Demographic Impact of Epilepsy in Africa: Results of a 10‐year Cohort Study in a Rural Area of Cameroon

Abstract

Summary:Purpose: To evaluate the demographic impact of epilepsy a rural area of Africa.Methods: A cohort study was conducted between 1991 and 2001 in the Mbam Valley (Cameroon) on two groups of subjects (one of persons with epilepsy, and the other of control individuals matched for sex, age, and village of residence). At the end of the follow-up, information on mortality, marital status, and numbers of offspring was obtained from 128 pairs of subjects.Results: Thirty-seven (28.9%) persons with epilepsy and six (4.7%) controls died between 1991 and 2001. The relative risk of dying during the follow-up among the group of people with epilepsy, compared with the controls, was 6.2 (95% CI, 2.7-14.1). The most frequent causes of death in the persons with epilepsy were status epilepticus, sudden unexpected death in epilepsy (SUDEP), and drowning. Of the 90 pairs, of which both members were still alive in 2001, 15 (16.7%) persons with epilepsy were married as compared with 53 (58.9%) controls. The mean number of children was 0.9 in the subjects with epilepsy, and 1.7 in the controls (p < 0.0001).Conclusions: Health personnel should be trained and sensitized about the devastating effect of this neglected disease in developing countries. In those areas where onchocerciasis control programs are organized by using the community-directed-treatment approach, the possibility that the ivermectin distributors could also be responsible for distributing antiepileptic drugs should be considered.

Prevalence of Epilepsy in a Rural District of Central Lao PDR

“…Unfortunately, no further data are available in either the district/province or in the region to support this hypothesis. High mortality rates in patients with epilepsy have been reported from Cameroon (28.9‰) [28] and Ethiopia (31.6‰) [29] where patients mostly died from drowning, status epilepticus, sudden unexpected death and severe burn during epileptic attacks [28,29] .…”

Epilepsy treatment in sub-Saharan Africa: closing the gap

“…Lack of drug supply is reported as a major problem in three-quarters of low-income countries 5 . A 2001 cohort study in a rural area of Cameroon found that only 16 of 91 patients were taking antiepileptic drugs every day 32 . In a study of 352 people with epilepsy in an agricultural region of Burundi 33 , only 18 of the patients were taking anti-epileptic medications (all on phenobarbital).…”

Suicide in people with epilepsy: How great is the risk?

“…The majority of the patients from the rest of the world were from Europe, particularly the United Kingdom, Spain, France, Germany, The Netherlands, and Italy, and so an overall rate for death by suicide was estimated from the rates in these six countries. One study took place in Africa (Kamgno et al, 2003) and one in India (Udani et al, 1993), where few data are available. For the African study the population data and numbers of deaths by suicide were taken from the estimations of the 2000 Global Burden of Disease (Murray et al, 2001).…”