The Current Availability of Antiepileptic Drugs in Zambia: Implications for the ILAE/WHO “Out of the Shadows” Campaign

Elwyn Nachanya Chomba Department of Paediatrics and Child Health, University of Zambia, Lusaka, Zambia; Department of Psychiatry, University of Zambia, Lusaka, Zambia; Chainama Hills College Hospital, Lusaka, Zambia; Department of Medicine, University of Zambia, Lusaka, Zambia; Centers for Disease Control and Prevention, Lusaka, Zambia; Ministry of Health, Lusaka, Zambia; International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, Michigan

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Alan Haworth Department of Paediatrics and Child Health, University of Zambia, Lusaka, Zambia; Department of Psychiatry, University of Zambia, Lusaka, Zambia; Chainama Hills College Hospital, Lusaka, Zambia; Department of Medicine, University of Zambia, Lusaka, Zambia; Centers for Disease Control and Prevention, Lusaka, Zambia; Ministry of Health, Lusaka, Zambia; International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, Michigan

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Edward Mbewe Department of Paediatrics and Child Health, University of Zambia, Lusaka, Zambia; Department of Psychiatry, University of Zambia, Lusaka, Zambia; Chainama Hills College Hospital, Lusaka, Zambia; Department of Medicine, University of Zambia, Lusaka, Zambia; Centers for Disease Control and Prevention, Lusaka, Zambia; Ministry of Health, Lusaka, Zambia; International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, Michigan

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Masharip Atadzhanov Department of Paediatrics and Child Health, University of Zambia, Lusaka, Zambia; Department of Psychiatry, University of Zambia, Lusaka, Zambia; Chainama Hills College Hospital, Lusaka, Zambia; Department of Medicine, University of Zambia, Lusaka, Zambia; Centers for Disease Control and Prevention, Lusaka, Zambia; Ministry of Health, Lusaka, Zambia; International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, Michigan

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Philimon Ndubani Department of Paediatrics and Child Health, University of Zambia, Lusaka, Zambia; Department of Psychiatry, University of Zambia, Lusaka, Zambia; Chainama Hills College Hospital, Lusaka, Zambia; Department of Medicine, University of Zambia, Lusaka, Zambia; Centers for Disease Control and Prevention, Lusaka, Zambia; Ministry of Health, Lusaka, Zambia; International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, Michigan

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Henry Kansembe Department of Paediatrics and Child Health, University of Zambia, Lusaka, Zambia; Department of Psychiatry, University of Zambia, Lusaka, Zambia; Chainama Hills College Hospital, Lusaka, Zambia; Department of Medicine, University of Zambia, Lusaka, Zambia; Centers for Disease Control and Prevention, Lusaka, Zambia; Ministry of Health, Lusaka, Zambia; International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, Michigan

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Gretchen Lano Birbeck Department of Paediatrics and Child Health, University of Zambia, Lusaka, Zambia; Department of Psychiatry, University of Zambia, Lusaka, Zambia; Chainama Hills College Hospital, Lusaka, Zambia; Department of Medicine, University of Zambia, Lusaka, Zambia; Centers for Disease Control and Prevention, Lusaka, Zambia; Ministry of Health, Lusaka, Zambia; International Neurologic and Psychiatric Epidemiology Program, Michigan State University, East Lansing, Michigan

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DOI:
https://doi.org/10.4269/ajtmh.2010.10-0100
Volume/Issue:
Volume 83: Issue 3
Page(s):
571–574
Restricted access
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Recent concerns regarding antiepileptic drug (AED) availability in Zambia led us to conduct a study in the Lusaka and Southern Provinces to quantify the availability and cost of AEDs and assess determinants. Among 111 pharmacies, almost one-half did not carry AEDs (N = 54; 49.1%). Available AEDs were phenobarbitone (21; 18.9%), carbamazepine (27; 24.3%), valproic acid (4; 3.6%), and phenytoin (3; 2.7%). Adult out-of-pocket monthly costs ranged from US $7 to $30. Pediatric syrups were universally unavailable. Interviews revealed several barriers to AED provision, including that handling phenobarbitone (historically the most affordable AED) has become increasingly difficult because of newly enforced regulatory requirements. Personal communications with epilepsy-care providers in other low income countries suggest that this problem may be widespread. Improved enforcement of existing drug regulations may be contributing to the AED shortage. Social programs aimed at encouraging people with epilepsy to come “out of the shadows” must be preceded by improved AED access.

Author Notes

*Address correspondence to Gretchen Lano Birbeck, Michigan State University, East Lansing, MI 48824. E-mail: Birbeck@msu.edu

Financial support: This work was funded by National Institutes of Health Grant 1R01NS061693-01. The funders played no role in project development, conduct, presentation, or the decision to submit this for publication.

Authors' addresses: Elwyn Nachanya Chomba, Department of Paediatrics and Child Health, University of Zambia, University Teaching Hospital, Lusaka, Zambia, E-mail: echomba@zamnet.zm. Alan Haworth, University of Zambia (retired), Lusaka, Zambia, E-mail: haworth@zamnet.zm. Edward Mbewe, Chainama Hills College Hospital, Lusaka, Zambia, E-mail: embewe2001@yahoo.com. Masharip Atadzhanov, Department of Medicine, University of Zambia, Lusaka, Zambia, E-mail: masharip@yahoo.com. Philimon Ndubani, Centers for Disease Control and Prevention, Lusaka, Zambia, E-mail: pndubani@yahoo.co.uk. Henry Kansembe, Ministry of Health, Lusaka, Zambia, E-mail: kansembeh@yahoo.com. Gretchen Lano Birbeck, Michigan State University, East Lansing, MI, E-mail: Birbeck@msu.edu.

Copyright:
©The American Society of Tropical Medicine and Hygiene 2010
Received:
15 Feb 2010
|
Accepted:
28 Apr 2010
|
Published Online:
07 Sep 2010
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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