Use of herbal medicines in rural communities in the northern coast of Peru and in rural and urban communities of Laos to treat people with epilepsy

International audienceBackground: More than 70 million people suffer epilepsy worldwide. Low availability of anti-epileptic drugs, side-effects and drug-resistant epilepsy affect the quality of life of persons with epilepsy (PWE) in low and middle income countries. In Peru, a country with a high prevalence of epilepsy (16.6/1000) and Laos, a country with a high treatment gap (97.0%), herbal medicine (HM) was frequently used for this neurological condition. Objectives: The aim of this study was to assess and compare the use of HM in Peru and Laos. Specific objectives were to determine therapeutic strategies of PWE, to assess knowledge, attitudes and practices of healthcare actors and to identify HM used to treat epilepsy.Methodology: We estimated the percentage of plants used among PWE in a study conducted in rural communities of Peru between February and June 2015 and in rural and urban communities of Laos between February and June 2017. Inclusion criteria were patients older than 2 years who had lived in the area for at least 3 months and a diagnosis of epilepsy confirmed by a neurologist. Information was collected thanks to structured interviews with a survey questionnaire. Botanical species mentioned were collected and identified by a botanist.Results: In Peru, of 228 PWE included, 60.0% had used HM prescribed by a traditional healer. A Traditional healer was consulted as first intention in 45.2% of PWE. Valeriana officinalis was the HM most prescribed as 25.0% of Traditional healers recommended its use. In Laos, preliminary results show that HM were known by 20.0% of market plant sellers. Most mentioned etiologies in Laos were contamination by rests of animal’s food and brain malformations. Conclusion: This study is the first one to identify a pattern of HM use for epilepsy in Peru and Laos and will allow understanding determinants of the care pathway for PWE