Childhood Epilepsy Management in Indonesia: Challenge and Current Condition

Abstract

Epilepsy is a chronic neurological disorder affecting 1-2% of the global population, with most cases in children. Approximately 30% of individuals have drug-resistant epilepsy. Low- and middle-income countries (LMICs) account for 80% of cases, with Southeast Asia facing challenges like birth asphyxia, infections, and trauma as common causes.

Indonesia, a middle-income country, faces significant challenges in childhood epilepsy management. A survey of 349 healthcare providers across 38 provinces highlighted limited diagnostic tools: only 26.9% had EEGs, 18.6% had MRIs, and 49% had CT scans. Antiseizure medications (ASMs), such as valproic acid, are commonly used, but 1.43% of respondents reported their unavailability in hospitals.

With an estimated 474,000 children affected by epilepsy in Indonesia, the country faces a critical shortage of neuro-pediatricians—only 84 nationwide, mostly concentrated in the capital. Most healthcare providers manage fewer than four seizure cases monthly, and 80.5% lack access to neuro-pediatricians in their cities, further compounding the issue.

While epilepsy is included in medical education, continuing education is limited. Many providers reported their last training was over a year ago. A community service program in Simpang Lima Gumul Hospital, Kediri successfully improved provider knowledge, demonstrating the need for more frequent and comprehensive training programs. Addressing these gaps in resources, training, and access to specialists is essential for improving childhood epilepsy management in Indonesia.