Classifying etiology of infantile spasms syndrome in resource‐limited settings: A study from the South Asian region

Abstract Objective Etiological classification of infantile spasms syndrome (ISS) is important, considering the influence on prognosis based on the presence or absence of a known etiology. This study was performed to describe the limitations and difficulties experienced within the South Asian region...

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Autores principales:	Jithangi Wanigasinghe, Jitendra Kumar Sahu, Priyanka Madaan, Kanij Fatema, Kyaw Linn, Prem Chand, Prakash Poudel, Esmatullah Hamed, Mimi L. Mynak, Samaahath Hassan
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	etiological classification infantile spasms syndrome South Asian region Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/6e7595e8af204b9e9a82cfc3b4b66500
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spelling	oai:doaj.org-article:6e7595e8af204b9e9a82cfc3b4b665002021-12-01T06:09:19ZClassifying etiology of infantile spasms syndrome in resource‐limited settings: A study from the South Asian region2470-923910.1002/epi4.12548https://doaj.org/article/6e7595e8af204b9e9a82cfc3b4b665002021-12-01T00:00:00Zhttps://doi.org/10.1002/epi4.12548https://doaj.org/toc/2470-9239Abstract Objective Etiological classification of infantile spasms syndrome (ISS) is important, considering the influence on prognosis based on the presence or absence of a known etiology. This study was performed to describe the limitations and difficulties experienced within the South Asian region when classifying the etiology of ISS according to the current recommendation. Method Data on healthcare indices and facilities related to management of ISS for the nine countries in the South Asian region were gathered by the South Asian West Syndrome Research Group. A Google survey was performed among three hundred and thirty pediatric neurologists in the region. The capacity within each country for investigating etiology of ISS according to current described benchmarks was evaluated. The difficulties experienced in this regard and the potential solutions were investigated. Results One hundred and sixty pediatric neurologists (response rate 48%) from Bangladesh (19/25), India (94/255), Myanmar (11/11), Nepal (6/8), Pakistan (19/25), and from Sri Lanka (7/8) responded. Three countries had no pediatric neurology services. Fifty‐six percent attempted to classify ISS etiology according to classification outlined by International League Against Epilepsy in 2017. The facilities to perform metabolic, genetic, and immunological investigations were very limited. Lack of funding for investigations and poor laboratory support were the two most frequent barriers encountered. Sixty percent indicated that a separate classification is suitable for low‐income setting; 78% suggested inclusion of separate category as “incompletely investigated” as an alternative solution to mitigate the barrier of achieving a better understanding of the etiological subtypes seen more frequently in this region. Significance The resources in South Asian region are limited to meet the recommendations for investigating etiology of ISS. Including the etiological subcategory “incompletely investigated” is proposed as an alternative to understand the true proportions of children in this region, with a definite known etiology and those with an unknown etiology.Jithangi WanigasingheJitendra Kumar SahuPriyanka MadaanKanij FatemaKyaw LinnPrem ChandPrakash PoudelEsmatullah HamedMimi L. MynakSamaahath HassanWileyarticleetiological classificationinfantile spasms syndromeSouth Asian regionNeurology. Diseases of the nervous systemRC346-429ENEpilepsia Open, Vol 6, Iss 4, Pp 736-747 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	etiological classification infantile spasms syndrome South Asian region Neurology. Diseases of the nervous system RC346-429
spellingShingle	etiological classification infantile spasms syndrome South Asian region Neurology. Diseases of the nervous system RC346-429 Jithangi Wanigasinghe Jitendra Kumar Sahu Priyanka Madaan Kanij Fatema Kyaw Linn Prem Chand Prakash Poudel Esmatullah Hamed Mimi L. Mynak Samaahath Hassan Classifying etiology of infantile spasms syndrome in resource‐limited settings: A study from the South Asian region
description	Abstract Objective Etiological classification of infantile spasms syndrome (ISS) is important, considering the influence on prognosis based on the presence or absence of a known etiology. This study was performed to describe the limitations and difficulties experienced within the South Asian region when classifying the etiology of ISS according to the current recommendation. Method Data on healthcare indices and facilities related to management of ISS for the nine countries in the South Asian region were gathered by the South Asian West Syndrome Research Group. A Google survey was performed among three hundred and thirty pediatric neurologists in the region. The capacity within each country for investigating etiology of ISS according to current described benchmarks was evaluated. The difficulties experienced in this regard and the potential solutions were investigated. Results One hundred and sixty pediatric neurologists (response rate 48%) from Bangladesh (19/25), India (94/255), Myanmar (11/11), Nepal (6/8), Pakistan (19/25), and from Sri Lanka (7/8) responded. Three countries had no pediatric neurology services. Fifty‐six percent attempted to classify ISS etiology according to classification outlined by International League Against Epilepsy in 2017. The facilities to perform metabolic, genetic, and immunological investigations were very limited. Lack of funding for investigations and poor laboratory support were the two most frequent barriers encountered. Sixty percent indicated that a separate classification is suitable for low‐income setting; 78% suggested inclusion of separate category as “incompletely investigated” as an alternative solution to mitigate the barrier of achieving a better understanding of the etiological subtypes seen more frequently in this region. Significance The resources in South Asian region are limited to meet the recommendations for investigating etiology of ISS. Including the etiological subcategory “incompletely investigated” is proposed as an alternative to understand the true proportions of children in this region, with a definite known etiology and those with an unknown etiology.
format	article
author	Jithangi Wanigasinghe Jitendra Kumar Sahu Priyanka Madaan Kanij Fatema Kyaw Linn Prem Chand Prakash Poudel Esmatullah Hamed Mimi L. Mynak Samaahath Hassan
author_facet	Jithangi Wanigasinghe Jitendra Kumar Sahu Priyanka Madaan Kanij Fatema Kyaw Linn Prem Chand Prakash Poudel Esmatullah Hamed Mimi L. Mynak Samaahath Hassan
author_sort	Jithangi Wanigasinghe
title	Classifying etiology of infantile spasms syndrome in resource‐limited settings: A study from the South Asian region
title_short	Classifying etiology of infantile spasms syndrome in resource‐limited settings: A study from the South Asian region
title_full	Classifying etiology of infantile spasms syndrome in resource‐limited settings: A study from the South Asian region
title_fullStr	Classifying etiology of infantile spasms syndrome in resource‐limited settings: A study from the South Asian region
title_full_unstemmed	Classifying etiology of infantile spasms syndrome in resource‐limited settings: A study from the South Asian region
title_sort	classifying etiology of infantile spasms syndrome in resource‐limited settings: a study from the south asian region
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/6e7595e8af204b9e9a82cfc3b4b66500
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Classifying etiology of infantile spasms syndrome in resource‐limited settings: A study from the South Asian region

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