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  1. Suryani G, Jehosua SY, Herlyani K, Zhi-Jien C, Kheng-Seang L
    Epilepsy Behav, 2021 10;123:108244.
    PMID: 34461382 DOI: 10.1016/j.yebeh.2021.108244
    BACKGROUND: Indonesia is the largest island country in the world with diverse ethnicity and cultural backgrounds. This study aimed to understand the variation in attitudes toward epilepsy among the Javanese, Sundanese, and the Minahasa ethnic groups in Indonesia.

    METHOD: This study recruited Sundanese from Tasikmalaya and Minahasan from Manado using the Indonesian Public Attitudes Toward Epilepsy (PATE) scale. The results were compared to the Javanese and Malaysian data in previous studies.

    RESULT: A total of 200 respondents, 100 from each ethnic group were recruited, with a mean age of 38.51 years. They were predominantly females (54%) and had secondary education level or lower (56.67%). The Javanese had a higher total mean score, indicating poorer attitudes toward epilepsy, as compared to the Minahasan and Sundanese groups. These differences were noted in the personal domain, but not the general domain. There were no significant differences in the mean scores in both personal and general domains between the Minahasan, Sundanese, and Malaysian populations. Subanalysis on the aspects of life showed that the Javanese had a significantly higher score in the aspects of education, marital relationship, and employment.

    CONCLUSION: The attitudes toward epilepsy were similar between the Indonesian (Sundanese and the Minahasan) and Malaysian, except the Javanese with poorer attitude. These differences could be socioeconomically or culturally related.

  2. Tanoto E, Khosama H, Jehosua S, Sekeon SAS, Karema W, Mawuntu AHP, et al.
    Epilepsy Behav, 2024 Jun;155:109787.
    PMID: 38657484 DOI: 10.1016/j.yebeh.2024.109787
    INTRODUCTION: Adverse skin reactions due to drugs such as Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) occur in 3% of people receiving anti epileptic drugs (AED). Although SJS/TEN has a low incidence, the mortality and morbidity rates are high. Indonesia has not adopted HLA-B*1502 screening prior to administration of carbamazepine (CBZ), although previous studies found a relationship between HLA-B*1502 and SJS/TEN.

    METHODS: A hybrid decision tree and Markov model was developed to evaluate three strategies for treating newly diagnosed focal epilepsy: CBZ direct therapy, levetiracetam (LEV) direct therapy, and therapy based on HLA-B*15:02 test results. From a societal perspective, base case and sensitivity analyses were carried out over a lifetime.

    RESULTS: Direct administration of CBZ appears to have a slightly lower average cost than the HLA-B*15:02 allele screening strategy. The increase in quality-adjusted life year (QALY) in HLA-B*15:02 screening before treatment related to the cost difference reached 0.519 with an incremental cost-effectiveness ratio (ICER) of around USD 984 per unit of QALY acquisition. Direct treatment of LEV increased treatment costs by almost USD 2000 on average compared to the standard CBZ strategy. The increase in QALY is 0.834 in direct levetiracetam treatment, with an ICER of around USD 2230 for each QALY processing.

    CONCLUSION: Calculation of the cost-effectiveness of lifetime epilepsy therapy in this study found that the initial screening strategy with the HLA-B*15:02 test was the most cost-effective.

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