Impact of epilepsy on employment in Malaysia

IntroductionStudies on the impact of epilepsy on employment have been extensively performed in European and some Asian countries but not in Southeast Asia such as Malaysia, a country with a robust economy, low unemployment rate, and minimal social security benefits for the unemployed. This study aims to determine the impact of epilepsy on employment in Malaysia.MethodsTwo hundred fifty subjects (52.4% male) with a mean age of 35.2 years were recruited from a tertiary neurology clinic in Malaysia.ResultsOf the 250 subjects, 69.6% were employed full-time, 10.4% employed part-time, and 20.0% unemployed. Furthermore, 42.8% had a monthly income below poverty line, i.e., RM1000 (USD 320). Unemployment was associated with female gender, lower education level, younger age of seizure onset, less responsiveness to first antiepileptic drug (AED), higher seizure frequency and less seizure freedom, and higher total score in seizure severity scale. The age of onset (p = 0.017), total score in the seizure severity scale (p = 0.018), and the responsiveness to first AED (p = 0.045) were the significant predictors of unemployment. Patients with part-time employment had similar education level with those who were unemployed, but they are more likely to be male and married, with intermediate age of seizure onset and seizure severity but with higher seizure frequency. As compared to their age-matched siblings, the patients were more likely to be unemployed (OR 13.1), to be single, and to have lower education level and lower monthly income.ConclusionPatients with epilepsy have high unemployment rate in Malaysia despite a robust economy and minimal social security. Besides those who were unemployed, many were in part-time or low-income employment.

► The impact of epilepsy on employment in Malaysia was studied. ► Age-matched sibling controls were recruited for comparison. ► Only 69.6% were employed full-time. ► Unemployment was associated with younger age of seizure onset. ► Unemployment was associated with higher score in the seizure severity scale.