, (b) training, developing, and piloting task-shifted epilepsy care teams to improve epilepsy care access, and (c) developing and piloting innovative epilepsy diagnostic paradigms designed for low-resource environments with limited access to electroencephalograms (EEGs). To accomplish these aims we have assembled a strong multidisciplinary team representing Vanderbilt University Medical Center, Aminu Kano Teaching Hospital in Kano, Nigeria, and the BRIDGE Advisory Board- a multi-disciplinary team of experts focused on bridging the childhood epilepsy treatment gap. BRIDGE, and the clinical trials that will be built upon the BRIDGE foundation, have the potential to close the childhood epilepsy treatment gap in sub-Saharan Africa, and in poor communities around the world.
Epilepsy is the most common serious neurological disorder among children worldwide, about 80% of whom live in low- and middle income countries (LMICs) where the advances in epilepsy care over the past 40 years have not translated to improved outcomes. Approximately 67%-90% of children with epilepsy in the LMICs of sub- Saharan Africa do not receive consistent appropriate treatment ? a phenomena known as the epilepsy treatment gap, with associated increased risk of co-morbid conditions and premature death. This BRIDGE project lays a foundation for future clinical trials designed to bridge the childhood epilepsy treatment gap in SSA by (a) mapping the childhood epilepsy treatment gap in Kano, Nigeria, (b) developing and piloting task- shifted epilepsy care teams to target areas of the most severe treatment gap, and (c) developing and piloting epilepsy diagnostic paradigms for use in resource-limited environments like Kano with limited access to EEG. BRIDGE, and the clinical trials to follow, has the potential to reduce the childhood epilepsy treatment gap in Nigeria and throughout sub-Saharan Africa.
