Epilepsy surgery program in a resource‐limited setting in Vietnam: A multicentered collaborative model

Le, Viet‐Thang; Le, Minh‐An Thuy; Nguyen, Duc Hue; Tang, Loc Ngoc Phuong; Pham, Tuan Anh; Nguyen, Anh Minh; Nguyen, Minh Kien; Ngo, TanVan; Tran, Thanh T.; Le, TuanVan; Jallon, Pierre; Lim, Kheng‐Seang

doi:10.1002/epi4.12650

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…For example, a study of the global burden of epilepsy (among other conditions) reported that 81% of epilepsy-deaths occurred in low and middle countries [ 80 ], reflecting both the larger number of people with epilepsy and the limited resources with which to effectively manage and treat patients [ 81 ]. Overall, there is an imperative need for innovative solutions to improve the outcomes of patients in these countries [ 82 , 83 ].…”

Section: Discussionmentioning

confidence: 99%

The burden of illness in Lennox–Gastaut syndrome: a systematic literature review

Strzelczyk

Zuberi

Striano

et al. 2023

Orphanet J Rare Dis

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Background Lennox–Gastaut syndrome (LGS) is a severe developmental and epileptic encephalopathy characterized by drug-resistant epilepsy with multiple seizure types starting in childhood, a typical slow spike-wave pattern on electroencephalogram, and cognitive dysfunction. Methods We performed a systematic literature review according to the PRISMA guidelines to identify, synthesize and appraise the burden of illness in LGS (including “probable” LGS). Studies were identified by searching MEDLINE, Embase and APA PsychInfo, Cochrane’s database of systematic reviews, and Epistemonikos. The outcomes were epidemiology (incidence, prevalence or mortality), direct and indirect costs, healthcare resource utilization, and patient and caregiver health-related quality of life (HRQoL). Results The search identified 22 publications evaluating the epidemiology (n = 10), direct costs and resource (n = 10) and/or HRQoL (n = 5). No studies reporting on indirect costs were identified. With no specific ICD code for LGS in many regions, several studies had to rely upon indirect methods to identify their patient populations (e.g., algorithms to search insurance claims databases to identify “probable” LGS). There was heterogeneity between studies in how LGS was defined, the size of the populations, ages of the patients and length of the follow-up period. The prevalence varied from 4.2 to 60.8 per 100,000 people across studies for probable LGS and 2.9–28 per 100,000 for a confirmed/narrow definition of LGS. LGS was associated with high mortality rates compared to the general population and epilepsy population. Healthcare resource utilization and direct costs were substantial across all studies. Mean annual direct costs per person varied from $24,048 to $80,545 across studies, and home-based care and inpatient care were significant cost drivers. Studies showed that the HRQoL of patients and caregivers was adversely affected, although only a few studies were identified. In addition, studies suggested that seizure events were associated with higher costs and worse HRQoL. The risk of bias was low or moderate in most studies. Conclusions LGS is associated with a significant burden of illness featuring resistant seizures associated with higher costs and worse HRQoL. More research is needed, especially in evaluating indirect costs and caregiver burden, where there is a notable lack of studies.

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Section: Discussionmentioning

confidence: 99%

The burden of illness in Lennox–Gastaut syndrome: a systematic literature review

Strzelczyk

Zuberi

Striano

et al. 2023

Orphanet J Rare Dis

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“…For instance, a study conducted in Ho Chi Minh City, Vietnam, aimed to determine the outcome of such a program. 8 The results indicated that out of 35 patients, 29 (82.8%) achieved Engel Class I outcomes, meaning they were free of disabling seizures, while 6 (17.2%) achieved Class II outcomes, indicating rare disabling seizures (“almost seizure‐free”). 8 These findings underscore the potential impact of establishing and expanding epilepsy surgery programs in resource‐limited settings to improve patient outcomes and address the unmet needs of individuals with drug‐resistant epilepsy.…”

Section: Transforming Surgical Landscapes: the Impact Of Surgical Men...mentioning

confidence: 97%

“…Mentorship programs in LMICS operate through a multifaceted approach involving guided observation, personalized instruction, and context‐specific interventions. 6 , 7 , 8 , 9 , 10 These interventions are tailored to meet the unique demands of the local healthcare landscape, which may include resource constraints, cultural consideration, and healthcare delivery challenges. There have been successful surgical mentorship initiatives that have resulted in some positive outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…Various mentorship programs in LMICs in Africa, Asia, and the Americas have all instilled confidence in surgical mentees, improved job satisfaction, and resulted in safer surgical procedures with favorable clinical outcomes. 7 , 8 , 9 , 10 By engaging in mentorship programs, surgical trainees not only develop technical skills but also gain insights into navigating the complexities of healthcare delivery in resource‐limited settings.…”

Section: Introductionmentioning

confidence: 99%

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Surgical mentorship in low‐resource environments: Opportunities and challenges, a perspective

Awuah,

Tan,

Bharadwaj

et al. 2024

Health Science Reports

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Background and aimsIn low‐ and middle‐income countries (LMICs), a shortage of skilled surgical practitioners hampers healthcare delivery, impacting well‐being and economic growth. Surgical mentorship programs offer a promising solution but face challenges in implementation. This review aims to comprehensively assess the impact of surgical mentorship programs in LMICs and identify challenges and opportunities for their development and implementation.MethodsA thorough literature search was conducted from 2000 to 2023 using multiple databases, focusing on surgical mentorship programs in LMICs. Inclusion criteria encompassed full‐text articles in English that demonstrated characteristics of mentorship. Rigorous exclusion criteria were applied to ensure high‐quality evidence inclusion.ResultsSurgical mentorship programs in LMICs strengthen local surgical capacity, improve surgical skills and patient outcomes, optimize resources and technology utilization, and positively impact medical students aspiring to be surgeons. However, challenges such as resistance to change, resource limitations, financial constraints, logistical and technological challenges, and time constraints hinder their implementation.ConclusionDespite challenges, surgical mentorship programs hold promise for enhancing surgical capacity and healthcare quality in LMICs. Standardized metrics for accountability, innovative funding mechanisms, collaborative partnerships for scalability, interdisciplinary integration, and leveraging virtual mentorship programs are key strategies to overcome challenges and foster sustainable learning cultures, ultimately contributing to improved healthcare equity and quality in low‐resource settings.

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Epilepsy surgery program in a resource‐limited setting in Vietnam: A multicentered collaborative model

Nguyen

et al. 2022

Epilepsia Open

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Objective: Although epilepsy surgery is more effective than medical therapy for drug-resistant patients, it is underutilized in both high-income and low-and middle-income countries. In light of our efforts to establish an epilepsy surgery program in a resource-limited setting, this study aimed to determine the outcome of the epilepsy surgery program in Ho Chi Minh City (HCMC), Vietnam. Methods:In 2018, we developed the HCMC epilepsy core multidisciplinary team with members from various hospitals and centers. The team typically included neurologists, neurosurgeons, neuropsychologists, psychiatrists, and nursing specialists. Presurgical evaluations were performed for patients with drug-resistant epilepsy, fulfilling the ILAE criteria, with an epileptogenic lesion (mesial temporal sclerosis, low-grade gliomas, or focal cortical dysplasia). All epilepsy surgeries were performed in two epilepsy surgery centers in HCMC between 2018 and 2021. The patients were followed up for at least 12 months.Results: Fifty-two patients with drug-resistant epilepsy underwent presurgical evaluation, of which 35 underwent surgery. Among the 52 patients, 20 (38.5%) underwent surgery after showing concordance among the results of standard presurgical assessments such as semiology, scalp interictal or ictal electroencephalography, and brain imaging. Among the 26 people with epilepsy who required more advanced evaluations, 15 underwent surgery with intraoperative electrocorticography to delineate the optimal resection borders.The outcomes of Engel Class I and Class II were achieved in 29/35 (82.8%) and 6/35 (17.2%) patients, respectively.

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Epilepsy surgery program in a resource‐limited setting in Vietnam: A multicentered collaborative model

Cited by 4 publications

References 21 publications

The burden of illness in Lennox–Gastaut syndrome: a systematic literature review

The burden of illness in Lennox–Gastaut syndrome: a systematic literature review

Surgical mentorship in low‐resource environments: Opportunities and challenges, a perspective

Epilepsy surgery program in a resource‐limited setting in Vietnam: A multicentered collaborative model

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