First‐ever, door‐to‐door cross‐sectional representative study in Prey Veng province (Cambodia)

Abstract

SUMMARYPurpose: To estimate the lifetime prevalence of epilepsy in Prey Veng province (Cambodia). Methods: Door-to-door screening was performed using a random cluster survey whereby all people >1 year of age were screened for epilepsy by using a validated and standardized questionnaire for epilepsy in tropical countries. Suspected epilepsy patients identified by the questionnaire were revisited and examined by epileptologists. The confirmation of epilepsy was based on an in-depth clinical examination. Electroencephalograms were recorded at the community dispensary. Key Findings: Five hundred three potential epilepsy cases were identified from 16,510 screened subjects, and 96 were diagnosed to have epilepsy. An overall prevalence of 5.8 per 1,000 [95% confidence interval (CI) 4.6-7.0 per 1,000] was obtained. Generalized epilepsy (76%) was more common than partial epilepsy (12.5%). Three cases were of generalized myoclonic epilepsy (3.1%) and one case each (1.0%) were of absence and olfactory partial epilepsy. Six cases (5.2%) had more than one seizure type [one case with absence + generalized tonic-clonic (GTC), one case each with GTC + partial seizures with secondary generalization and absence + generalized myoclonic seizures and absence + simple partial seizures, and two cases with GTC + complex partial seizures]. Electroencephalography (EEG) studies revealed spike and wave discharges in 43.8%, focal spikes in 21.0%, generalized slow waves in 19.2%, and generalized slowing of background in 15.7%. Significance: This is the first population-based study in Cambodia that had epilepsy as a primary objective, and compared to Western and neighboring countries it shows a lower prevalence.

Multicenter Transversal Two-Phase Study to Determine a National Prevalence of Epilepsy in Algeria

“…Generalized seizures were the predominant pattern (68.7%) followed by partial seizures (29.8%). This was in contrast to some previous reports [10] but in agreement with others [3,4,5,9]. Conditions associated with symptomatic epilepsy were different between studies and included all major conditions.…”

“…The average prevalence of epilepsy is estimated at 8 per 1,000 in the world population [1]. However, studies carried out in developing countries have reported higher rates [2] although many countries in Asia have reported lower rates compared to sub-Saharan or Latin American countries [3]. In Algeria, as in the other countries of North Africa, epilepsy remains an important public health issue with medical, economic and sociocultural implications.…”

Methodological Difficulties in the Conduct of Neuroepidemiological Studies in Low- and Middle-Income Countries

“…In many LMICs this approach makes possible the estimation of the burden of epilepsy more rapidly in a given setting at a much lower cost. Most frequently, villages are taken as clusters [21]. They are selected by lot to have all their inhabitants included in the survey.…”

Epilepsy in Asia: A Cambodian Experience

“…For the first time, the France-based INSERM Institute of Tropical Neurology (IENT) along with its collaborators investigated epilepsy in Cambodia and estimated in a representative manner that Cambodia has about 86,000 (mean) people with epilepsy [9]. This provides the Cambodian government (and its financiers) with a representative figure on which to base their policies and mobilize their funds.…”

“…Many of these cases were never offered a diagnosis or treatment [11], and thus our work has at least helped to bring them ‘out of the epilepsy shadow’. These surveys yielded a lifetime prevalence of 5.8/1,000 (lower than in SSA), a predominance of generalized seizures, a young mean age of the cases, and a male predominance [9], somewhat similarly to what has been observed in other REP countries [4,5]. Subsequent surveys [11] have shown several particularities, for instance the predominant importance of pregnancy- and birth-related risk factors, absence of a supernatural belief or absence of specific contagions such as blood, low use of traditional therapies, absence of use of spiritual intervention as treatment, etc.…”