A Large-Scale Study of Epilepsy in Ecuador: Methodological Aspects

Placencia, M.; Suarez, Jhon David Cárdenas; Crespo, Francisco de Asís Pérez; Sander, J.W.; Shorvon, SD; Ellison, R.H.; S, Cascante

doi:10.1159/000110915

Cited by 46 publications

(41 citation statements)

References 8 publications

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“…Screening instrument -We adopted the screening questions of the instrument used in the Ecuadorian study of epilepsy prevalence carried out by Placencia et al [7][8][9] . The questionnaire had been translated into Portuguese and pretested in 30 patients on clinical grounds (15 with epilepsy, and the other 15, without).…”

Section: Methodsmentioning

confidence: 99%

A house-to-house survey of epileptic seizures in an urban community of Rio de Janeiro, Brazil

Gomes

Zeitoune

Kropf

et al. 2002

Arq. Neuro-Psiquiatr.

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-Objective: To carry out a prevalence study about epileptic seizures and epilepsy in an urban lowincome population. Method: Prevalence study in a two-phase model: screening and diagnosis confirmation. It was applied a structured questionnaire in 982 people all effectively resident on March 1rst 2000 based on a population census previously carried out by the Nurse Faculty. One neurologist interviewed all the suspected cases. Results: It was detected 176 suspected cases of epileptic seizures: 156 with non-epileptic events, and 20 with epileptic seizures. The lifetime point prevalence was of 16.3 cases per 1000 inhabitants, and of active epilepsy, 5.1 / 1000. If we consider false negative diagnosis from the screening procedures, the lifetime pointprevalence rates until 20.8/1000. Conclusion: The prevalence data of epilepsy shows less impressive than in other Latin-American studies and even some Brazilian, but similar to other Brazilian studies. This suggests geographical diversity and/or methodological differences among studies. Anyway, probably the epilepsy prevalence in Rio de Janeiro is not so high as that found in the Latin countries rural areas.KEY WORDS: epilepsy, prevalence, community study.Estudo porta-a-porta sobre crises epilépticas em comunidade urbana do Rio de Janeiro, Brasil RESUMO -Objetivo: Estudar a prevalência de crises epilépticas e epilepsia em uma população urbana de baixa renda do Rio de Janeiro. Método: Estudo de prevalência, em um modelo de duas etapas: de triagem e de confirmação diagnóstica. Foi aplicado questionário estruturado de triagem em 982 pessoas. Todos os efetivamente residentes na comunidade em primeiro de março de 2000 (dia prevalente) eram os sujeitos em potencial. A população de estudo foi aquela que constava no censo efetuado pela Escola de Enfermagen Anna Nery. Um neurologista entrevistou os sujeitos suspeitos de apresentarem crises epilépticas. Resultados: Foram detectados 176 casos suspeitos de crises epilépticas: 156 casos com eventos não epilépticos e 20 com crises epilépticas. A prevalência acumulada na comunidade foi 16,3 casos por 1000 habitantes e a de epilepsia ativa foi 5,1 / 1000. Caso se considere o diagnóstico falso negativo da fase de triagem, a prevalência acumulada iria a 20,8/1000. Conclusão: Os dados de prevalência mostram-se menores do que de outros países latinoamericanos e mesmo de alguns brasileiros, mas similares a outros nacionais, o que sugere diversidade geográfica e/ou diferenças metodológicas entre os estudos. A prevalência de epilepsia no Rio de Janeiro provavelmente não é tão alta quanto a de outros países latinos, principalmente nas suas regiões rurais. PALAVRAS-CHAVE: epilepsia, prevalência, estudo de campo.

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Section: Methodsmentioning

confidence: 99%

A house-to-house survey of epileptic seizures in an urban community of Rio de Janeiro, Brazil

Gomes

Zeitoune

Kropf

et al. 2002

Arq. Neuro-Psiquiatr.

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“…The prevalence of epilepsy in many developing countries significantly exceeds that of developed nations (1)(2)(3)(4)(5)(6)(7). Extremely limited medical resources exist to address the needs of epilepsy patients, particularly in rural areas.…”

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confidence: 99%

Seizures in Rural Zambia

Birbeck

2000

Epilepsia

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Summary:Purpose: To describe the period prevalence of epilepsy and febrile seizures in a bush hospital and discuss the medical sequelae and social impact of seizures in this population.Methods: For 13 weeks, an evaluation of inpatients was made at Chikankata Hospital in rural Zambia. Inpatients identified as having seizures, "fits," "spells," or "fainting," were evaluated by a medical records review, basic demographic data, a neurological history and physical examination, and a treatment history. A semistructured questionnaire was administered to evaluate the social impact of seizures and assess factors associated with delayed care seeking.Results: Seizures composed 44% of all inpatient neurologic disease and resulted in 84 admissions. Epilepsy patients received treatment primarily from traditional healers; only 3 1% reported ever receiving antiepileptic drugs (AEDs). Among those who had received treatment, AEDs were frequently underdosed. Patients with epilepsy had significantly less education than their sex-matched siblings. Patients with untreated epilepsy for >2 years were more likely to have experienced serious burns or falls requiring hospitalization. Children with febrile seizures whose parents held supernatural beliefs regarding seizures were more likely to be treated with traditional medicines, had higher malarial parasite counts, and required longer hospitalizations than children with febrile seizures whose parents recognized the association between seizures and hyperthermia.Conclusions: Epilepsy and febrile seizures are responsible for a significant burden of disease in rural Zambia. Serious medical complications often result from seizures, especially if untreated for >2 years. Social stigma decreases educational opportunities and misperceptions regarding seizures may result in delayed care for children with febrile seizures. Some evidence suggests that epilepsy is underreported, underrecognized, and undertreated in this population.

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“…; Q9., Have you ever been told that you have had epilepsy or epileptic fits? (by Placencia et al 5 ) to misinterpretation. The majority of these events were not of long term duration, but evanescent.…”

Section: Discussionmentioning

confidence: 93%

“…In the second phase, a senior neurologist interviewed the subjects with a positive screening questionnaire for epilepsy. This questionnaire, designed by Placencia et al 5 , was translated to the Portuguese and pretested for our study. Those participants who tested positive according to the questionnaire were then examined in a non-structured neurological interview (which included relatives or witnesses of the seizures).…”

Section: Methodsmentioning

confidence: 99%

Inferences from a community study about non-epileptic events

Gomes

Kropf

Beeck

et al. 2002

Arq. Neuro-Psiquiatr.

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-Objective: To demonstrate the epidemiological importance of the different types of non-epileptic events (NEE) in a low-income urban community. Method: The patients suspected of having epilepsy, who were detected in the first phase (screening one) of this prevalence study, were interviewed by a neurologist in a non-structured neurological interview. These NEE were classified as physiological and psychogenic, subdivided by various types. The psychogenic NEE were classified according to the DSM-IV criteria. Results: We compared the cases suspected of having epilepsy (n=176) with those not suspected (n=806) and discovered that those cases suspected of having epilepsy had a greater median age (<0.01) and female predominance (p<0.01). Among the cases suspected of having epilepsy there were different diagnosis: epileptic events without identifiable cause (n=20) or with identifiable causes (e.g., febrile convulsions and eclampsia). The most prevalent diagnosis for those suspected of having epilepsy was syncope (n=63; 35.8%). In terms of physiological events, the most frequent were: epileptic seizures, paroxysmal toxic phenomena (including alcoholism) and brain trauma, besides syncope; in terms of psychogenic events the most frequent were: dissociative and anxiety disorders. Regarding gender differences, paroxysmal toxic problems were significantly more prevalent in men (p= 0.02), and dissociative disorders (p=0.01) in women. Conclusion: This survey confirms the epidemiological importance of syncope in a populational sample with NEE. However, among the psychogenic disorders of this NEE sample, the most frequent were dissociative and anxiety phenomena. This finding contrasts with the literature based on samples from tertiary epileptic centers with video-EEG resources, which found somatoform disorders to be more prevalent than dissociative and anxiety phenomena.KEY WORDS: epilepsy, non-epileptic events, community study. Inferências de estudo populacional sobre eventos não epilépticosRESUMO -Objetivo: Demonstrar a importância epidemiológica dos diferentes tipos de eventos não epilépticos (ENE) em uma comunidade urbana de baixa renda. Metodo: Os casos suspeitos de terem epilepsia foram detectados na primeira fase de um estudo de prevalência de epilepsia, de triagem. Na segunda fase, eles foram entrevistados por um neurologista em entrevista não estruturada. Os casos de ENE foram classificados como fisiológicos ou psicogênicos e divididos em vários tipos. Esses últimos foram classificados segundo o DSM-IV. Resultados: Entre os suspeitos de terem epilepsia (176, mais idosos do que os outros casos, <0.01, com predominância feminina, p<0.01) existem diferentes diagnósticos: eventos epilépticos sem causa aguda subjacente conhecida (20) ou com (convulsão febril e eclâmpsia). O diagnóstico mais prevalente é o de síncope (n=63; 35,8%), crises epilépticas, fenômeno tóxico paroxístico (incluso alcoolismo) e trauma craniano, nos eventos fisiológicos, e transtornos dissociativos, ansiedade, entre os psicogênicos. O predomínio ...

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A Large-Scale Study of Epilepsy in Ecuador: Methodological Aspects

Cited by 46 publications

References 8 publications

A house-to-house survey of epileptic seizures in an urban community of Rio de Janeiro, Brazil

A house-to-house survey of epileptic seizures in an urban community of Rio de Janeiro, Brazil

Seizures in Rural Zambia

Inferences from a community study about non-epileptic events

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