Validación de un método para la detección temprana de crisis convulsivas y su aplicación en el programa Atención Integrada a las Enfermedades Prevalentes de la Infancia AIEPI

Abstract

Epilepsy is a public health problem with serious biological, psychological and economic consequences, so Organaización the Pan American Health Organization PAHO and WHO Mundfial Health, together with other international organizations, have decided to incorporate the epilepsy program "Integrated Management of Childhood Illness Children" IMCI. The aim of the study is to validate the instrument will use the Surgeon General at the level of primary health care, for early detection and treatment of epilepsy in children 1-10 years old. This is a cross-sectional observational study designed to validate a procedures manual as a diagnostic tool to discriminate between children with epilepsy and children without epilepsy. The instrument was apicado in children attending the Regional Epilepsy Center, and Outpatient of "Vicente Corral Moscoso" (HVCM) Hospital in the city of Cuenca, Ecuador. Four students of sixth year medical apply the instrument in the course of three months, upon approval of a training course on the use of this instrument. The sample consistency in 102 cases diagnosed by neurologist specialist and 102 controls with diseases that were convlusivas nu crisis, diagnosed by the pediatric doctor. The diagnostic instrument discrimination was measured by testing sensitivity, specificity, and positive and negative predictive values. The gold standard for calculating these measures was the clinical diagnosis of epilepsy by neurologist. The diagnostic tool sensibiliad of 95,1y demonstrated specificity 97,06para detect convlusivas crisis in the group applied, suggesting that can be effectively used by a general practitioner. The instrument seems to be reliable for diagnosing generalized seizures, but not for partial seizures which could affect the diagnostic reliability of the next step "observe and verify." It is recommended to validate the application module (treatment and follow-up) in a population and defined period