TABLE 3.

Literature on Infantile spasms syndrome and its etiology from the countries in the South Asian region

	Afghanistan	Bangladesh	Bhutan	India	Maldives	Myanmar	Nepal	Pakistan	Sri Lanka
No of articles on ISS indexed in PubMed or Scopus	None	5	0	>100	None	0	3	10	8
Abstracts if no full texts	None	NA	None	NA	None	2	NA	NA	NA
Reported incidence/prevalence of WS per 1000	None	None	None	Age specific prevalence: 0.0628/1000	None	None	None		None
Proportion with**
Structural etiology	None	None	None	82% (CI: 75%‐89%)	None	None	None	75% (CI: 57%‐89%)	68% (CI: 57%‐78%)
Acquired structural insult	None	None	None	71% (CI: 61%‐80%)	None	None	None	64% (CI: 55%‐73%)	62% (51%‐73%)
Described etiologies of WS	None	HIE/Perinatal asphyxia: 58% TORCH: 3.22% Brain malformation: 3.22%, Neonatal Hyperbilirubinemia: 3.22%, Neonatal sepsis: 3.2% Unknown: 6.5%*	None	Perinatal asphyxia/HIE (34.6%) Hypoglycemic brain injury (HBI) 16.7% Combined HIE and HBI (9%) Congenital brain malformations (3%) Other structural (10.7%) Infections (0.7%) Metabolic (0.7%) Proven genetic (7.2%) Not known/incompletely investigated (17.1%)^	None	Perinatal asphyxia (27.7%) Structural abnormality (15.7%) CNS infection (8.4%) Others (6%) No known etiology (42.2%)#	Perinatal asphyxia (50%) CNS infection (22%)###	HIE 32% CNS infection 13.6% Congenital malformations‐ 13.6% Perinatal stroke 13.6% Hypoglycemia 9% IEM 9% TSC 4.6%	Known‐ 71% Unknown −18% Incompletely investigated −11%
Average age of onset (months)	NR	5**	NR	NR	NR	5.5#	6###	4‐6#	5**
Average lead time to diagnosis/treatment (months)	NR	7.5**	NR	4.4**	NR	NR	NR	6	1.4**
Ratio of male in comparison to female	NR	2.1**	NR	2.6**	NR	1.44#	NR	NR	1.36**

* ²⁷ , ** ⁹ , ^{# 29} , ^{## 26} , ^{### 28} , ^ ⁴¹ .