<p>Epilepsy diagnosis and management of children in Kenya: review of current literature</p>

Abstract

Introduction: The growing impact of non-communicable diseases in low- to middle-income countries makes epilepsy a key research priority. We evaluated peer-reviewed published literature on childhood epilepsy specific to Kenya to identify knowledge gaps and inform future priorities. Methodology: A literature search utilizing the terms “epilepsy” OR “seizure” as exploded subject headings AND “Kenya” was conducted. Relevant databases were searched, generating 908 articles. After initial screening to remove duplications, irrelevant articles, and publications older than 15 years, 154 papers remained for full-article review, which identified 35 publications containing relevant information. Data were extracted from these reports on epidemiology, etiology, clinical features, management, and outcomes. Results: The estimated prevalence of lifetime epilepsy in children was 21–41 per 1,000, while the incidence of active convulsive epilepsy was 39–187 cases per 100,000 children per year. The incidence of acute seizures was 312–879 per 100,000 children per year and neonatal seizures 3,950 per 100,000 live births per year. Common risk factors for both epilepsy and acute seizures included adverse perinatal events, meningitis, malaria, febrile seizures, and family history of epilepsy. Electroencephalography abnormalities were documented in 20%–41% and neurocognitive comorbidities in more than half. Mortality in children admitted with acute seizures was 3%–6%, and neurological sequelae were identified in 31% following convulsive status epilepticus. Only 7%–29% children with epilepsy were on antiseizure medication. Conclusion: Active convulsive epilepsy is a common condition among Kenyan children, remains largely untreated, and leads to extremely poor outcomes. The high proportion of epilepsy attributable to preventable causes, in particular neonatal morbidity, contributes significantly to the lifetime burden of the condition. This review reaffirms the ongoing need for better public awareness of epilepsy as a treatable disease and for national-level action that targets both prevention and management.

High prevalence of epilepsy in Northern Rwanda: Exploring gender differences

“…Co-morbidity or history of infectious diseases affecting more than 10%, was similar for both genders and in line or slightly lower (range 5.5%-13%) than in other SSA regions (Assadeck et al, 2019;Bistervels et al, 2016;Burton et al, 2012;Carter et al, 2004;Kariuki et al, 2014;Samia et al, 2019). The frequency of cerebral malaria in our cohort of PwE was higher than the reported malaria prevalence of 1% in the There is a clear association between epilepsy and HIV with newonset seizures occurring in up to 11% of HIV infected persons (Howlett, 2019).…”

Seizures and Epilepsy in Childhood

“…The etiology of seizures and epilepsy in childhood in these areas follows a different pattern where acquired causes (eg, perinatal and neonatal adverse events, infections) represent the principal causes. 16…”

Human toxoplasmosis in Mozambique: gaps in knowledge and research opportunities

“…A multicenter study conducted in Kenya, South Africa, Uganda, Tanzania, and Ghana in a total of 1711 individuals with active convulsive epilepsy found an odds ratio of 1.39 with previous exposure to T. gondii [74]. Moreover, studies from Kenya and other African countries concluded that in addition to Toxoplasma infection, malaria, onchocerciasis, neurocysticercosis, and toxocariasis also might be involved in the pathogenesis of epilepsy [75,76]. There is also evidence of possible association with some neurodegenerative disorders, such as Parkinson and Alzheimer diseases, in which the prevalence of Toxoplasma infection is around 85% and 66%, respectively [3,[77][78][79][80][81].…”