Active convulsive epilepsy in a rural district of Kenya: a study of prevalence and possible risk factors

Edwards, Tansy; Scott, Anthony; Munyoki, Gilbert; Odera, Victor Mung ala; Chengo, Eddie; Bauni, Evasius; Kwasa, Thomas; Sander, Josemir W.; Neville, Brian; Newton, Charles R.

doi:10.1016/s1474-4422(07)70292-2

Cited by 122 publications

(177 citation statements)

References 21 publications

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“…Children admitted with acute seizures in 2002–2008 (in whom an epilepsy clinician had ruled out epilepsy during hospitalization) and those admitted without seizures/epilepsy in the same period were followed up in large baseline cross‐sectional surveys conducted in 2003 and 2008 to examine the subsequent risk of epilepsy 1, 25. These surveys consisted of two to three stages in which fieldworkers visited households to ask about a history of seizures; those with a positive history were invited for evaluation by a clinician to confirm a diagnosis of epilepsy.…”

Section: Methodsmentioning

confidence: 99%

Risk of convulsive epilepsy following acute seizures in Kenyan children

2016

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SummaryObjectiveThe prevalence of epilepsy is high in Africa, and people with epilepsy often have a history of acute seizures. We determined whether acute seizures are associated with risk for epilepsy in rural Africa, where both conditions are common and may have shared risk factors.MethodsA total of 16,438 children (2,991 with acute seizures and 13,447 without seizures) admitted to Kilifi County Hospital from 2002 to 2008 were followed up with epidemiological surveys conducted in 2003 and 2008 to assess the prevalence of epilepsy and the associated risk factors. Cox proportional hazards regression models were used to identify the risk factors. Prevalence ratios were computed using log binomial regression models.ResultsThe prevalence of epilepsy was higher in admissions with acute seizures (5.0% [95% confidence interval (CI), 4.3–5.9%]) than in those without seizures (0.7% [95% CI, 0.5–0.8%]), p < 0.0001). Acute seizures were associated with epilepsy after accounting for potential confounders in a Cox regression model (hazard ratio [HR] = 1.53 [95% CI, 1.10–2.14]). Prevalence was greater in complex acute seizures (5.9%; prevalence ratio [PR] = 1.58 [95% CI, 1.13–2.20]) or status epilepticus (7.5%; PR = 1.96 [95% CI, 1.32–2.91]) than in simple acute seizures (3.7%). Factors independently associated with epilepsy following acute seizures in Cox regression models were perinatal complications (HR = 3.60 [95% CI, 1.89–6.87]), cerebral palsy (HR = 1491.51 [95% CI, 144.30–15,416.21]), duration of follow‐up (HR = 1.21 [95% CI, 1.09–1.35]), and malnutrition (relative risk [RR] = 0.24 [95% CI, 0.08–0.69]).SignificanceAcute seizures in children are associated with subsequent risk for epilepsy that is greater than in the general population. The burden of epilepsy may be reduced by control of causes of acute seizures.

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Section: Methodsmentioning

confidence: 99%

Risk of convulsive epilepsy following acute seizures in Kenyan children

2016

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“…The differences are in part related to different study designs and differences regarding the defi nitions of active epilepsy. Some stud-ies require two or more unprovoked seizures in the year before the index date to be considered "active epilepsy" [4][5]8••]; others use a 2-year period [9] or 5-year period [10•,11-15,16•,17•]. Limiting assessment to studies that provide information for age-adjusted rates (Table 1), the average age-adjusted prevalence of active epilepsy is 8.5 per 1000 people.…”

Section: Prevalence and Incidencementioning

confidence: 99%

Epilepsy in the developing world

Carpio

Hauser²

2009

Curr Neurol Neurosci Rep

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“…[22] Also, studies conducted in Africa found that epilepsy prevalence in ages 20-24 and 25-29 varied from 9.86/1000 to 7.18/1000 in Benin and in Kenya it was 4.0/1000 and 3.4/1000 (in males and females, respectively) in those aged 18-28. [19][20][21][22][23] This variability in prevalence rates may be due to socio-cultural, socioeconomic and geographical specifications and differences in study design, case detection techniques and inclusion criteria.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of epilepsy in the university students representing a young adult population with normal intelligence

Huseyinoglu¹,

Palanci²,

Güneş³

et al. 2014

Epilepsi

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Amaç: Epilepsi, dünya üzerinde yaklaşık 69 milyon kişiyi etkileyen en yaygın nörolojik hastalıklardan birisidir. Özellikle genç erişkinlerde epilepsinin sosyal ve özel hayat açısından getirdiği yük oldukça fazladır. Türkiye'nin doğusunda genç erişkin nüfus arasındaki epilepsi prevalansı ve risk faktörlerine dair yapılmış bir araştırma bulunmamaktadır. Bu nedenle, çalışmamızda Türkiye'nin doğusundaki normal zekaya sahip genç popülasyonun temsilcileri olarak Kafkas Üniversitesi öğrencilerinde epilepsi prevalansı ve risk faktörlerini araştırmayı amaçladık. Gereç ve Yöntem:Çalışmamızın örneklem grubunun sayısı en az 1135 öğrenci olarak hesaplandı. Dağıtılmış olan 2000 anketten 1829'u istatiksel analiz için kullanıldı. 43 muhtemel epilepsi olgusu ileri incelemeler için hastanemize davet edildiler. Sonuç olarak, yedi katılımcıya aktif epilepsi tanısı konuldu. Bulgular: 30 Aralık 2010 tarihi itibarıyla aktif epilepsinin nokta prevalansı 3.8/1000 olarak hesaplanmıştır. Epilepsi gelişiminde, febril nöbet öyküsü ve kafa travması istatistiksel olarak anlamlı risk faktörleri olarak saptanırken; cinsiyet, aile öyküsü, maddi gelir düzeyi, prematürite, doğum şekli ve akrabalık evliliği, epilepsi için istatistiksel olarak anlamlı risk faktörleri değildi.Sonuç: Türkiye'nin doğusundaki genç erişkin nüfusta epilepsi prevalans değerlerinin gelişmiş ülkelerdeki ile karşılaştırılabilir düzeyde olduğunu söyleyebiliriz. SummaryObjectives: Epilepsy is one of the most common neurological diseases and involves about 69 million patients worldwide. Especially in young adults, the social and private burden of epilepsy is high. The young adult population of Eastern Turkey has not been investigated with respect to the prevalence and risk factors of epilepsy. For these reasons we aimed to investigate the prevalence and some risk factors of active epilepsy in Kafkas University students as representatives the young adults of Eastern Turkey with normal intelligence. Methods:The sample size for our study of consisted of a minimum of 1135 students. A total of 2000 questionnaires were distributed among the students and 1829 were accepted for statistical analysis. 43 students were identified as possibly having epilepsy and invited for further investigation. As a result, 7 participants were determined to have active epilepsy. Results:The point prevalence of active defined epilepsy on December 30, 2010 was estimated to be 3.8/1000 for both sexes. The statistical analysis identified a history of febrile seizures and head trauma to be significant as risk factors for the development of epilepsy, while gender, family history of epilepsy, financial status, history of prematurity, cesarean or vaginal birth and parental consanguinity were not significant risk factors for epilepsy. Conclusion:We can conclude that the prevalence of epilepsy in young adults in the eastern region of Turkey is comparable to those in developed countries.

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Active convulsive epilepsy in a rural district of Kenya: a study of prevalence and possible risk factors

Abstract: Background-There are few large-scale studies of epilepsy in sub-Saharan Africa. We estimate the prevalence, treatment gap and risk factors for active convulsive epilepsy (ACE) in Kenyans aged ≥6 years in a rural area.

Cited by 122 publications

References 21 publications

Risk of convulsive epilepsy following acute seizures in Kenyan children

Risk of convulsive epilepsy following acute seizures in Kenyan children

Epilepsy in the developing world

Prevalence of epilepsy in the university students representing a young adult population with normal intelligence

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